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"ABSTRAKPendahuluan: Prevalensi pasien dengan penyakit gagal ginjal yang menjalani hemodialisis (HD) pada usia kerja cukup tinggi. Berdasarkan data Indonesian Renal Registry 2017 terdapat 85,73% pasien dengan HD kronik berada pada usia produktif. Dengan menjalani HD, diharapkan sebagian besar pekerja masih dapat bekerja secara produktif. Di Indonesia belum terdapat studi mengenai status kerja pada pekerja dengan HD kronik. Penelitian ini bertujuan untuk untuk mengetahui proporsi status kerja, pekerja yang menjalani HD, faktor-faktor yang berhubungan dan status kelaikan kerjanyaMetode: Penelitian ini menggunakan desain studi potong lintang. Sebanyak 79 pekerja yang telah menjalani HD minimal tiga bulan diikutsertakan dalam penelitian. Data didapat dari wawancara umum, kuisioner Skala Kepuasan Kerja, rekam medis dan penilaian kelaikan kerja oleh dokter spesialis kedokteran okupasi.Hasil: Proporsi pekerja dengan hemodialisis kronik yang tidak aktif bekerja lagi adalah 38%. Hanya 3,8% membuat keputusan untuk berhenti atau lanjut bekerja berdasarkan nasihat dokter. Status kepegawaian dan sektor usaha tempat kerja dan sektor usaha tempat kerja merupakan faktor determinan status kerja pada pekerja yang menjalani HD, dengan nilai p keduanya < 0,01. Proporsi pekerja yang tidak kerja namun laik kerja dengan catatan setelah dilakukan penilaian kelaikan kerja oleh dokter spesialis kedokteran okupasi adalah sebanyak 76,7%.Kesimpulan: Sebanyak 38% pekerja yang menjalani HD kronik sudah tidak kerja. Faktor pekerjaan seperti status kepegawaian dan sektor usaha memengaruhi status kerja pekerja yang menjalani HD.

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ABSTRACT

Introduction: The prevalence of End-Stage Renal Disease patients who need hemodialysis (HD) at productive age is quite high. Based on 2017 Indonesian Renal Registry data, 85.73% of of patients with chronic HD, are at productive age. With HD it is expected that most of the patients can still be actively engaged in their daily life, including work. In Indonesia no study exists on the work status of workers with chronic HD. This study aims to identify the proportion of work status, in workers receiving chronic hemodialysis treatment, its associated factors and their fit to work status.

Method: This study used a cross sectional study design. Seventy nine workers who are receiving HD treatment for at least three months were involved in this study. Data was gathered from questionnaires, Job Satisfaction Survey, medical records and Fit to Work Assessment by occupational medicine specialists.

Result: The proportion of workers with chronic hemodialysis who have stopped working is 38%. Only 3.8% of the respondents, made the decision to stay or stop working based on advise by the doctor. Employee status and work sector are determinants of work status in workers with chronic HD, with both p values <0.01. Results of Fit to Work Assessment showed, that 76.7% of those workers, who have stopped working are actually still fit to work with note.

Conclusion: Thirty eight percent of workers with chronic HD stopped working. Employee status and work sector are associated with employment status of workers who with chronic HD."

"Hipertensi sering dijumpai dalam praktek sehari-hari dan prevalensinya di Indonesia cukup tinggi (31,7%). Penanaman benang catgut terbukti menurunkan tekanan darah, tetapi belum ada penelitian untuk mengukur kadar nitrit oksida (NO). Penelitian ini bertujuan mengetahui pengaruh penanaman benang catgut terhadap kadar NO serum dan tekanan darah pada hipertensi esensial. Disain penelitian adalah uji klinis acak tersamar tunggal dengan kontrol. Melibatkan 40 pasien hipertensi yang dibagi menjadi dua kelompok. Kelompok kontrol mendapatkan obat antihipertensi. Kelompok kasus mendapatkan obat antihipertensi dan penanaman benang catgut, kemudian pada kedua kelompok dilakukan penilaian kadar NO dan tekanan darah. Hasil penelitian menunjukkan terdapat perbedaan rerata kadar NO kelompok kasus dibandingkan kontrol (p<0,05), terdapat perbedaan rerata tekanan darah sistolik dan diastolik kelompok kasus dibandingkan kontrol (p<0,05). Dapat disimpulkan bahwa penanaman benang catgut memiliki pengaruh terhadap kadar NO serum dan tekanan darah pada pasien hipertensi esensial.

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Hypertension is commonly seen in daily practice and its prevalence in indonesia is fairly high (31,7%). Catgut embedding is proven to reduce blood pressure, but until now there has not been any research to evaluate concentration of nitric oxide (NO). This research was to assess the effect of catgut embedding on serum NO concentration and blood pressure in essential hypertension.

