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"Latar Belakang: Risiko aritmia pasta infark miokard akut 5-11%. Perlu adanya stratifikasi risiko tedadinya aritmia pasca infark miokard akin. Aritmia yang terjadi pasta infark miokard akut dapat disebabkan karena perubahan elektrofisiologi, milieu (transient factors) dan aritmia spontan. Penelitian menggunakan late potential sebagai salah satu modalitas untuk mendapat gambaran perubahan elektrofisiologi yang terjadi pasta infark miokard akin dan sebagai prediktor risiko terjadinya aritmia. Late potential didapatkan dengan pemeriksaan SA-ECG.Subyek: Dikurnpulkan 38 kasus infark miokard akut barn, sejak bulan Juni 2004 sampai dengan Februari 2005. Usia berkisar antara 35 - 65 tahun. Kriteria inklusi diagnosis infark miokard akut dengan menggunakan kriteria WHO. Kriteria eksklusi: infark sebeluinnya, blok cabang berkas, angina pektoris tak stabil, atrial fibrilasi dan fluter, infark miokard dengan strok iskemia, bedah pintas koroner dan riwayat angioplasti (sten atau balon).Metodologi: Penelitian ini menggunakan disain kohor, dilakukan pemeriksaan Signal Averaged ECG untuk mendapatkan late potential, kontrol internal late potential negatif Dilakukan uji hipotesis yang sesuai untuk mendapatkan nilai kemaknaan pada penelitian ink Pemeriksaan SA-ECG dilakukan pada hari 6-16 perawatan di RS Harapan Kita, late potential sesuai dua dari 3 kriteria WHO.Hasil : Laki-laki 30 (78,9%), wanita 8 (21,1%) dan usia rerata 52,34 tahun. Jens infark Q wave 18 (47,4%) dan non Q wave 20 (52,6%). Aritmia terutarna PVC 7 (18,4%), ventrikular takikardia (VT) 2 (5,3%) dan 29 (76,3%) normal. Lokasi infark terutama inferior 17 (44,7%) , non inferior 21 (55,3%).Rerata seat dilakukan pemeriksaan SA-ECG yaitu 9,6 hail dengan SB ± 2,6 hari. Parameter pemeriksaan SA-ECG yaitu 1. QRSD rerata 114,8 ins, SB ±15,8 ms, 2_ HFLA rerata 36,2 ms, SB ± 12,8 ms, 3, RMS rerata 30,2 u.V, SB ± 15,9 µV. Didapatkan late potential positif 13 (34,2%). Kadar kalium bulan pertarna dan bulan kedua dalann Batas normal. Aritmia terjadi pada bulan pertama 2 (5,3%) dan 9 (23.5%). Pada bulan pertama aritmia terjadi pada pasien dengan satu late potential positif dan satu dengan late potential negatif.Sedangkan pada bulan ke 2 didapatkan terjadi aritmia 7 (53,8%) dengan late potential positif dan 2 (8%) dengan late potential negatif, p < 0.003, IK 95% dan relatif risk (RR) 6.73.Tidak didapatkan hubungan bermakna lokasi infark, slat pemeriksaan SA-ECG dengan terbentuknya late potential. Tidak didapat hubungan bermakna antara kaliurn dan kejadian aritmia.Kesimpulan : Late potential dapat digunakan sebagai salah satu modalitas untuk stratifikasi risiko teijadinya aritmia, didapatkan aritmia dengan late potential positif pada bulan 2,.p < 0,003 dan risiko relatif sebesar 6,73. Perlu dilakukan penelitian dengan populasi yang lebih banyak, melibatkan beberapa seater, dilakukan menggunakan halter monitor untuk mengawasi terjadinya aritmia dan dalam waktu 1 tahun pasca infark miokard akut.

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Background: Risk of arrhythmias in post acute myocardial infarction in first 2 years was within range 5-i 1%. The stratification of arrhythmia event in post acute myocardial infarction was needed. There are several factors in arrhythmias mechanism, such as electrophysiology alteration, milieu (transient factors) and spontaneous arrhythmias. In this study, late potential as cardio electrophysiology state post infarction is used to be arrhythmias predictor. Late potential description was obtained used by Signal-Averaged ECG.

Subjects: Thirty eight consecutive patients admitted to coronary care unit in Dr. Cipto Mangunkusumo and Persahabatan hospitals with documented acute myocardial infarction, since Juny 2004 to February 2005. Their ages were ranging from 35 to 65 years: Patients were included according to WHO acute myocardial infarction criteria.

