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Abstrak :
Latar Belakang : Kolitis merupakan penyakit gastrointestinal yang banyak ditemukan dan menjadi masalah utama di negara berkembang termasuk Indonesia. Zinc, trace element penting dengan berbagai fungsi diantaranya antimikrobial mukosa intestinal, meningkatkan fungsi barrier gastrointestinal, dan fungsi imun. Kolitis menyebabkan perubahan anatomis saluran gastrointestinal, dianggap dapat menyebabkan defisiensi zinc akibat gangguan penyerapan dan peningkatan ekskresi. Penelitian ini bertujuan mengetahui profil zinc darah dan analisa tinja pada pasien kolitis di RSUPN dr. Cipto Mangunkusumo. Metode : Dilakukan penelitian potong lintang pada bulan Agustus 2019-November 2019. Subjek kolitis diperoleh secara konsekutif dari pasien yang kontrol di poliklinik gastroenterologi atau menjalani kolonoskopi di Pusat Endoskopi Saluran Cerna RSUPN. dr. Cipto Mangunkusumo. Pemeriksaan sampel zinc darah secara spektrofotometri dan analisa tinja subjek kolitis untuk menilai profil zinc darah dan analisa tinja. Kadar zinc darah subjek kolitis dibandingkan dengan kadar zinc darah subjek sehat. Hasil : Terdapat 40 subjek kolitis dan 16 subjek sehat yang disertakan untuk dianalisis pada penelitian ini. Diperoleh 45% pasien kolitis yang defisiensi zinc dengan rerata kadar zinc kelompok kolitis adalah 10,9 ± 1,9 µmol/L dan rerata kadar zinc subjek sehat 12,3 ± 1 µmol/L. Profil analisa tinja kelompok kolitis ditemukan konsistensi lembek 90%, BAB berlendir 17,5%, peningkatan jumlah eritrosit 60%, peningkatan jumlah leukosit 5%, positif amilum 20%, positif lemak 7,5%, pH asam 97,5%, positif darah samar tinja 37,5%, dan jamur di tinja 7,5%. Simpulan : Kadar zinc pada kelompok kolitis lebih rendah bermakna dibanding kadar zinc pada kelompok sehat. Perlu dilakukan penelitian lebih lanjut untuk mempertimbangkan pemberian terapi zinc pada pasien kolitis dengan defisiensi zinc. ...... Background: Colitis is a common gastrointestinal disease that is a major problem in developing countries including Indonesia. Zinc, an important trace element with various functions including antimicrobial intestinal mucosa, improves gastrointestinal barrier function, and immune function. Colitis causes anatomical changes in the gastrointestinal tract, considered to cause zinc deficiency due to impaired absorption and increased excretion. This study aims to determine the profile of blood zinc and fecal analysis in colitis patients at RSUPN Dr. Cipto Mangunkusumo. Methods: A cross-sectional study was conducted on 40 colitis and 16 healthy subjects in August 2019-November 2019. Colitis subjects were obtained consecutively from patients who were in the gastroenterology outpatient clinic or underwent colonoscopy at the Gastroenterological Endoscopy Center of RSUPN. dr. Cipto Mangunkusumo. Spectrophotometric examination of blood zinc samples and fecal analysis of colitis subjects to assess blood zinc profile and stool analysis. The level of colitis in the subjects' blood zinc was compared with the level of zinc in the healthy subject. Results: There were 40 colitis subjects and 16 healthy subjects included for analysis in this study. 45% of colitis patients who were deficient in zinc with a mean zinc level in the colitis group were 10.9 ± 1.9 μmol / L and the mean zinc level in healthy subjects was 12.3 ± 1 μmol / L. Fecal analysis profile of colitis group found 90% soft stool consistency, 17.5% slimy stool, increase in erythrocyte count 60%, increase in leukocyte count 5%, positive starch 20%, positive fat 7.5%, acid pH 97.5%, positive Fecal blood feces 37.5%, and fungi in feces 7.5%. Conclusion: Zinc levels in the colitis group were significantly lower than zinc levels in the healthy group. Further research needs to be done to consider giving zinc therapy to colitis patients with zinc deficiency.

Abstrak :
Nowadays, many children in developing countries are suffering from micro nutrient deficiencies (Lartey et at., 2000b; Zhao et al., 1998; van Stuijvenberg et al, 1999; Sempertegui et at, 1995). And the most prevalent ones are VAD (Vitamin A Deficiency), IDA (Iron Deficiency Anemia), IDD (Iodine Deficiency Disorder), and lately is zinc deficiency (Sandstead, 1991). The causes of micro nutrient deficiencies are varied and include inadequate dietary intakes (Robert et al, 2000), repeated infections (Khanum et al, 1998) and poor bioavailability from foods due to the presence of inhibitors or inadequate intake of dietary enhancers (Berdanier, 1998; Lunnerdal, 2000; de Pee et al, 1998; Donnen et al, 1996; Lartey et al, 2000a). Due to the roles of micronutrients in metabolic process, immune competence and taste acuity (Golden, 1995), previous findings showed that micronutrient deficiencies might impaired growth (Allen, 1994b; Rosado, 1999; Krieger et al, 1986; Simondon et al, 1996; Hambidge, 2000; Golden & Golden, 1981) and immune system (Black, 1998; Khanum et al, 1998; Semba et al, 1993). The reversibility of impairments caused by micronutrient deficiencies depends on the severity, duration, and stage of development. In some cases, micronutrient supplementation can correct the impairment right after a certain period of supplementation. Ninh et al (1996) stated that zinc deficiency among nutritionally deprived children may limit growth because the growth stimulating effects of zinc might be mediated through changes in circulating insulin-like growth factor (IGF). And after 5 months supplementation with daily-10 mg zinc, weight and height of growth-retarded children in supplemented group significantly increased compared to those of placebo group. In Uganda, zinc supplementation had a short-term effect (within 3 months) on weight gain and MUAC increment only among children from the school with the highest socioeconomic status (Kikafunda et al, 1998). Clinical vitamin A deficiency has been associated with poor child growth (Tarwotjo et al, 1992). Study in Zaire among moderately malnourished preschoolers found that high dose vitamin A supplementation (60 mg of oily solution of retinal palmitate, 30 mg if aged <12 months) increased MUAC and weight significantly compared to control group although without deforming at baseline (Donnen et al, 1998). In Indonesia, the intervention using vitamin A-monosodium glutamate did not merely result on increment of serum vitamin A level, but it also increased the linear growth of supplemented children compared to children in control group at every age (Muhilal et al, 1988). Similar with zinc and vitamin A, iron deficiency may also lead to slowing of growth in regarding to the increment of iron demands during periods of rapid growth and the adverse effects of morbidity.