Research design was single blind random controlled clinical trial, involving 40 hypertension patients randomly assigned to two groups. Control group received anti hypertension drugs whereas case group received anti hypertension drugs and catgut embedding and then the two groups evaluated for NO concentration and blood pressure.

Result showed that there was a mean difference of NO concentration between case group and control group (p<0,05) and mean difference of systolic and diastolic blood pressure between case group and control group (p<0,05). In conclusion, catgut embedding can influence serum NO concentration and blood pressure in essential hypertension patients."

"Latar belakang: Transplantasi ginjal dapat memperbaiki fungsi endotel. Berbagai penelitian membuktikan bahwa peningkatan kadar eritropoietin (Epo) dapat mengaktifasi dan memobilisasi Endothelial Progenitor Cell (EPC) sehingga mampu memperbaiki fungsi endotel melalui proses angiogenesis dan neovaskularisasi. Membaiknya fungsi endotel akan menurunkan angka kesakitan dan kematian akibat penyakit kardiovaskular pada penderita PGK. Tujuan: Untuk mengetahui hubungan peningkatan kadar Epo dan jumlah EPC CD34+ serta CD133+ dengan perbaikan fungsi endotel pada penderita gagal ginjal 3 bulan setelah transplantasi ginjal. Metode Penelitian: Potong lintang sebelum dengan 3 bulan setelah transplantasi ginjal pada penderita gagal ginjal yang menjalani transplantasi ginjal di RSCM. Jumlah subyek 21 orang yang dikumpulkan dalam kurun waktu Juli 2013 - Februari 2014. Pengambilan sampel darah untuk memeriksa kadar Epo, jumlah EPC CD34+ dan CD133+ dan kadar asimetrik dimetilarginin (ADMA) dilakukan sebelum dan 3 bulan setelah transplantasi ginjal. Analisis statistik dengan uji korelasi Pearson atau Spearman. Hasil: Penelitian ini menunjukkan adanya peningkatan kadar Epo tetapi tidak bermakna secara statistik (p>0.05), sedangkan jumlah EPC CD34+ dan CD133+ meningkat (p<0.05), serta kadar ADMA menurun yang bermakna secara statistik (p<0.05). Tiga bulan setelah transplantasi ada korelasi bermakna antara peningkatan kadar Epo dengan jumlah EPC CD34+ (r = 0.466 ; p < 0.05). Tidak ada hubungan peningkatan kadar Epo dan jumlah EPC CD34+ serta CD133+ dengan perbaikan fungsi endotel 3 bulan setelah transplantasi ginjal. Kesimpulan: Tiga bulan setelah transplantasi ginjal didapatkan adanya peningkatan kadar Epo, jumlah EPC CD34+ dan CD133+ serta penurunan kadar ADMA. Tetapi tidak ada korelasi peningkatan kadar Epo dan jumlah EPC CD34+ serta CD133+ dengan perbaikan fungsi endotel dalam rentang 3 bulan setelah transplantasi ginjal.

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Background: Kidney transplantation improved endothelial function. Various studies have shown that elevated level of erythropoietin (Epo) could activate and mobilize Endothelial Progenitor Cell (EPC), thus would improve endothelial function through the process of angiogenesis and neovascularization. The improvement of endothelial function will decrease morbidity and mortality from cardiovascular disease in patients with CKD.

Aim: To determine association between elevated level of Epo and the numbers of EPC CD34+ - CD133+ with the improvement of endothelial function in patients three months after kidney transplantation.

Methods: cross sectional study prior and 3 months after kidney transplantation in patients with renal failure who underwent kidney transplantation in RSCM. The study included 21 subjects who enrolled from July 2013 to February 2014. Blood samples prior and 3 months after kidney transplantation were collected to evaluate the level of Epo, numbers of EPC CD34+ and CD133+ and level of assymetric dimethylarginine (ADMA). Statistical analysis was performed using Pearson or Spearman correlation test.

Resulys: The results of the study showed that prior to kidney transplantation, level of Epo was increased but not statistically significant (p>0.05). The EPC numbers of CD34+ and CD133+ were significantly increased (p<0.05), whereas the ADMA level was significantly decreased (p<0.05). Three months after transplantation showed a significant association between elevated level of Epo and the numbers of EPC CD34+ (r = 0.466, p > 0.05). There was no association between the elevated level of Epo and the numbers of EPC CD34+ and CD133+ with the improvement of endothelial function three months after kidney transplantation.

Conclusion: Three months after kidney transplantation showed an elevated level of Epo, the numbers of EPC CD34+ and CD133+ and the decreased level of ADMA. However, there was no association between the elevated level of Epo and the numbers of EPC CD34+ and CD133+ with the improvement of endothelial function in patients 3 months after kidney transplantation."

