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"Peningkatan jumlah penderita penyakit filariasis yang terus terjadi di Kota Tangerang Selatan sejak tahun 2002 hingga tahun 2008 dan nilai Mfrate yang masih berkisar antara 1,2% - 2,4% menunjukkan bahwa derajat endemisitas filariasis cukup tinggi sehingga risiko penduduk di lokasi tersebut untuk tertular filariasis lebih besar. Penelitian ini bertujuan untuk mengetahui faktor risiko lingkungan yang berhubungan dengan kejadian filariasis. Pendekatan penelitian adalah kuantitatif dengan metode kasus kontrol dengan total 106 orang responden. Faktor lingkungan yang, diteliti adalah suhu, kelembaban, dinding rumah, plafon, penggunaan kawat kassa, keadaan ruangan, sampah, keberadaan semak, tempat perindukan nyamuk, pengetahuan, sikap, kebiasaan menggunakan obat nyamuk, kelambu dan keluar rumah saat malam hari. Hasil penelitian menunjukkan 7 variabel berhubungan dengan kejadian filariasis, yaitu dinding rumah (p=0,004; OR 6,0), plafon (p=0,000; OR 10,5), penggunaan kawat kassa (p=0,000; OR 8,55), keadaan ruangan (p=0,001; OR 9,006), sampah (p=0,023; OR 3,84), tempat perindukan nyamuk (p= 0,001; OR 5,68), dan kebiasaan keluar malam hari (p=0,033; OR 3,35). Hasil analisis multivariat didapatkan faktor yang paling dominan adalah plafon rumah, penggunaan kawat kassa, dan tempat perindukan nyamuk. Berdasarkan hasil penelitian ini disimpulkan bahwa faktor lingkungan buatan, yaitu kondisi rumah, sampah dan tempat perindukan nyamuk, serta faktor lingkungan sosial berupa kebiasaan masyarakat keluar rumah saat malam hari berhubungan dengan kejadian filariasis di Kota Tangerang Selatan. Perlu adanya kebijakan kesehatan dari Pemerintah Kota Tangerang Selatan terkait penyakit filariasis yang berkenaan dengan intervensi faktor lingkungan, terutama kondist rumah masyarakat dan sanitasi lingkungan.

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An increasing number of filariasis cases that occured in South Tangerang City since 2002 until 2008 and also the value of Mf rate between 1.2% - 2.4% indicating that the degree of endemicity of filariasis is high enough. That situation increase the risk the local population to contract filariasis. This study aim to identify the environmental risk factors associated with the occurrence of filariasis. This is a quantitative research approach with case-control design, and involved 106 respondents. Environmental factors that had been studied are the house walis, ceilings, the use of wire gauze, room conditon, garbage, the existence of a bush, mosquitoes breeding places, respondent’s knowledge, respondent’s attitudes, respondent’s habits using insect repellent, mosquito nets and go out at night.

The results showed seven variables associated with the incidence of filariasis, the wall of the house (p=0,004, OR 6,0), ceiling (p=0,000, OR 10,5), the use of wire gauze (p=0,000, OR 8,55), room condition (p=0,001; OR 9,006), garbage (p~0,023, OR 3,84), mosquitoes breeding places (p=0,001, OR 5,68), and the habit of going out at night (p=0,033; OR 3,35). The results of multivariate analysis showed that the most dominant factor is the ceiling of the house, the use of wire gauze, and mosquito breeding places.

