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"Tujuan: Mengetahui pengaruh konsumsi jus tomat 350 gram/hari selama 4 hari berturut-turut terhadap kadar likopen plasma dan 8-OHdG DNA lekosit pada 27 subyek pekerja laki-laki perokok ringanBahan dan cara: Penelitian eksperimental dengan desain pre dan post test, dengan subyek penelitian sebanyak 27 orang yang telah memenuhi kriteria penerimaan. Subyek penelitian diberikan jus tomat sebanyak 350 gram setiap hari selama 4 hari berturut-turut. Data yang dikumpulkan meliputi data demografi, data antropometri sebelum perlakuan, data asupan nutrisi sebelum dan selama perlakuan serta data laboratorium sebelum dan sesudah perlakuan berupa kadar likopen plasma dan 8-OHdG DNA lekosit.Hasil : Data demografi menunjukkan sebagian besar subyek berpendidikan menengah dengan penghasilan di bawah garis kemiskinan, mengalami paparan tidak langsung terhadap debu panas dalam pekerjaannya dan merokok jenis rokok standar. Data antropometri sebelum perlakuan menunjukkan 1MT dan persentase massa lemak tubuh masih dalam Batas normal. Asupan nutrisi selama perlakuan meliputi asupan energi, lemak, serat dan likopen meningkat bermakna (p<0,05). Data laboratorium menunjukkan median kadar likopen plasma sesudah perlakuan mengalami peningkatan bermakna (p<0,05) sebesar 39,1% dari 0,143 (0,019 - 0,259) µmol/L menjadi 0,185 (0,065 - 0,317) µmol/L. Median kadar 8-OHdG DNA lekosit sesudah perlakuan mengalami penurunan berrnakna (p<0,05) sebesar 45,3% dari 62,425 (13,499 - 133,206) ng/mL menjadi 35,459 (7,595 - 91,247) ng/mL. Terdapat korelasi negatif derajat cukup (r = -0,28) antara persentase massa lemak tubuh dengan kadar likopen plasma sebelum perlakuan. Juga tedapat korelasi negatif derajat cukup (r = -0,39) dan bermakna (p<0,05) antara besarnya peningkatan kadar likopen plasma dengan penurunan kadar 8-OHdG DNA lekosit sesudah perlakuan.Simpulan : Konsumsi jus tomat sebanyak 350 gram/hari selama 4 hari berturut-turut pada pekerja laki-laki perokok ringan, terbukti meningkatkan kadar likopen plasma dan menurunkan kadar 8-OHdG DNA lekosit.

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The Effects of Tomato Juices on Plasma Lycopene and 8-Hydroxy-Deoxyguanosin of Leukocyte DNA Levels of Light Smoking Male WorkersObjective : To evaluate the effects of 350 gram/day tomato juices consumption for 4 consecutive days on plasma lycopene and 8-hydroxy-deoxyguanosin of leukocyte DNA levels of 27 light smoking male worker subjects.Material and method: An experimental study with pre and post test design was carried out on 27 subjects who fulfilled the criteria of the selection. Subjects were given 350 gram tomato juices daily for 4 consecutive days. Data collected were demographic, anthropometric, nutritional and laboratory such as plasma lycopene and 8-OHdG of leukocyte DNA.Results: Demographic data showed that most of the subjects had moderate education, monthly income below the poverty line, indirect exposure to the working environmental pollutant and smoked standard cigarette. Anthropometric data showed that BMI and fat mass percentage were in normal range. Dietary intake during treatment increased significantly (p<0.05), for energy, fat, fiber and lycopene intake. Median value of plasma lycopene after treatment increased significantly (p<0.05) by 39.1% from 0.143 (0.019 - 0.259) µmol/L to 0.185 (0.065 - 0.317) µmol/L. Median value of 8-OHdG of leukocyte DNA after treatment decreased significantly (p<0.05) by 45.3% from 62.425 (13.499 - 133.206) ng/mL to 35.459 (7.595 - 91.247) ng/mL. A moderate negative correlation (r = -0.28) was obtained between percentage of body fat mass and plasma lycopene levels before treatment although non significant. There were a moderate negative and significant (pc0.05) correlation (r = - 0.39) was obtained between elevated plasma lycopene level and decreased of 8-OHdG of leukocyte DNA after treatment.Conclusion: Consumption of 350 gram tomato juices daily for 4 consecutive days on light smoking male workers was proven to elevate the level of plasma lycopene and decrease the level of 8-OHdG of leukocyte DNA."