"[ABSTRAKLatar belakang: Berdasarkan data riskesdas 2013, prevalensi batu saluran kemih di Indonesia adalah 0,6 persen. Batu saluran kemih disebabkan oleh beberapa faktor; lingkungan kerja panas dan BJ Urin. Sebagian pekerja dapur RS X Tangerang mengeluh lingkungan kerja yang panas berlebihan sehingga berkeringat dan data medical check up tahun 2014 tidak ada pemeriksaan urin sehingga gambaran status kesehatan pekerja akibat lingkungan panas tidak dapat diketahui. Penelitian ini bertujuan untuk mengetahui hubungan lingkungan kerja panas dengan kristalisasi urin pada pekerja dapur RS X Tangerang.Metode: Rancangan penelitian yang digunakan adalah kros seksional. Pengumpulan data dilakukan di RS X Tangerang dari bulan Januari sampai Maret 2015, dengan menggunakan kuesioner, wawancara, pemeriksaan tanda vital responden sebelum dan sesudah kerja, pemeriksaan urinalisa sebelum dan sesudah kerja serta pengukuran suhu lingkungan kerja dengan menggunakan alat area heat stress monitor Quest Stemp 36 dan perhitungannya berdasarkan Indeks Suhu Bola Basah. Berdasarkan metode total populasi dan setelah mempertimbangkan faktor eklusi dan inklusi didapatkan sampel sebanyak 105 orang.Hasil: Prevalensi kristal urin ditemukan sebesar 6,7% pada pemeriksaan urin sebelum kerja dan 10,5% sesudah kerja. Lingkungan kerja panas tidak mempunyai hubungan yang bermakna dengan terjadinya kristalisasi urin pada pekerja (p=0,316). BJ urin mempunyai hubungan yang bermakna dengan terjadinya kristalisasi urin (p<0,05), dimana risiko untuk terjadinya kristalisasi urin meningkat 1,8 kali sesudah kerja. Faktor risiko lain seperti umur, jenis kelamin, riwayat penyakit, Indeks Masa Tubuh, kebiasaan makan dan minum, masa kerja, lama kerja, dan jenis pekerjaan tidak terdapat hubungan yang bermakna (p>0,05).Kesimpulan: Lingkungan kerja panas dan faktor risiko lainnya tidak berhubungan dengan terjadinya kristalisasi urin pada pekerja di bagian dapur RS X Tangerang. BJ Urin responden berhubungan dengan terjadinya kristalisasi urin baik pada pemeriksaan urin sebelum dan sesudah kerja, Ini berarti sebelum kerja responden sudah dehidrasi, mungkin karena kurang minum atau paparan panas sebelumnya. Ditambah lingkungan kerja panas kepekatan urin meningkat, karenanya dianjurkan pekerja mengkonsumsi cairan minimal dua liter perhari.

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ABSTRACTBackground: According to 2013 Riskesdas data, the prevalence of urinary tract calculus in Indonesia is 0.6%. Several factors like temperature of working environment and urine specific gravity contribute to the formation of urinary tract calculus. Some of kitchen workers in the hospital X Tangerang complain about their hot working environment which caused them to sweat excessively and medical check-ups data in 2014, there was no urine examination so that an overview of health status of workers due to hot environment can‟t be obtained.This study aims to determine the relationship between hot working environment and urine crystallization on the kitchen workers of hospital X TangerangMethods: The research used a cross-sectional design. Data collection was done in Hospital X Tangerang from January to March 2015 using questionnaire, interview, and vital signs examination of the respondents before and after work, urine examination before and after work. Environment temperature was measured using area heat stress monitor Quest Stemp 36 and the calculation was done based on WBGT (Wet Bulb Globe Temperature Index). Using total population methods after considering the inclusion and exclusion factors, we acquired 105 people as samples.Result: The prevalence of urinary crystals was 6. 7% on urine samples before work and 10.5% after work. The relationship between hot working environment and the formation of crystals in the urine was not significant in the kitchen workers (p>0.316). Urine specific gravity has a significant relationship to the formation of crystals in the urine (p<0.05) in which the risk of the crystals formation increase 1,8 time after work. The other risk factors such as age, sex, hospital sheet, body mass index, eating and drinking habits, tenure, long working, and type of work showed no significant relationship (p>0.05).Conclusion: Hot working environment and the other risk factors are not related to urine crystallization in the kitchen workers of Hospital X Tangerang. Urine specific gravity is related to the formation of crystals in the urine before and after work. This means, before working respondents already dehydrated, probably due to lack of drinking or heat exposure before. Hot working environment increases urine concentration. It‟s recommended for workers to consume at least two liters of fluid perday., Background: According to 2013 Riskesdas data, the prevalence of urinary tract calculus in Indonesia is 0.6%. Several factors like temperature of working environment and urine specific gravity contribute to the formation of urinary tract calculus. Some of kitchen workers in the hospital X Tangerang complain about their hot working environment which caused them to sweat excessively and medical check-ups data in 2014, there was no urine examination so that an overview of health status of workers due to hot environment can‟t be obtained.This study aims to determine the relationship between hot working environment and urine crystallization on the kitchen workers of hospital X TangerangMethods: The research used a cross-sectional design. Data collection was done in Hospital X Tangerang from January to March 2015 using questionnaire, interview, and vital signs examination of the respondents before and after work, urine examination before and after work. Environment temperature was measured using area heat stress monitor Quest Stemp 36 and the calculation was done based on WBGT (Wet Bulb Globe Temperature Index). Using total population methods after considering the inclusion and exclusion factors, we acquired 105 people as samples.Result: The prevalence of urinary crystals was 6. 7% on urine samples before work and 10.5% after work. The relationship between hot working environment and the formation of crystals in the urine was not significant in the kitchen workers (p>0.316). Urine specific gravity has a significant relationship to the formation of crystals in the urine (p<0.05) in which the risk of the crystals formation increase 1,8 time after work. The other risk factors such as age, sex, hospital sheet, body mass index, eating and drinking habits, tenure, long working, and type of work showed no significant relationship (p>0.05).Conclusion: Hot working environment and the other risk factors are not related to urine crystallization in the kitchen workers of Hospital X Tangerang. Urine specific gravity is related to the formation of crystals in the urine before and after work. This means, before working respondents already dehydrated, probably due to lack of drinking or heat exposure before. Hot working environment increases urine concentration. It‟s recommended for workers to consume at least two liters of fluid perday.]"