Methods: This is a cohort study. SA-ECG was performed to obtained late potential, negative late potential patients as internal control. Signal-Averaged ECG was done in 6 - 16 days post acute myocardial infarction in Harapan Kita hospital. An abnormal (positive) SA-ECG is considered if two or more of the following three criteria from WHO.

Results: Subjects consisted of 30 (78,9%) male patients and female of 8 (21,1%). The mean age was 52,34 years.The incidence Q wave and non Q wave of acute myocardial infarction were 18 (47,4%) and 20 (52,6%). Type of arrhytrnias were premature ventricle contraction (PVC) 7 (18,4%), ventricular tachycardia (VT) 2 (5,3%) and normal 29 (76,3%). The inferior and non inferior wall site of infarction were 17 (44,7%) and 21 (55,3%). The mean time (days) recording of SA-ECG was 9,6 days, SD 1 2,6 days. There were three parameters of SA ECG included L QRSD mean 114,8 ms, SD 115,8 ms, 2. HFLA mean 36,2 ms, SD ± 12,8 ms, 3, RMS mean 30,2 p.V, SD ± 15,9 IN. The incidence abnormal SA-ECG was 13 (34,2%), Kalium level in first and second month of following was within normal range. The arrhytmias event in first and second month were 2 (5,3%) and 9 (23,7%). in first month, arrhytmia event in one positive and one negative late potential. In second month, seven of 9 patients had positive late potential. There was significant relation between abnormal SA-ECG and arrhytmia event in second month, p < 0.003 (CI 95%: 1,63-27,89), relative risk (RR) 6,73. There was no significant relation in site of infarction, time recording of SA-ECG, and kalium level with arrhytmia event.

Conclusion: The late potential could be used as one of arrhytmia predictors of post acute myocardial infarction. There was significant relation between late potential and arrhytmia in second month, p < 0,003, relative risk (RR) 6,73. Furthere study is needed with greater samples size and appropriate instruments (eg. Holter monitor)."

"Mengelahui efek pemberian suplementasi vitamin C dan E terhadap kadarmalondialdehida plasma pada perokok kretek filter selama empat minggu di Jakarta.Penelitian ini merupakan uji klinis paralel, acalg tersamar tunggal antara kelompokyang inendapat suplementasi vitamin C dan E (P) dengan kelompok yang mendapatplasebo (K). Sebanyak 40 orang perokok kretek filterr di rumah makan, Jakarta Utaramemenuhi ln-iteria dan diikutkan dalam penelitian Dilakukan randomisasi blolc untukmenentukan kclompok perlakuan dan kontrol. Kelompok perlakuan mendapatkansuplementasi vitamin C 500 mg dan E 400 IU/hari selama empat minggu, dankclompok kontrol mendapat plasebo. Data yang dikumpulkan meliputi data demograti(usia, konsumsi rokok, indeks Brinkman, tekanan dan lg kadar glukosa darah puasa,kadar kolesterol tétal), IMT, analisis asupan zat gizi, kadar malondialdehida plasma.Analisis data menggunakan uji t tidak berpasangan atau uji Mann Whimsy denganbatas kemaknaan p <0,05.Karakteristik demografi subyek pada awal penelitian meliputi usia, konsumsi rokok,indeks Brinkman, tel-canan damh, Radar glukosa darah puasa, kadar kolesterol total,IMT , analisis asupan zat gizi, kadar malondialdchida plasma antara kelompokperlakuan dan kontrol homogen. Rerata kadar MDA plasma awal pada kelompokperlakuan dan pada kelompok kontrol 1,39i0,19 vs 1,34=b=0,09 nmol/mL. Pada akhirperlakuan, rerata kadar MDA plasma sabesar 1,18=l=0,22 pada kelompok perlakuan dan1,3 1=k0,13 nmol/mL kelompok kontrol, berbeda bermakna (p <0,03‘7).Setelah suplementasi vitamin C 500 mg dan E 400 IU/hari selama empat minggutcrdapat perbedaan bermakna renta kadar MDA plasma antara kedua kelompok.