"Tujuan: Mengelahui kadar karoten plasma, Malondialdehida plasma dan kebiasaan merokok pekerja laki-laki. Hasilnya diharapkan dapat digunakan sebagai salah satu dasar memperbaiki pola hidup untuk menurunkan risiko aterosklerosis.Tempat: PT Nasional Gabel Bogor Jawa Barat.Metodologi: Penelitian dengan desain cross sectional pada 115 pekerja laki-laki baik yang merokok maupun tidak memrokok, berusia 20 - 55 tahun yang memenuhi kriteria penerimaan dan penolakan, dan terpilih secara simple random sampling, menggunakan tabel bilangan acak. Data yang dikumpulkan meliputi: umur, pendidikan, penghasilan, IMT, persentase massa lemak tubuh, asupan lemak, asupan serat, asupan karoten, kadar karoten plasma dan MDA plasmaHasil: Median kadar karoten plasma subyek yang tidak merokok [0,38 (0,09 - 1,95) mmol/L] lebih linggi dari subyek yang merokok [0,34 (0,08 - 0,94) mmol/L]. Median kadar MDA plasma subyek yang tidak merokok [0,61 (0,22 -- 4,75) mmol/mL] lebih rendah dari subyek yang merokok [0,68 (0,32 - 3,01) mmol/mL]. Tidak didapat hubungan yang bermakna (p>0,05) antara asupan karoten, kadar karoten plasma, kadar MDA plasma dengan kebiasaan merokok. Terdapat korelasi negatif yang bermakna (p<0,05) antara IMT (r = - 0,23), persentase massa lemak tubuh (r = - 0.27) dengan kadar D-karoten plasma. Hampir tidak didapatkan korelasi (r = - 0.06) antara kadar 13-karoten dengan MDA plasma.Kesimpulan: Hampir tidak didapatkan korelasi antara kadar R-karolen plasma dengan kadar MDA plasma.

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Objective: To study plasma 0-carotene concentration, plasma MDA concentration and smoking habit male workers. The results are expected to be used as one of basis to enhance life pattern, to decrease atherosclerosis risk.

Place: PT National Gobel Bogor West Java

Method: A cross sectional study was carried out among 115 male smoking workers and non smoking workers, age 20 - 55 years old, who fulfilled the inclusion and exclusion criteria and were selected by simple random sampling using random table. The collected data consist of age, education, income, body mass index, fat mass percentage, fat intake, fiber intake, carolene intake, plasma 0-carotene and MDA concentrations.

Results: Median of plasma fl-carotene concentration among non smokers was higher [0.38 (0.09 - 1.95) µmol/L] than smokers [4.34 (0.08 -- 0.94) µmol/L]. Median of plasma MDA concentration among non smokers [0.61 (0.22 - 4.75) mmol/mL] was lower than smokers [0.68 (0.32 - 3.01) mmol/mL]. There was no significant relationship (p>0.05) between [carotene intake, plasma II-carotene concentration, plasma MDA concentration and smoking. There was significant (p<0.05) negative correlation between body mass index (r = -0.23), fat mass percentage (r = -0.27) and plasma [-carotene concentration. Almost no con-elation (r = -0.06) was found. between plasma [carotene and MDA concentrations.

Conclusions: Almost no correlation was found between plasma carotene and MDA concentrations."