Abstrak :
Diare merupakan masalah global karena menyebabkan tingginya angka kesakitan dan kematian pada bayi dan anak. Diare yang belangsung 7 - 13 hari disebut diare melanjut, dan akan meningkatkan risiko terjadinya diare persisten 6 kali lebih tinggi.Penelitian ini bertujuan untuk mengkaji faktor-faktor risiko terjadinya diare melanjut pada anak < 2 tahun, membuat dan menerapkan sistem skor untuk memprediksi kejadian diare melanjut, dan mengetahui apakah faktor etiologi diare persisten telah ditemukan pada diare melanjut.Suatu penelitian operasional dengan rancangan nested case control, pada anak < 2 tahun dengan diare akut yang dirawat di ruang rawat inap RSUP Fatmawati. Subjek direkrut dengan metode consecutive sampling pada September 2015 - Maret 2016. Subjek dieksklusi bila mendapat pengobatan imunosupresi, menderita HIV, penyakit metabolik, penyakit keganasan, mengalami disentri, mengalami diare saat dirawat di rumah sakit, ada penyakit penyerta, dan subjek pasca mengalami operasi pada organ saluran cerna. Evaluasi luaran penelitian dilakukan sejak subjek masuk perawatan di rumah sakit sampai subjek pulang rawat.Sebanyak 62 subjek untuk tiap kelompok kasus dan kontrol mengikuti penelitian. Seluruh faktor risiko dianalisis secara bivariat dan multivariat regresi logistik. Faktor risiko terjadinya diare melanjut yang didapatkan adalah riwayat penggunaan antibiotik, defisiensi seng, leukosit tinja, peningkatan kadar AAT tinja dan malnutrisi. Model skor prediksi diare melanjut terdiri dari 2 model. Model 2 lebih dapat diterapkan di fasilitas kesehatan primer. Sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif, rasio kemungkinan positif, dan rasio kemungkinan negatif dari validasi skoring model 2 berturut-turut adalah 73, 95, 94, 76, 14,6, dan 0,28. Area di bawah kurva ROC pada validasi 0,898. Faktor etiologi diare persisten telah ditemukan pada diare melanjut intoleransi laktosa, malabsorpsi lemak, dan infeksi Clostridium difficile .Sebagai simpulan, faktor risiko terjadinya diare melanjut pada anak < 2 tahun dengan diare akut yang berperan paling bermakna adalah riwayat penggunaan antibiotik, defisiensi seng, leukosit tinja, peningkatan kadar AAT tinja dan malnutrisi. Selain itu, faktor etiologi diare persisten telah ditemukan pada diare melanjut, dan model skor yang dibuat dapat dipertimbangkan digunakan dalam praktek klinik sehari-hari. ...... Diarrhea has been a global problem since it has high morbidity and mortality rate in infants and children. Diarrhea lasting for 7 ndash 13 days is called prolonged diarrhea, and the risk of progressing into persistent diarrhea will be 6 times higher. The aim of this study was to assess the risk factors for prolonged diarrhea in children below 2 years old, to establish and apply a scoring system to predict the occurence of prolonged diarrhea, and to determine whether the etiologic factor of persistent diarrhea have already been found in prolonged diarrhea. An operational study with a nested case control design, in children 2 years old with acute diarrhea hospitalized in the inpatient wards of Fatmawati Hospital. Subjects were recruited using the consecutive sampling method from September 2015 to March 2016. Subjects were excluded when they were receiving immunosupressive treatment, suffering from HIV, metabolic disease, malignancy, dysentery, just had diarrhea during hospitalization, comorbidities, and had underwent digestive surgery. Evaluation of the research outcome was started when the subject admitted to the hospital until the subject being discharged. The number of subjects included was 62 for each case and control group. All risk factors were analyzed using bivariate and multivariate logistic regression. We found that the risk factors for the occurrence of prolonged diarrhea are history of antibiotic use, zinc deficiency, fecal leukocytes, elevated level of stool AAT, and malnutrition. The prolonged diarrhea prediction score model had 2 models. Model 2 is more applicable in primary health care. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of scoring model 2 validation were 73, 95, 94, 76, 14.6, and 0.28 respectively. The area under the ROC curve for validation is 0.898. The etiologic factor of persistent diarrhea have already been found in prolonged diarrhea lactose intolerance, fat malabsorption, Clostridium difficile infection. In conclusion, the most significant risk factors for prolonged diarrhea in children below 2 years old are the history of antibiotic use, zinc deficiency, fecal leukocytes, elevated levels of stool AAT, and malnutrition. In addition, etiologic factors of persistent diarrhea have already been found in prolonged diarrhea and scoring model can be considered be used in daily clinical practice.