"Latar Belakang: Transplantasi ginjal telah menjadi pilihan utama terapi bagi pasien dengan penyakit ginjal tahap akhir, baik yang berasal dari donor hidup maupun donor jenazah. Transplantasi ginjal memiliki risiko yang lebih rendah baik untuk mortalitas maupun kejadian kardiovaskular, serta memiliki kualitas hidup yang lebih baik dibandingkan pasien yang menjalani dialisis kronis, baik hemodialisis maupun dialisis peritoneal. Penelitian ini bertujuan mengetahui faktor-faktor yang mempengaruhi kesintasan transplantasi ginjal di RSUPN Ciptomangunkusumo tahun 2010-2017. Metode: Penelitian Desain penelitian ini adalah kohort retrospekstif menggunakan data rekam medis pasien transplantasi ginjal. Sampel penelitian adalah resipien transplantasi ginjal ≥ 18 tahun di di RSUPN Ciptomangunkusumo tahun 2010-2017, yaitu sebanyak 548 pasien. Hasil: penelitian probabilitas kesintasan resipien transplantasi ginjal selama pengamatan 5 tahun adalah 84,1% Hasil analisis dengan regresi cox menunjukkan bahwa resipien dengan donor yang berusia ≥ 40 tahun lebih cepat 1,487 kali untuk meninggal dibandingkan resipien dengan donor yang berusia < 40 tahun, resipien yang berusia ≥ 45 tahun lebih cepat 2,356 kali untuk meninggal dibandingkan pasien yang berusia <45 tahun, lama hemodialisis ≥ 24 bulan lebih cepat 2,356 kali untuk meninggal dibandingkan pasien yang lama hemodialisisnya < 24 bulan, skor charlson > 1 lebih cepat 2,861 kali untuk meninggal dibandingkan pasien yang skor charlson ≤ 1, resipien yang memiliki DM lebih cepat 2,947 kali untuk meninggal dibandingkan dengan yang tidak DM. Simpulan: Kesintasan lima tahun di Indonesia cukup baik. Insiden kematian relatif tinggi, menyebabkan penurunan kelangsungan hidup pasien lima tahun. Namun, hasil keseluruhan masih sebanding dengan negara-negara berkembang lainnya.

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Background: Kidney transplantation has become the main choice of therapy for patients with end-stage kidney disease, both from living donors and donor bodies. Kidney transplantation has a lower risk for both mortality and cardiovascular events, and has a better quality of life than patients who undergo chronic dialysis, both hemodialysis and peritoneal dialysis. This study aims to determine the factors that influence the survival of kidney transplants in Ciptomangunkusumo Hospital in 2010-2017.

Methods: A retrospective cohort study with total consecutive sampling is performed on all kidney transplant recipients in Cipto Mangunkusumo Hospital from March 2019 until May 2019. Data is acquired by analysing medical records and contacting patients directly. Each recipient is followed from the day of transplant until death or december 2018, whichever comes first. Five-year death and patient survival is documented. Kaplan-Meier Curve is used to describe patient survival until the end of study and analysis with Cox regression.