Based on the results of this study concluded that man-made environmental factors, specifically the condition of the house, garbage and mosquito breeding places, and social environmental factors such as customs of the society to go out at night related to the occurrence of filariasis in the South Tangerang city. Government of South Tangerang City need to make a filariasis-related health policy associated with intervention to environmental factors, particularly public housing conditions and environmental sanitation. "

"Although iron is the most abundant element ¡n the universe , anemia is still the most prevalent nutritional disorders worldwide including in Indonesia. Among other approaches of combating iron deficiency anemia, iron supplementation is known to be the simplest and most effective way in improving iron status. This study is aimed to investigate the effect of iron supplementation given during menstruation as compared with weekly administration using the same dosage and number of iron tablets. The findings of this study are reported in three parts. Part I contains introduction which consists of background, problem statement and rationale, literature review, causal model, hypotheses, objectives, variables and indicators. This part supports the idea of the study. Manuscript for publication that covers main methods and findings of this study ¡s presented in part Il. The last part is appendices which comprise questionnaires, detailed methodology, detailed results, informed consent and ethical approval, references, Asia Pacific Journal of Chnical Nutrition?s guidelines for contributors, and curriculum vitae."

"Follow-up study of severely malnourished children during early chIldhood have been carried out in Bogor, Indonesia. The aim of the study is to investigate the long-term effects of severe malnutrition during early childhood on intelligence level and physical growth of school-age children. Fifty six children recovered from severe malnutrition after rehabilitation at NRDC outpatient clinic in Bogor for six months and fifty six well-nourished children matching for age, sex and some socioeconomic condition were included in the study.Weight and height measurement were conducted in 1991 when they were under-five years of age and in 1998 when they were nine to 13 years of age. Psychological test using the WISC were carried out in 1998.Intelligence level of the children suffered from severe malnutrition during early childhood were lower 11.34 1Q point compared to the children who did not Those who were rehabilitated at younger age had significantly higher 10 scores compared to those of older age before the age of 18 months. The more severe the children at admission to the clinic, the lower their IQ level. Previously malnourished group Were signifiCt1Y shorter than match control group. Only little catch-up were observed at 5fooI-ag6 among previously malnourished children. Those wto came to rehabilitation clinic at older age tend to have the better improvement on physical growth compared to those who came during infancy."