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AbstractTo investigate the effects of vitamin C and E supplementation on plasmamalondialdehycle in clove cigarettes smokers during four weeks in JakartaThis is a parallel randomized single-blind clinical study between interventionalgroup with vitamin C and E supplementation (P) and control group with hasplacebo (K). Forty clove cigarettes smokers in Rmtaurant, Jakarta had fulfilledthe criteria and recruited in the research. Subjects were allocated by blockrandomization into intervention and control group. Intervention group treatedwith vitamin C 500 mg and vitamin E 400 IU daily for 4 weeks, while controlgroup treated with placebo. Data collection includes demographic characteristic(age, smoking habits, Brinkman index, blood pressure, blood glucose, totalcholesterol), body mass index (BMI), daily nutrient analysis, plasma MDA.Statistical analysis using unpairod t-test or Mann Whitney test with significantlevel at p < 0,05.Demographic characteristic (age, smoking habits, Brinlcman index, bloodpressure, blood glucose, total cholesterol), body mass index (BMI), dailynutrient analysis, plasma MDA between both groups were homogen. Initialplasma MDA in the intervention group. and control were l,39=|=0,l9 vsl,34=l=0,09 nmol/tnL. After intervention plasma MDA were l,l8=k0,22 in theintervention group and 1,3l£),13 nmol/mL in control group (p <0,03'7).After supplementation of vitamin C 500 mg/day and vitamin E 400 IU/dayduring 4 weeks, showed significantly differences average of plasma MDAbetween two groups."

"Latar Belakang. Hipotensi ortostatik merupakan masalah yang sering ditemukan pada usia lanjut, dan berhubungan dengan peningkatan morbiditas dan mortalitas. Penyakit penyerta pads usia lanjut diketahui berpotensi mengakibatkan timbulnya hipotensi ortostatik Mengacu pada hal tersebut maka deteksi awal adanya hipotensi ortostatik pada pasien usia lanjut dan pengendalian faktor-faktor risiko hipotensi ortostatik perlu dilakukan dalam upaya mencapai kualitas hidup yang optimal.Tujuan. Mengetahui prevalensi dan faktor-faktor risiko yang mempengaruhi timbulnya hipotensi ortostatik pada usia lanjut yaitu usia, hipertensi, diabetes melitus, gagal jantung, riwayat strok, dehidrasi dan obat antihipertensi.Metodologi : Sembilan puluh tujuh subyek usia lanjut dengan usia 60 tahun atau lebih.yang berobat jalan di Poliklinik dan Instalasi Gawat Darurat RSCM diikutsertakan dalam penelitan. Data dikumpulkan dengan melakukan serangkaian anamnesis, pemeriksaan fisik, tekanan darah posisi berbaring, segera setelah 1-3 menit berdiri, pemeriksaan laboratorium, pemeriksaan EKG dan foto torak. Penelitian ini menggunakan desain cross sectional ..dengan variabel yang diteliti meliputi faktor usia, adanya hipertensi, diabetes melitus, gagal jantung, riwayat strok, dehidrasi dan penggunaan obat antihipertensi, dihubungkan dengan hipotensi ortostatik.Hasil : Laki-laki 40 (41,2%), wanita 57 (58,8%) dan usia rerata 67,4 tahun, didapatkan subyek yang mengalami hipotensi ortostatik sebanyak 15 orang(15,5%). Analisis bivariat dan multivariat menunjukkan bahwa variabel hipertensi dan dehidrasi menunjukkan hubungan bermakna dengan hipotensi ortostatik. Faktor risiko lainnya tidak terbukti secara bermakna dengan terjadinya hipotensi ortostatik.Kesimpulan : Hipertensi dan dehidrasi merupakan faktor risiko terjadinya hipotensi ortostatik. Subyek usia lanjut dengan hipertensi memerlukan pengendalian tekanan darah lebih baik. Kondisi dehidrasi pada usia lanjut perlu dikenali sedini mungkin, sehingga dapat dilakukan tatalaksana guna mencegah timbulnya hipotensi ortostatik.

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Background: Orthostatic hypotension is widely known as a problem that. frequently found in elderly individuals and is associated with an increase of morbidity and mortality rate. Comorbidity in elderly have been recognized to potentially give rise to the development of orthostatic hypotension. Reffering to this matter, early detection of orthostatic hypotension in elderly and management of.risk factors need to be done in effort to achieve the optimal quality of life.

Objectives. To find out the prevalence and some risk factors for the development of orthostatic hypotension in elderly individuals such as age, hypertension, diabetes mellitus, heart failure, history of stroke,dehydration and anti-hypertension drug usage.