Result: which was as many as 548 patients. The results of this study indicate the probability of survival of kidney transplant recommendations during the 5-year observation was 84.1%. The results of the analysis with Cox regression showed that donors aged ≥ 40 years were 1,487 faster to die than recipients with donor aged <40 years, prescriptions aged ≥ 40 years 2,356 times faster to die than patients aged <40 years, duration of hemodialysis ≥ 24 months faster 2,356 times to die compared to patients with long hemodialysis <24 months, Charles score> 1 faster 2,861 times to die than patients who score charlson ≤ 1, the recipients who have DM are 2.97 times faster to die compared to those without DM.

Conclusions: The outcome of five-year death in Indonesia is very satisfactory. The incidence of death is relatively high, causing a decline in five-year patient survival. However, the overall results are still comparable to other developing countries."

"Lataar Belakang : Pasca nefrektomi ginjal, terjadi proses kompensasi dari ginjal sisa dalam bentuk hiperfiltrasi untuk mempertahankan laju filtrasi glomerulus, yang dapat berujung pada penyakit ginjal kronik. Sejumlah penelitian menemukan adanya perubahan hemodinamika vaskular ginjal pada ginjal sisa donor yang diperiksa menggunakan ultrasonografi (USG) Doppler. Akan tetapi penelitian tersebut umumnya berfokus pada jangka panjang, dan menggunakan parameter indeks resistensi (RI), belum banyak penelitian yang memfokuskan pada parameter indeks pulsatilitas (PI) dalam jangka pendek, yang dapat bermanfaat untuk memperkirakan prognosis donor. Tujuan : Penelitian ini bertujuan untuk mengetahui gambaran USG Doppler dan adanya perbedaan nilai PI pada ginjal sisa donor transplantasi ginjal antara sebelum dan sesudah nefrektomi dalam jangka pendek. Metode : Desain penelitian merupakan studi prospektif historikal tanpa pembanding menggunakan data sekunder. Sampel adalah donor hidup transplantasi ginjal yang telah menjalani nefrektomi di RSUPN Cipto Mangunkusumo (RSCM) periode Maret 2019 hingga Januari 2020. Data USG Doppler berupa parameter PI a. renalis, segmental, interlobar, dan arkuata di superior, mid, dan inferior ginjal yang tidak dioperasi/ginjal sisa beserta rerata seluruhnya mulai dari preoperasi, H+1, H+7, dan H+30 pasca operasi. Hasil : Didapatkan 40 sampel USG Doppler ginjal sisa donor (rentang usia 24 hingga 66 tahun). Gambaran USG Doppler pada nilai rerata PI preoperatif, H+1, H+7, dan H+30 pasca operasi secara berturut-turut adalah: a. renalis: 1,33, 1,42, 1,31, dan 1,08; a. segmentalis: 1,24, 1,27, 1,18, dan 1,17. a. interlobaris: 1,11, 1,20, 1,19, dan 1,08; a. arkuata: 1,09, 1,14, 1,06, dan 1,02. Pada analisis kemaknaan dengan ANOVA tidak ada perbedaan bermakna pada perubahan rerata nilai PI a. renalis, segmentalis, interlobar, dan arkuata baik keseluruhan maupun per segmen ginjal, kecuali a. interlobar mid ginjal (p = 0,049). Akan tetapi pada analisis post hoc membandingkan dua titik waktu berbeda, tidak didapatkan perbedaan yang bermakna Kesimpulan : Tidak terdapat perbedaan bermakna dari nilai PI ginjal sisa donor sebelum dan sesudah nefrektomi dalam jangka pendek.

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Background : After kidney nephrectomy, there is a compensation process in remnant kidney in the form of hyperfiltration to preserve glomerular filtration rate, which may lead to chronic kidney disease. Several studies found changes in renal vascular hemodynamics in donor’s remnant kidney, examined by Doppler ultrasound (US). However those studies mostly focused on long term and used resistive index (RI), while not many studies focused on pulsatility index (PI) in short term, which may be beneficial to predict donor’s prognosis. Objective : This study aimed to know the Doppler US of and differences in PI values in renal transplantation donor’s remnant kidney before and after nephrectomy within short term. Method : The study design is historical prospective without comparison using secondary data. Samples are renal transplantation donor underwent nephrectomy in Cipto Mangunkusumo National Central General Hospital (RSUPN-CM) from March 2019 until January 2020. Doppler ultrasound data presented in the form of PI parameter of renal, segmental, interlobar, and arcuate arteries, in superior, middle, and inferior kidney of unoperated/remnant kidney and their mean, from pre-surgery, D+1, D+7, and D+30 after surgery. Result : This study obtained 40 samples of donor’s remnant kidney Doppler US (age range 24-66 years old). Doppler US of mean PI from pre-surgery, D+1, D+7, and D+30 after surgery consecutively were: renal artery: 1.33, 1.42, 1.31, and 1.08;segmental artery: 1.24, 1.27, 1.18, and 1.17; interlobar artery: 1.11, 1.20, 1.19, and 1.08; arcuate artery: 1.09, 1.14, 1.06, and 1.02. Significance analysis using ANOVA showed no significant difference of PI value changes of renal, segmental, interlobar, and arcuate artery, both in the mean of whole and segments of kidney, except interlobar artery in the middle segment of kidney (p = 0.049). However, post hoc analysis comparing two different time points showed no significant difference. Conclusion : There was no significant difference of donor’s remnant kidney PI value before and after nephrectomy within short term."