"Tujuan : Mengetahui pengaruh diet rendah kalori seimbang terhadap resting energy expenditure (REE), respiratory quotient (RQ) dan profil lipid serum untuk menurunkan morbiditas dan mortalitas penderita obesitas.Tempat : Rumah Sakit Sumber Waras JakartaBahan dan cara : Penelitian merupakan suatu eksperimental pra dan pasca pemberian diet rendah kalori seimbang 1000 Kkal dengan komposisi 55 % karbohidrat, 20 % protein dan 25 % lemak selama 14 hari terhadap 38 subjek perempuan obes (19-55 tahun) yang telah memenuhi kriteria penerimaan dan penolakan. Data yang dikumpulkan meliputi data karakteristik sosial demografi, data asupan energi dan makronutrien, antropometri, REE, RQ, kadar kolesterol total, trigliserida, kolesterol LDL dan kolesterol HDL serum.Hasil : Setelah pemberian diet 1000 kkal selama 14 hari pada perempuan obes terjadi penurunan bermakna dari berat badan sebesar 2,64% (p= 0,001), penurunan IMT 2,77% (p= 0,001), penurunan persentase massa lemak tubuh 1,44% (p= 0,001), peningkatan persentase massa bebas lemak 1,36% (p= 0,001), penurunan rasio Lpi-Lpa 2,5% (p= 0,001), penurunan tidak bermakna dari REE 4,41% (p= 0,071), penurunan bermakna dari RQ 4,78% (p= 0,036), penurunan kolesterol total 6,67% (p= 0,001), penurunan trigliserida 22,92% (p= 0,001), penurunan kolesterol LDL 4,22% (p 0,027) dan penurunan kolesterol HDL serum 5,54% (p= 0,004).Simpulan : Pemberian diet rendah kalori seimbang sebesar 1000 Kkal/hari selama 14 hari terbukti dapat menurunkan secara bermakna berat badan, IMT, persentase massa lemak, meningkatkan persentase massa bebas lemak, menurunkan rasio Lpi-Lpa, RQ, kolesterol total, trigliserida, kolesterol LDL dan kolesterol HDL serum, tetapi tidak menurunkan secara bermakna REE pada perempuan obes.

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Objective : To identify the effect of balanced low calorie diet on REE, RQ and serum lipid profile of obese women in reducing morbidity and modality of obese people.

Place : Sumber Waras Hospital, Jakarta.

Materials and Methods : The study was an experimental, pre and post balanced low calorie diet (1000 Kcals/day, 55% carbohydrate, 20% protein and 25% fat) for 14 days. Thirty eight obese women, 19.-55 years old had been selected as subjects according to inclusion and exclusion criteria The data that had been collected were social and demographic characteristics, the energy and macronutrient intake, anthropometric, REE, RQ, level of total serum cholesterol, triglyceride, LDL cholesterol and HDL cholesterol.

Results : After 14 days balanced low calorie diet , there were significant reduction of body weight 2,64% (p= 0,001), body mass index 2,77% (p= 0,001), percentage of fat mass 1,44% (p= 0,001), increarnent percentage of fat free mass 1,36% (p= 0,001), reduction of waist to hip ratio 2,5% (p= 0,001), insignificant reduction of REE 4,41% (p= 0,071), significant reduction of RQ 4,78% (p= 0,036), level of total serum cholesterol 6,67% (p= 0,001), triglyceride 22,92% (p= 0,001), LDL cholesterol 4,22% (p= 0,027) and HDL cholesterol 5,54% (p= 0,004).

Conclusion : Balanced low calorie diet was had been shown to reduce body weight, body mass index, percentage of fat mass, to increase percentage of fat free mass, to reduce waist to hip ratio, RQ, level of total serum cholesterol, triglyceride, LDL cholesterol and HDL cholesterol of obese women significantly, but didn't reduce REE significantly."