Methods: Ninety-seven elderly subjects with 60 years of age or more who had come to Outpatient clinic and Emergency Room of Cipto Mangunkusumo Hospital were included in the study. Data were obtained by anamnesis, physical examination, blood pressure examination in lie down position, immediately after 1-3 minutes of standing. We also perfomed laboratory examination, ECG and thorax X-ray. This study had a cross-sectional design and the studied variables include age, hypertension, diabetes mellitus and heart failure, history of stroke, dehydration and anti-hypertension drug usage, which were correlated to orthostatic hypotension.

Result: The subjects consists of found 40 males (41.2%), 57 females (58.8%) and mean of age 67.4 years. We found 15 subjects with orthostatic hypotension (15.5%)_ Analysis bivariate and multivariate indicated that the variables of hypertension and dehydration had a significant correlation to orthostatic hypotension. Other risk factors were not proven to have significant correlation with the development of orthostatic hypotension.

Conclusion: Hypertension and dehydration were proven as risk factor of orthostatic hypotension. Elderly subject with hypertension needs a more careful management of blood pressure. Dehydration condition should be detected immediately in order to perform appropriate management to prevent the development of orthostatic hypotension."

"Latar Belakang. Kualitas hidup merupakan hal yang penting pada penyakit kronik, termasuk pada usia lanjut. Kualitas hidup yang dibahas di bidang kesehatan adalah kualitas hidup terkait kesehatan (health related quality of life). Salah satu kuesioner untuk mengukur kualitas hidup yang banyak digunakan adalah formulir European Quality of Life - 5 Dimensions (EQ-5D). Di Indonesia belum ada suatu alat mengukur kualitas hidup terkait kesehatan pada usia lanjut yang sudah diuji keandalan dan kesahihan.Tujuan. Membuktikan bahwa formulir EQ-5D merupakan alat pngukur yang andal dan sahib untuk menentukan kualitas hidup terkait kesehatan pada usia lanjut di Indonesia.Metodologi. Dirancang suatu studi validasi. Prosedur yang dilakukan adalah pada hari pertama kunjungan, semua pasien melakukan pengisian formulir European Quality of life - 5 Dimensions (EQ-5D) dan Short Form - 36 (SF-36) dan pada hari ke 7-14 kunjungan dilakukan pengisian ulang formulir EQ-5D.Hasil. Telah dilakukan pengambilan data terhadap 86 responden, nilai ICC EQ-5D masing-masing dimensi, EQ-5D indeks maupun VAS didapatkan sangat baik (>0,75), kecuali untuk rasa cemas/ depresi, dengan nilai ICC 0,611. Keandalan internal consistency penelitian ini didapatkan nilai Cronbach a 0,829. Uji kesahihan ekstemal EQ-5D-dibandingkan SF-36 dan dianalisis-dengan uji Pearson/ Spearman correlation coefficient. Terdapat hubungan bermakna (p<0,0I), yaitu antara dimensi EQ-5D, EQ-5D indeks, EQ-5D VAS dengan dimensi SF-36 maupun SF-36 nilai total, kecuali hubungan EQ-5D VAS dan kesehatan jiwa SF-36. Hasil uji kesahihan konstruksi EQ-5D, didapatkan semua dimensi berhubungan bermakna dengan EQ-5D indeks ( p<0,01).Simpulan. Fornulir EQ-5D merupakan alat pngukur yang andal dan sahih dan dianjurkan dapat digunakan untuk mengukur kualitas hidup terkait kesehatan usia lanjut di Indonesia.

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Background. Quality of life is an important issue in chronic disease and elderly population. Quality of life discussed here is Health Related Quality of Life (HRQOL). HRQOL is an abstract variable. It contents two dimensions, subjective or perception and objective component. One of the HRQOL instrument most commonly used is European Quality of Life - 5 Dimensions (EQ-5D) form. So far there isn't any tool to measure HRQOL in elderly population in Indonesia, which has been validated consistently.

Objectives. To verify that EQ-5D form is a reliable and valid instrument to measure health related quality of life in elderly population in Indonesia.

Methods. A validation study was arranged. On the first day of visit, all patients filled in EQ-5D form and Short Form - 36 (SF-36), which was repeated on day 7 through day 14 of visits.