"Latar Belakang: Populasi lansia di Indonesia terus meningkat. Proses penuaan meningkatkan terjadinya PGK. Data mengenai mortalitas pada pasien lansia yang menjalani inisiasi Hemodialisis (HD) selama perawatan rumah sakit sangat terbatas. Suatu model prediktor dapat menjadi alat bantu dan diharapkan dapat menjadi sarana stratifikasi prognosis dan menjadi pertimbangan pemilihan terapi bagi pasien dan keluarga. Tujuan. Mengetahui insiden dan prediktor mortalitas pasien lanjut usia yang menjalani Inisiasi HD selama perawatan Rumah SakitMetode: Studi kohort retrospektif dengan menelusuri rekam medis pada pasien lansia yang menjalani inisiasi HD di RSCM pada Januari 2018 hingga Desember 2022. Dilakukan analisis survival terhadap variabel usia, jenis kelamin, akses vaskular, kadar hemoglobin, komorbid, status nutrisi, gangguan kesadaran, status fungsional, dan risiko jatuh. Dilakukan analisis Bivariat dengan cox regression.Hasil: Terdapat 201 subjek diteliti. Mortalitas pasien lansia yang menjalani inisiasi HD selama perawatan rumah sakit sebesar 35,32%. Beberapa faktor prediktor signifikan berpengaruh terhadap mortalitas pasien, meliputi usia ≥ 75 tahun, komorbid, gangguan kesadaran, dan status fungsional. Pada model akhir uji multivariat, ditemukan faktor gangguan kesadaran (HR 5,278, IK 95% 3,163 – 8,805]) yang berpengaruh signifikan terhadap mortalitas pasien. Kesimpulan: Insiden mortalitas pada pasien lansia yang menjalani inisiasi HD adalah 35,32% dengan faktor prediktor gangguan kesadaran yang berpengaruh signifikan terhadap mortalitas pasien.

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Background: Elderly population in Indonesia continue to increase. Aging is known enhance the risk of CKD. Data regarding mortality in elderly patients undergoing Hemodialysis (HD) initiation are very limited. A predictor model will help to stratify prognosis and guide phycisian to make a consideration for selecting therapy for patients.

Aim: To determine incidence and mortality predictors of elderly patients undergoing HD initiation during hospital care

Method: This retrospective cohort study was conducted by reviewing medical records of elderly patients undergoing HD initiation at RSCM from January 2018 to December 2022. Survival analysis was performed on the variables age, sex, vascular access, hemoglobin levels, comorbidities, nutritional status, impaired consciousness, functional status, and risk of falling. Bivariate analysis were performed using the cox regression method.

Results: There was 201 subjects to be studied. The mortality of elderly patients undergoing HD initiation during hospital care was 35,32%. Several significant predictor factors influence patient mortality, including age ≥ 75 years, comorbid, impaired consciousness, and functional status. In the final model of the multivariate test, factors of impaired consciousness (HR 5,278 [CI 3.163 – 8.805]) were found to have a significant effect on patient mortality.

Conclusion: The incidence of mortality in elderly patients undergoing HD initiation was 35,32% with impaired consciousness are significant factors related to mortality during HD initiation"

"[ABSTRAKUremik pruritus masih menjadi masalah dan mengurangi kualitas hidup pada pasien hemodialisis, meskipun telah banyak kemajuan dalam teknik dialisis, serta terapi yang ada belum memberikan hasil yang maksimal. Terapi akupunktur dapat dikembangkan sebagai terapi pendamping pada terapi hemodialisis untuk mengurangi gejala uremik pruritus. Penelitiasn ini merupakan penelitian akupunktur pertama di Indonesia dengan subyek pasien hemodialisis. Tiga puluh tujuh pasien hemodialisis dengan uremik pruritus dibagi dalam dua kelompok secara acak, kelompok akupunktur (n=18) mendapat terapi akupunktur pada titik tunggal LI11 Quchi, sementara kelompok kontrol (n=19) mengunakan jarum plasebo The Park Sham Device. Terapi akupunktur dilakukan saat hemodialisis, seminggu dua kali sebanyak 12 kali. Skor pruritus dinilai menggunakan kuesioner pruritus 5D sebelum terapi, setelah terapi ke-4, ke-8 dan setelah terapi ke-12, serta penilaian lanjutan 4 dan 8 minggu setelah terapi selesai. Perbedaan bermakna skor pruritus 5D antara kelompok akupunktur dan kelompok kontrol terjadi setelah akhir terapi akupunktur (7,89±0,832 vs 10,63±3,166; p=0,003) dan penilaian lanjutan 4 minggu setelah terapi selesai(8,06±1,830 vs 10,95±3,341; p=0,001). Terapi akupunktur efektif menurunkan skor uremik pruritus pada pasien hemodialisis yang menjalani dialisis seminggu dua kali.