"Malnutrisi merupakan salah satu masalah penting yang sering terjadi pada pasien dengan penyakit gagal jantung kronik. Perubahan neurohormonal dan reaksi inflamasi yang terjadi menyebabkan serangkaian perubahan metabolisme. Kondisi ini jika tidak diimbangi asupan nutrisi yang adekuat akan terjadi kaheksia kardiak. Adanya kaheksia kardiak terbukti meningkatkan morbiditas dan mortalitas. Laporan serial kasus ini memaparkan empat kasus pasien gagal jantung kongestif dengan etiologi penyakit jantung hipertensi disertai berbagai kondisi penyerta. Semua pasien telah mengalami kaheksia kardiak sehingga memerlukan dukungan nutrisi selama perawatan.Masalah yang turut menyertai dan berkaitan erat dengan nutrisi pada keempat pasien adalah infeksi, anemia, hipoalbuminemia, gangguan fungsi ginjal, gangguan fungsi hati, keseimbangan cairan dan elektrolit serta defisiensi mikronutrien tertentu serta nutrien spesifik. Penentuan kebutuhan energi total dihitung berdasarkan rumus Harris Benedict disesuaikan dengan faktor stres tergantung beratnya kasus dan kondisi penyerta. Pemberian protein disesuaikan dengan fungsi ginjal pada masing-masing pasien. Restriksi cairan dan natrium disesuaikan dengan keadaan retensi cairan, keadaan hiponatremia dan respon terhadap diuretik yang diberikan. Pemberian mikronutrien tertentu dan nutrien spesifik belum sepenuhnya dapat dilaksanakan pada keempat kasus.Monitoring dan evaluasi yang diberikan meliputi klinis, antropometri terutama perubahan berat badan akibat retensi cairan, toleransi asupan, keseimbangan cairan dan kapasitas fungsional. Selama pemantauan didapatkan peningkatan asupan nutrisi dengan toleransi yang baik disertai dengan perbaikan klinis, kapasitas fungsional dan kondisi metabolik. Tata laksana penyakit primer yang adekuat disertai dukungan nutrisi yang optimal menghasilkan outcome yang baik selama perawatan. Perlu penatalaksanaan nutrisi berkelanjutan untuk mempertahankan status nutrisi, membantu mengontrol progresifitas penyakit dan mengendalikan komplikasi.

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Malnutrition is the one of the most important problem which is frequently occurred in chronic heart disease patients. Neurohormonal changes and inflammatory reactions which developed will cascading metabolism shifts. If this condition is not followed by adequately nutrition intake, patients will have cardiac cachexia. The present of cardiac cachexia is evidenced in increasing the morbidity and mortality. This case series described four congestive heart failure patients which caused by hypertensive heart disease with various morbid conditions. All of the patients had cardiac cachexia and require nutritional support during the inward.

Several problems accompany and strongly relate with nutritional aspect in this cese series were infection, anemia, hypoalbuminemia, renal dysfunction, hepatic dysfunction, water and electrolyte imbalance, and specific micronutrient and nutrient deficiency. Total energy needs based on Harris Benedict formula and stress factors depend on case severity and other morbid conditions. Protein requirement adjusted to renal function for every patient. Water and sodium restriction adjusted to water retention, hyponatremia, and given diuretic responses conditions. Specific micronutrient and nutrient were not fully maintained in those four cases.

Monitoring and evaluation of this case series including clinical, antropometry especially weight changes due to water resistance, tolerance of intake, water balance and functional capacity conditions. During follow up, the improvement of nutrition intake and tolerance were developed as good as improving clinical, functional capacity, and metabolic condition. Adequate treatment for primary disease accompanied by optimal nutritional support resulted great outcome during inward. Further nutritional support are required to maintain nutritional status, help controlling disease progression, and control complications."