"Five Dayak ethnic groups : Iban, Tamambaloh, Kantu', Bukat and Punan are residing inside the Bentuang Karimun National Park and its vicinity. Most Dayak members are earning their life as farmers, hunters, poachers and collective of forest products either for commercial or personal purposes. They live harmoniously with their surrounding. Research on "Biodiversity of plants and the utility of landscape by communities of Dayak ethnics at Bentuang Karimun National Park and its vicinity", were carried out from November 1996 to May I997. The result had been presented in a thesis, which is composing of two subjects. First subject, concerning with "The indigenous knowledge and the landscape usage of the Dayak". This study is separated into two consecutive chapters. Data were collected by using exploration and square methods. Diversity index are obtained by using Shanon & Wiener formula 1949 (Kreb, 1989); Equation of plant community are calculated using Jaccard (Greig-Smith, 1983) and Cluster analysis is performanced by Ludwig & Reynolds formulation (1988). The result of the research shows that each ethnic group has particular characteristic as follows : a. Housing Sadap village (Dayak Iban), and Sungai Ulu' Palin ViIIage (Dayak Tamambaloh) have long and single house. The other villages such as Nanga Potan (Dayak Kantu'), Along Hovat (Dayak Bukat) and Nanga Bungan (Dayak Punan) do not have. Sadap village is the only village that has water pipe system, while other four villages do not. They get water from the river and from the rain water for drinking. At Along Hovat and Nanga Bungan village, the road has been made from concrete base, while the other three villages have not. Sungai Ulu' Palin village of the Dayak ethnic has the highest population, which. consisted of 92 families or 403 persons, while Nanga Potan village of the Dayak has the lowest, which consisted only 10 families or 45 persons. b. Home garden Based on the plant composition of the home garden at the five villages we visited that the Dayak practice different type of home garden . At Sadap village and Sungai Ulu' Palin village : the Iban and Tamambaloh prefer to grow industrial plants such as rubber Ffevea brasilliensis), while at Nanga Potan and along Hovat : Kantu' and Bukat prefer to grow fruits plants, such as jackfruit (Artocarpus heterophyllus) and durian (Dario zibethinus). However, the Punan at Nanga Bungan does not practice home garden , therefore, there is no any special plants in their garden. c. Variaton of plants at the active field Generally, at the five villages there are about 27 varieties of glutinous rice and 77 varieties of rice. Beside the main plant, they also grew the supplementary plants such as cucumber (Cucumis melo), cassava (Manihot esculenta), egg plant (Soiwnan sp.), small chili (Capsicum frutescens), "katuk" (Sauropus albicans), ginger (Zingiber officinale) and "paria" (Momordica charantia). d. Vegetation of the abandoned field. The composition of the plants at the abandoned garden has variation. The abandoned garden for 1 - 5 years were dominated by wild plants such as Themeda gigantea and Melastoma malabathricum. The abandoned garden for 5 - 10 years, were dominated by secondary plants such as Macaranga gigantea, A. trilaba, M lapadanta, and Threma orientalis. The abandoned field of more than 20 years are primarily dominated by Dipterocarpaceae. e. Cluster analysis Based on what we observed , we categorize three stages of growth such as "belta" , "trees", and "seedling" stadium on the field. There is an indication that the factor of human activities influence the plant's growth. Second subject, "Me indigenous knowledge and the utility of plant diversity of Dayak ethnic at the Bentuang Km-isms National Park and its vicinity". The purpose of the research was to study how the communities around the National Park benefing the landscape of the park. The data obtained by interviewing members of the community. a. The using of plants Categorization of plant use in five villages communities : 1. Edible plants : consisted of 129 species, 94 genus, and 42 families. 2. Housing materials : consisted of 63 species. 21 genus_ and 14 families.. And tfor agricultural tool consisted of 23 species, 13 genus, and 9 families. 3. Medicinal purposes : consisted of 55 species. 51 genus. and 34 families, 4. Ceremonials and rituals : consisted of 21 species, 19 genus, and 17 families. 5. Clothing : consisted of 7 species, 6 genus, and 5 families. 6. Utensils,rope and braid consisted of 27 species. 14 genus, and 9 families. 7. Dyes : consisted of 7 species, 7 genus, and 6 families.8. Firewood consisted of 19 species, 11 genus and 9 families9. Ornamental or decoration : consisted of 7 species, 6 genus, and 5 families.10. Poison and toxic ingredient : consisted of 4 species, 3 genus, and 2 families.b. The indigenous knowledge The indigenous knowledge of plants of the communities among the ethnics shows varies from one to another. The differences in the knowledge between those of the male and those of the female were tested using the proportional test."