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ABSTRACTUremic pruritus still gives problems for hemodialysis patients especially to reducing their quality of life, although it has been many advancements in dialysis techniques, recent therapies not yet provide optimum results. Acupuncture has a role as a complement in hemodialysis therapy to alleviate the symptoms of uremic pruritus in hemodialysis patients. This study is the first acupuncture research in Indonesia with the subject of hemodialysis patients. Thirty-seven hemodialysis patients with uremic pruritus were divided randomly into two groups, the acupuncture group (n = 18) received acupuncture treatment at a single point LI11 Quchi, while the control group (n = 19) using a placebo needle The Park Sham Device. Acupuncture treatment was done simultaneously with hemodialysis therapy, twice a week for 12 times. The pruritus scores was assessed using a 5D pruritus questionnaire before treatment, after 4th, 8th, 12th acupuncture treatment and at 4 and 8 weeks follow up. Significant differences 5D pruritus scores between the acupuncture group and the control group occurred after the end of acupuncture treatment (7.89±0.832 vs 10.63±3.166; p = 0.003) and at 4 weeks follow up (8.06±1.830 vs. 10.95±3.341; p = 0.001). Acupuncture treatment is effective in lowering the score of uremic pruritus in hemodialysis patients who undergo dialysis twice a week.;Uremic pruritus still gives problems for hemodialysis patients especially to reducing their quality of life, although it has been many advancements in dialysis techniques, recent therapies not yet provide optimum results. Acupuncture has a role as a complement in hemodialysis therapy to alleviate the symptoms of uremic pruritus in hemodialysis patients. This study is the first acupuncture research in Indonesia with the subject of hemodialysis patients. Thirty-seven hemodialysis patients with uremic pruritus were divided randomly into two groups, the acupuncture group (n = 18) received acupuncture treatment at a single point LI11 Quchi, while the control group (n = 19) using a placebo needle The Park Sham Device. Acupuncture treatment was done simultaneously with hemodialysis therapy, twice a week for 12 times. The pruritus scores was assessed using a 5D pruritus questionnaire before treatment, after 4th, 8th, 12th acupuncture treatment and at 4 and 8 weeks follow up. Significant differences 5D pruritus scores between the acupuncture group and the control group occurred after the end of acupuncture treatment (7.89±0.832 vs 10.63±3.166; p = 0.003) and at 4 weeks follow up (8.06±1.830 vs. 10.95±3.341; p = 0.001). Acupuncture treatment is effective in lowering the score of uremic pruritus in hemodialysis patients who undergo dialysis twice a week., Uremic pruritus still gives problems for hemodialysis patients especially to reducing their quality of life, although it has been many advancements in dialysis techniques, recent therapies not yet provide optimum results. Acupuncture has a role as a complement in hemodialysis therapy to alleviate the symptoms of uremic pruritus in hemodialysis patients. This study is the first acupuncture research in Indonesia with the subject of hemodialysis patients. Thirty-seven hemodialysis patients with uremic pruritus were divided randomly into two groups, the acupuncture group (n = 18) received acupuncture treatment at a single point LI11 Quchi, while the control group (n = 19) using a placebo needle The Park Sham Device. Acupuncture treatment was done simultaneously with hemodialysis therapy, twice a week for 12 times. The pruritus scores was assessed using a 5D pruritus questionnaire before treatment, after 4th, 8th, 12th acupuncture treatment and at 4 and 8 weeks follow up. Significant differences 5D pruritus scores between the acupuncture group and the control group occurred after the end of acupuncture treatment (7.89±0.832 vs 10.63±3.166; p = 0.003) and at 4 weeks follow up (8.06±1.830 vs. 10.95±3.341; p = 0.001). Acupuncture treatment is effective in lowering the score of uremic pruritus in hemodialysis patients who undergo dialysis twice a week.]"