"Tata laksana nutrisi pada sindroma nefrotik idiopatik anak meliputi penilaian status gizi, kebutuhan nutrisi baik makronutrien, mikronutrien, maupun managemen cairan. Penyakit sindroma nefrotik anak dapat menyebabkan berbagai komplikasi yang mengganggu pertumbuhan, memperberat kerja ginjal hingga berakhir pada keadaan gagal ginjal. Untuk itu peran nutrisi menjadi sangat penting dalam menekan progresifitas penyakit dan memperbaiki kualitas hidup pasien. Keempat pasien serial kasus ini memiliki karakteristik penyakit sindroma nefrotik idiopatik, dengan rentang usia 1–8 tahun, semua kasus merupakan serangan pertama dan sedang menjalani perawatan di sebuah rumah sakit. Penghitungan kebutuhan energi menggunakan rumus Schoefield (W–H) dikalikan faktor stres, kebutuhan protein sesuai RDA dikalikan faktor stres, dan lemak tidak lebih dari 28% total kalori, dengan komposisi SAFA 8 %, PUFA 8% dan MUFA 12 %. Berdasarkan hasil analisis keempat kasus tersebut, pencapaian asupan sesuai kebutuhan energi total sudah mencapai 100 % pada kisaran hari perawatan ke–3 sampai ke–6, dengan rata–rata kepulangan pasien setelah perawatan hari ke–7. Terjadinya peningkatan tekanan darah di atas persentil rata–rata mengalami perbaikan seiring perbaikan klinis yang terjadi. Pemberian nutrisi pada pasien sindroma nefrotik anak dilakukan secara individual, menyangkut status gizi, analisis asupan, serta berbagai komplikasi yang terjadi. Monitoring dan evaluasi meliputi keadaan klinis, tanda vital, analisis asupan dan toleransi, keseimbangan cairan dan elektrolit, keadaan hipoalbuminemia, proteinuria, hematuria dan gambaran darah lengkap. Tata laksana nutrisi yang optimal harus disertai konseling dan motivasi kepada orang tua pasien ataupun pengasuh, dengan harapan dapat menekan progresifitas penyakit, meminimalisir kekambuhan, menekan komplikasi lebih lanjut, tercukupinya kebutuhan nutrisi, perbaikan status nutrisi, dan tercapainya tumbuh kembang yang optimal

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Nutritional management therapy for idiopathic nephrotic syndrome in children includes nutritional status assessment, nutritional requirement including macronutrient, micronutrient, and fluid management. Nephrotic syndrome in children could cause several complications which disrupt growth and worsening kidney function which ends to kidney failure. According to that condition, nutritional therapy has become more important to alleviate disease progression and increase quality of life of the patient. On this case series, four patients had the characteristics of idiopathic nephrotic syndrome. All of them was on the age group of 1–8 years, on the first attack, and admitted in certain hospital. Energy requirement calculation was done using Schoefield (W-H) formula multiplied by stress factor, protein requirement based on RDA multiplied by stress factor, and fat requirement was no more than 28% of total calories, with the composition of SAFA 8%, PUFA 8%, and MUFA 12%. Based on the analysis of those patients, energy intake of the patients which met 100% of total energy requirement had accomplished on day 3 to day 6 of hospitalization, and they were discharged from hospital after 7 days hospitalization. An increase in blood pressure above the median percentile improved as clinical improvement occurs. Nutritional management therapy for nephrotic syndrom in children was done individually, includes nutritional status, dietary assesment, and the possible complications. Monitoring and evaluations included clinical condition, vital signs, dietary assesment and tolerance, fluid and electrolyte balance, hypoalbuminemia condition, proteinuria, hematuria, and full blood count. Optimal nutritional management therapy should be completed with counseling and encouragment to parents or caregiver to alleviate the disease progression, prevent relaps, and avoid further complications, nutritional requirement completion, nutritional status improvement, and optimal growth and development."

"Malnutrisi dan tuberkulosis seringkali ditemukan secara bersamaan, Adanya malnutrisi pada tuberkulosis meningkatkan morbiditas dan mortalitas. Serial kasus ini bertujuan mempelajari efek terapi nutrisi pada pasien TB paru dengan malnutrisi. Pada serial kasus ini tiga orang pasien mengalami malnutrisi berat dan satu pasien mengalami malnutrisi ringan. Nutrisi tahap awal diberikan ≤ 50% kebutuhan energi total (KET) dan ditingkatkan bertahap. Pada akhir masa perawatan, nutrisi dapat mencapai 90% KET. Protein diberikan sebesar 15-20% total kalori. Konseling gizi diberikan pada akhir masa rawat pada pasien dan keluarga. Terapi nutrisi sebaiknya harus menjadi bagian integral dari terapi tuberkulosis.