Results. There were 86 respondents in this study. Interclass Correlation Coefficient (ICC) EQ-5D for each dimension, EQ-5D index and EQ-5D VAS were found to be excellent (>0.75) with the exception of anxiety/ depression with ICC 0.611. The internal consistency was found to have Cronbach a 0.829. Compared to SF-36, the external validity of EQ-SD was found to be significant (p<0.01) using Pearson/ Spearman correlation coefficient, except the correlation of EQ-5D VAS and mental health. The construct validity was found to be significant (p<0.01).

Conclusions. EQ-5D form is a reliable and valid instrument which is recommended to measure health related of life in elderly population in Indonesia."

"Latar belakang: Fakultas Kedokteran Universitas Pembangunan Nasiona1 "Veteran" Jakarta (FK UPNVJ) sejak tahun 2006 telah melakukan perubahan kurikulum dari kurikulum konvensional menjadi kurikulum berbasis kompetensi (KBK). Perubahan tersebut membawa dampak pada perubahan lingkungan pembelajaran. Mengingat lingkungan pembelajaran merupakan faktor penting dalam proses pembelajaran mahasiswa, dan menjadi salah satu faktor penentu keberhasilan mahasiswa, maka sudah waktunya bagi FK UPNVJ untuk melakukan penilaian terhadap lingkungan pembelajaran, dan salah satu cara penilaian adalah melalui persepsi mahasiswa. Tujuan dari penelitian ini adalah untuk melihat ada tidaknya perbedaan antara persepsi mahasiswa dari berbagai tingkat terhadap lingkungan pembelajaran dan untuk mengidentifikasi hubungan antara lingkungan pembelajaran dengan prestasi belajar mahasiswa yang diwakili dengan indeks prestasi semester. Metode: Desain penelitian menggunakan cross sectional yang dilakukan di FK UPNVJ pada bulan Nopember 2010 dan melibatkan 299 responden mahasiswa tingkat 2,3 dan 4. Penelitian dilakukan dengan menggunakan quesioner DREEM (Dundee Ready Educational Environment Measure) untuk menilai persepsi mahasiswa terhadap lingkungan beJajar. Pengolahan data dengan menggunakan SPSS vcrsi 13. Hasil: Analisis data menunjukkan nilai rata~rata skor Dreem seluruh responden adalah 128/200, yang berarti lebih banyak sisi positif. Terdapat perbadaan yang bermakna mengenai persepsi mahasiswa terbadap lingkungan pembelajaran dari mahasiswa yang berbeda tingkat. Terdapat hubungan bermakna antara persepsi mahasiswa tingkat 3 terhadap lingkungan pembelajaran dengan prestasi akademik mereka. Kesimpulan: Mahasiswa menilai proses pembelajaran yang ada saat ini di FK UPNVJ sudah cukup baik. Menurut persepsi mahasiswa tingkat 3 lingkungan pembelajaran mempunyai pengaruh langsung terhadap prestasi akademik mahasiswa, namun menurut mahasiswa tingkat 2 dan 4 lingkungan tidak secara langsung mempengaruhi prestasi akademik mahasiswa.

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Background: Faculty of Medicine. University of National Development "Veteran" Jakarta (UPNVJ) has revised its curriculum from conventional to competency-based curriculum (CBC) since 2006. These changes had an impact on the learning environment. Given that learning environment is an important factor in student learning as well as a detemining factor for student success, then ifs time for FK UPNVJ to conduct an assessment of the learning environment, and one way to do that is through the perception of students.

The purpose of this study is to see whether perceptions of students on learning environment differs according to their level of training and to identify the relationship between learning environment and academic achievement of students which represented by their GPA.

Method: This study started on November 2010 using cross sectional design with 299 students involved as respondens. Research carried out by using questioner DREEM (Dundee Ready Educational Environment Measure) to assess students' perceptions of learning environment. Processing data using SPSS version 13.

Results: Data analysis shows that rating of all respondents Dreem score is 128/200, which means the learning environment in FK UPNVJ has more positive side, There are significant differences regarding students' perceptions of the learning environment according to their level of training. There is a significant relationship between students perceptions of learning environment with their academic achievement in 3rd grade students.

Conclusion: According to student perception the learning environment at Faculty of Medicine UPNVJ had more positif side. Learning environment has a direct impact on students academic achievement in the 3rd grade students but in the 2nd and 4th grade students, learning environment does not directly affect students academic achievement."