"Pengemudi bis antar kota adalah profesi yang bertanggung jawab terhadap keselamatan banyak jiwa, tidak hanya para penumpang yang dibawanya namun juga para pengguna jalan yang lain. Untuk itu dibutuhkan stamina dan kondisi fisik yang prima agar mereka dapat bekerja dengan baik. Sementara cara kerja yang cukup melelahkan serta beberapa perilaku kurang baik yang banyak dilakukan oleh para pengemudi bis antar kota ini membuat mereka rentan terkena gangguan kesehatan antara lain hipertensi. Hasil skrining kesehatan pada pengemudi bis antar kota yang dilakukan pada bulan Juli 2015 di terminal Poris Plawad Tangerang didapatkan kejadian hipertensi sebesar 25 %. Tujuan penelitian ini adalah diketahuinya masalah hipertensi dan hubungannya dengan faktor pekerjaan serta faktor lain pada pengemudi bis antar kota di terminal Poris Plawad Tangerang. Penelitian ini menggunakan metode potong lintang, dimana dilakukan pengukuran tekanan darah serta wawancara terhadap responden. Dari penelitian yang dilakukan terhadap 84 responden, didapatkan prevalensi hipertensi sebesar 57,1 %, dan terdapat hubungan yang bermakna antara Indeks Masa Tubuh berlebih dengan kejadian hipertensi pada pengemudi bis antar kota di terminal Poris Plawad Tangerang ini. Dimana pengemudi dengan indeks masa tubuh berlebih memiliki risiko sebesar 16 kali untuk terkena hipertensi dibandingkan dengan pengemudi dengan indeks masa tubuh normal.

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Inter city bus driver is a profession that is responsible for the safety of many people, not only his passengers but also other road users. It requires good performance so that they can work well and safely. Exhausting way of working as well as some bad behavior which is mostly done by this inter city bus drivers have made them susceptible to health problems such as hypertension or other cardiovascular diseases. The results of inter city bus drivers’s health screening in Poris Plawad bus station Tangerang held on July 2015 found the prevalence of hypertension is 25 %. The purpose of this study is to determine hypertension problems and it relations with work related and other factors among the inter city bus drivers in Poris Plawad Bus Station Tangerang. This study using cross sectional method, with examination of respondent’s blood pressure and also some interviews for collecting other data. From 84 respondents it was found that the prevalence of hypertension was 57,1% and there was a significant relationship between body mass index and hypertension, which is the drivers with overweight had 16 times risk to have hypertension compare with them with normal weight."

"ABSTRAKHipertensi sering dijumpai dalam praktek sehari-hari dan prevalensinya di Indonesia cukup tinggi 31,7 . Press needle PN pada titik PC6, MA-IC 7 dan MA_TF 1 diketahui dapat menurunkan tekanan darah, tetapi belum ada penelitian khusus terhadap penderita hipertensi esensial. Penelitian ini bertujuan mengetahui efek PN pada titik PC6, MA-IC 7 dan MA_TF 1 terhadap tekanan darah dan skor kualitas hidup dari pasien hipertensi esensial. Disain penelitian adalah uji klinis acak tersamar ganda dengan kontrol. Melibatkan 52 pasien hipertensi yang dibagi menjadi dua kelompok. Kelompok kasus mendapatkan terapi PN dikombinasi dengan obat antihipertensi dan kelompok kontrol mendapatkan terapi PN plasebo dikombinasi dengan obat antihipertensi. kemudian pada kedua kelompok dilakukan penilaian perubahan tekanan darah dan kualitas hidup SF-36 . Hasil penelitian menunjukkan terdapat penurunan tekanan darah sistolik 30 menit dan 3 hari setelah perlakuan p0,05 , peningkatan skor SF-36 komponen MH, SF, BP dan GH 3 hari setelah perlakuan p0,05 pada kelompok kasus dibandingkan kelompok kontrol. Dapat disimpulkan bahwa terapi PN dikombinasi dengan obat antihipertensi lebih efektif menurunkan tekanan darah dan meningkatkan skor kualitas hidup pada pasien hipertensi esensial dibandingkan dengan terapi PN plasebo dikombinasi dengan obat antihipertensi.

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ABSTRACTHypertension is commonly seen in Daily Practice and its prevalence in Indonesia is fairly high 31.7 . Press needle PN on PC6, MA IC 7 and MA TF 1 points is known to reduce Blood Pressure, but yet there has not been any research specially for essential hypertension. This study aims to determine the press needle Effects on PC6, MA IC 7 and MA TF 1 points to Blood Pressure And Quality of Life Score of essential hypertension patients. The study design is a randomized double blind clinical trials with Control, involving 52 hypertension randomly assigned to two groups. Treatment groups get the press needle therapy combined with antihypertensive drugs and The control group who get the press needle placebo therapy combined with antihypertensive drugs. Then the two groups evaluated for Blood Pressure And Quality of Life SF 36 . The results showed a decrease in systolic blood pressure of 30 minutes and 3 days after treatment p 0.05 , improvement of the SF 36 component scores MH, SF, BP and GH 3 days after treatment p 0.05 in the treatment group compared to the control group. It can be concluded that the PN therapy in combination with antihypertensive drugs more effectively reduce blood pressure and improve the quality of life scores in patients with essential hypertension compared with placebo PN therapy in combination with antihypertensive drugs."