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Malnutrition has been found to coexist with tuberculosis (TB). Malnutrition is associated with increased morbidity and mortality in those with TB. Objective of this case serial is to review the impact of nutritional therapy in pulmonary TB patient with malnutrition. All of four patients were malnourished and had pulmonary TB, of which 3 were severely malnourished. Initially, nutrition therapy commenced with ≤ 50% estimated energy requirement (EER) and incrementally increased to 90% EER at the end of hospitalization. Protein was given 15–20% of total calories. Bedside counseling was provided prior to discharge. Nutrition therapy should be considered as integral part of TB treatment."

"Pasien pada serial kasus ini adalah empat pasien dewasa dengan luka bakar berat, masuk perawatan dalam kondisi resusitasi. Status nutrisi sebelum sakit adalah overweight dan satu pasien normoweight. Inisiasi nutrisi enteral dilakukan 15-39,5 jam pasca kejadian. Pemberian nutrisi dimulai dari hipokalori (<20 Kkal/kgBB/hari), ditingkatkan bertahap menuju kebutuhan energi total yang dihitung berdasarkan formula Xie dengan berat badan sebelum sakit. Selama perawatan di ICU, pasien mencapai kalori sebesar 60-96% KET, protein sebesar 0,6-1,9 g/kgBB/hari, komposisi lemak dan karbohidrat berturut-turut sebesar 15-25%, dan 50-64%. Jalur pemberian nutrisi parenteral dengan central venous cathether (CVC) sedangkan enteral dengan nasogastric tube (NGT) tetes lambat secara intermiten. Mikronutrien yang diberikan berupa multivitamin antioksidan, vitamin B kompleks dan asam folat. Pemantauan terapi nutrisi meliputi tanda klinis, toleransi asupan makanan, kapasitas fungsional, imbang cairan, parameter laboratorium dan antropometri. Pada kelompok survivor diberikan edukasi nutrisi terkait penyembuhan luka dan preservasi massa otot.

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Patients in the case report were four adult patients with severe burns and admitted to the hospital under resuscitation conditions. Three patients were overweight and one was normoweight Enteral nutrition was initiated within 15–39.5 hours post injury. Nutrition administration began from hypocalory (<20 kcal/kg/day), then increased gradually to the total energy requirement using Xie formula based on the pre-illness weight. In the ICU, energy intake achieved 60-96% of total requirement, protein was 0.6 to 1.9 g/kgBW/day, fat, and carbohydrate were 15-25% and 50-64% respectively. Parenteral nutrition was given via central venous cathether while enteral nutrition was dripped intermittently. Micronutrients were given as multivitamin antioxidants, vitamin B complex, and folic acid. The survivors were given nutrition education related to wound healing and preservation of muscle mass."

"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.

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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."

"Tujuan : Mengetahui pengaruh suplementasi vitamin B6, B12 dan asam folat terhadap kadar homosistein plasma pada lansia dalam rangka mengurangi risiko terjadinya aterosklerosis.Tempat : Panti werdha Santa Anna - Jakarta.Bahan dan cara : penelitian eksperimental pra dan pasca suplementasi vitamin B6 (10 mg), B12 (400 µg) dan asam folat (1 mg) yang diberikan per oral, sekali sehari selama 6 minggu, terhadap 10 subyek lansia (60 tahun) yang telah memenuhi kriteria penerimaan dan penolakan. Data yang dikumpulkan meliputi data non nutrisi, data nutrisi, data antropametri, status vitamin B6, kadar vitamin B12 serum dan asam folat serum dan kadar homosistein plasma.Hasil : Pada pra suplementasi, diketahui prevalensi subyek dengan hiperhomosisteinemia tipe ringan sebesar 70%. Prevalensi defisiensi vitamin B6 (KA ASATE>I,40), 812 (<258 pmol/L) dan asam folat (<15 nmo/L) adalah 30%,30% dan 90%. Prevalensi defisiensi vitamin B6, B12 dan asam folat pada subyek dengan hiperhomosisteinemia adalah 14%, 43% dan 85%. Pada pasca suplementasi didapatkan perbaikan pada seluruh hasil pemeriksaan laboratorium secara bermakna (p<0,05) yaitu penurunan KA ASATE 11,68%, kenaikan kadar vitamin B12 serum 111,75%, kenaikan kadar asam folat serum 139,05% dan penurunan kadar homosistein plasma 36,68%.Kesimpulan : Suplementasi vitamin B6, B12 dan asam folat terbukti secara efektif dan elision dapat memperbaiki status vitamin dan menurunkan kadar homosistein plasma secara bermakna pada seluruh subyek penelitian.

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Objective : To identify the effect of vitamin B6, B12 and folate supplementation to plasma homocysteine concentration of elderly people in respect of minimizing atherosclerosis risks.Place :Panri werdha Santa Anna - Jakarta.Materials and Methods :Experimental study of pre and post oral supplementation of vitamin B6 (10 mg), B12 (400 }1g) and folate (1 mg), once a day for 6 weeks continuously applied to 10 elderly subjects NO years) passing through pre-defined inclusion criteria. Relevant information and data was collected through questionnaire, field observation and laboratory measurement which comprise of ages, sex, education, anthropometrics, dietary intake, food frequency amount, food habits, vitamin B6, B12 and folate status and finally plasma homocysteine concentration.Results :During pre-supplementation, 70% of subjects was classified as moderate hyperhomocysteinemia. Cut off points to define deficiency vitamin status are erytrocyte aspartate aminotransferase activity coefficient (EAST-AC) >1,40 for vitamin B6 , serum vitamin B12 and folate concentrations were <258 pmol/L and <15 nmol/L respectively. The overall prevalence of deficiencies vitamin B6, B12 and folate status were 30%, 30% and 90% respectively. The prevalence of deficiencies vitamin B6, B12 and folate status in hyperhomocysteinemia subjects were 14%, 43% and 85% respectively. During post supplementation, no more vitamins deficiencies subjects was detected. Post supplementation laboratory measurement indicate the following significant improvement (p<0,05) on EAST-AC reduction 11,68%, serum vitamin B12 concentration improvement to 111,75%, serum folate concentration improvement to 139,05% and reduction of plasma homocysteine concentration of 36,68%.Conclusion :Supplementation of vitamin B6, B12 and folate are effectively and significantly improve both vitamin status and plasma homocysteine concentration level of all subjects."

"Tujuan : Untuk mengetahui gambaran status vitamin B-12, asam folat, nutrisi dan profit lipid serum pada lanjut usia, agar dapat dimanfaatkan untuk pertimbangan pencegahan dan terapi penyakit jantung ; coroner (PJK) dan aterosklerosis.Tempat : Sepuluh puskesmas kecamatan di Jakarta Selatan,Cara : Studi cross-sectional pada lanjut usia z 60 tahun, subjek dipilih secara acak pada tingkat puskesmas. Data yang dikumpulkan meliputi sosio-demografi; pola makan; asupan energi, karbohidrat, lemak, protein, kolesterol, vitamin B-12, asam folat; kadar vitamin B-12; asam folat dan lipid serum, indeks massa tubuh (A.fl) dan rasio LPe-LPa.Hasil : Prevalensi kekurangan vitamin B-12 serum 34,6% dan kekurangan asam folat serum 34,0%. Konsentrasi vitamin B-12 serum dan asam folat serum pada pria lebih rendah dari wanita. Pada pria dan wanita vitamin B-12 serum kelompok umur z 70 tahun lebih rendah dibanding kelompok umur 60-69 tahun. Prevalensi hiperkolesterolemia dan kolesterol LDL serum yang tinggi (z 160 mg/dL) adalah, 42,6% dan 24,1%. Pada pria dan wanita kolesterol total serum pada kelompok umur z 70 tahun lebih rendah dibanding kelompok umur 60-69 tahun. Di lain pihak kolesteroI HDL serum pada pria dan wanita kelompok umur Z 70 tahun lebih tinggi dibanding kelompok umur 60-69 tahun. Rata-rata IMl' untuk pria 23,9 dan wanita 24,1 dan rata-rata rasio LPe-LPa untuk pria 0,93 dan wanita 0,85. Pada lanjut usia dengan konsentrasi vitamin B-I2 serum < 350 pg/mL berkorelasi positif dengan kolesterol HDL serum (r = 0,29; P = 0,03), tetapi tidak berkorelasi dengan kolesterol total serum, kolesterol LDL serum, rasio kolesterol total/ kolesterol HDL dan rasio kolesterol LDLlkolesterol HDL. Di lain pihak lanjut usia dengan konsentrasi vitamin B-I2 serum Z 350 mg/mL tidak berkorelasi dengan lipid serum.Kesimpulan : Melalui pendekalan faktor resiko PiK, prevalensi kekurangan vitamin B-12 dan kekurangan asam folat di Indonesia relatif tinggi dan sesuai dengan penelitan-penelitian yang telah dilakukan di negara-negara maju. Interaksi antara vitamin B-12 serum dan lipid serum belum dapat ditentukan sebagai interaksi yang linier tanpa adanya informasi mengenai homosistein serum. Kecukupan vitamin B-12 serum untuk lanjut usia sangatlah esensial untuk memperkecil terjadinya dislipidemia sebagai salah satu faktor resiko PJK.

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Objective : To determine vitamin B-l2, folic acid, anthropometric and serum lipid profiles of the Indonesian elderly which are considered to be important in the prevention and treatment of coronary atherosclerosis.

Place : Ten PHC in the district of South Jakarta.

Methods : A cross-sectional study on the elderly (z 60 year) was carried out in 10 PHCs, Subjects were drawn randomly at the PHC levels. Data collected were sosio-demography; food habits; intakes of energy, carbohydrate, fat, protein, cholesterol, vitamin B-12, and folic acid; serum vitamin B-12, serum folic acid, serum lipids; anthropometry [body mass index (BMI) and waist-hip ratio].

Results : The prevalence of biochemical vitamin B-12 and folic acid deficiencies were 34.6% and 34.0% respectively. Serum vitamin B-12 and folic acid concentrations of the elderly men were lower than those of the elderly women. Serum vitamin B-12 of both elderly men and women aged Z 70 years was lower than their younger counterparts aged 60-69 years. The prevalence of hypercholesterolemia and high serum LDL cholesterol (z 160 mg/di.) was 42.6% and 24.1% respectively. Mean serum total cholesterol of both elderly men and women aged z 70 years was lower than those aged 60-69 years old. On the other hand, serum HOL cholesterol of both elderly men and women aged z 70 years was higher than their younger counterparts aged 60-69 years. Mean BMI values were 23.9 kglm2 for the elderly men and 24,1 kglrn2 for the elderly women. Mean waist-hip ratios for the elderly men and women were 0.93 and 0.85 respectively, In the elderly subjects with low serum vitamin B-12 (< 350 pg/mL), positive correlations were found between serum vitamin B-12 and serum HDL cholesterol (r 0.29; P = 0.03), but not with any of serum total cholesterol, serum LDL cholesterol, total cholesterol/HDL cholesterol ratio, and LDLIHDL ratio. On the other hand, in the elderly subjects with normal and high serum vitamin B-12 (z 350 pglmL), there were no correlations between serum vitamin B-I2 and serum lipids.

Conclusions: Using the CHD-risk approach, the prevalence of biochemical vitamin B-12 and folic acid deficiencies of the Indonesian elderly was relatively high and comparable with existing studies in developed countries. Without information on serum homocysteine concentration, the interactions between serum vitamin B-12 and lipids were not linear. Clearly, adequacy of serum vitamin B-12 for the elderly is essential to minimize disorder of lipid metabolism as one amongst other CHD risk factors."