"ABSTRAKTujuan penelitian adalah untuk mempelajari faktor-faktor yang berpengaruh sehingga pada pasien yang menderita penyakit Talasemia Mayor sering terjadi gangguan psikopatologis. Juga ingin diketahui secara khusus adalah bagaimana peranan orangtua dalam menimbulkan gangguan jiwa pada anaknya yang menderita talasemia. langsung terhadap timbulnya gangguan jiwa pada anaknya. Ibu memainkan peranan yang. lebih besar dalam menimbulkan gangguan jiwa anaknya. Disamping itu orang juga sangat tertekan oleh pendapatan keluarga yang tidak memadai serta keadaan anak yang dengan bertambahnya umur semakin buruk prognosisnya.Subjek penelitian meliputi 192 kasus yang terdiri dari 110 anak laki-laki dan 82 anak perempuan yang berumur antara 1-17 tahun dan datang berobat jalan pada Unit Talasemia, Bagian Ilmu Kesehatan Anak FKUI/RSUPN Cipto Mangunkusumo. Disamping itu penelitian juga dilakukan terhadap 192 pasang orangtuanya.Tempat Penelitian adalah Unit Talasemia, Bagian Ilmu Kesehatan Anak FKUI/RSUPN Cipto Mangunkusumo.Pemeriksaan dilakukan dengan pemeriksaan psikiatrik dengan berpedoman pada wawancara standar "Pedoman pembuatan laporan psikiatrik" dan kuesioner-kuesioner. Kuesioner itu adalah kuesioner yang secara khusus dirancang untuk orangtua pasien untuk mendapat data demografis dan memeriksa persepsi orangtua mengenai penyakit talasemia serta kesepakatan antara orangtua. Disamping itu, juga dipakai kuesioner SCL 90 untuk memeriksa terdapatnya kecenderungan gangguan jiwa pada orangtua.Hasil utama1. Jumlah kasus talasemia yang menderita gangguan jiwa adalah 62 orang (32.3%), ibu yang mempuyai kecenderungan gangguan jiwa adalah 73 orang (38.0%) sedangkan ayah adalah 95 orang (49.5%). Pemeriksaan klinis psikiatrik yang dilakukan pada 108 ibu menunjukkan bahwa 39 (36.1%) orang menderita gangguan jiwa sedangkan pada pemeriksaan 104 orang ayah sebanyak 35 orang (32.7%) menderita gangguan jiwa.2. Tidak terdapat hubungan antara kecenderungan gangguan jiwa pada orangtua dengan gangguan jiwa pada anaknya. Terdapat hubungan antara gangguan jiwa pada ibu dengan gangguan jiwa pada anaknya.3. Persepsi orangtua mengenai penyakit talasemia cukup realistik. Persepsi ibu mengenaikemampuan anak berhubungan secara negatif dengan gangguan jiwa pada anaknya4. Persepsi orangtua mengenai talasemia sangat dipengaruhi oleh pendapatan keluarga danumur anakKesimpulanPenyakit Talasemia Mayor merupakan stresor psikososial yang berat baik bagi anak maupun orangtuanya sehingga merupakan faktor yang menentukan timbulnya psikopatologi pada anak dan orangtuanya. Temyata bahwa orangtua tidak berperan secara;Purpose the aim is to study the influence of factors on patients suffering from Thalassemia Mayor and their parents which often causes the emergence of psychopathology. Special attention is placed upon the role of parents in developing mental disorders in their children who are thalassemics.

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ABSTRACT

Study subjects

Study subjects were taken from the population of patients who regularly visit the Thalassemia Unit of Cipto Mangunkusumo Hospital in Jakarta. The number of cases included in the study is 192 patients , consisting of 110 boys and 82 girls, aged between I - 17 years. Their parents were also included in the study

Measurements

Measurements were performed by interviews and observation. All the cases and their parents were examined using general psychiatric examination technique based on Manual for Constructing a Psychiatric Report. In addition to this examination a special questionnaire was constructed to obtain demographic data and perception of parents about their children's illness. The parents were also asked to complete a form of SCL-90 which is a self-rating questionnaire to evaluate their mental status.

Main Results

1. The number of cases who besides Thalassemia Mayor also suffer from mental disorder is 62 (32.3%). The number of fathers who have a tendency for mental disorders is 73 (38.0%), the number of mothers is 95 (49.5%), Psychiatric examination of 108 mothers showed that 39 (36.1%) suffer from mental disorder and examination of 104 fathers showed that 35 (32.7%) suffer from mental disorder

2. There was no relationship found between tendency for mental disorder of the parents and mental disorders of their children. On the contrary there was relationship found between mental disorder of the cases and mental disorder of their mothers.

3. Perception of the parents about Thalassemia Mayor was quite realistic. Perception of the

mothers about the child's ability was negatively related towards mental disorder of the children.

4. Perception of the parents about Thalassemia Mayor was influenced by income of the family and

age of the child

Conclusion

It has been proven that Thalassemia Mayor is a severe psycho-social stress causing psychopathology in thalassemics and their parents, The parents do not directly influence the emergence of mental disorder in their children. Mothers play a greater role in precipitating mental disorder in their children.;Purpose the aim is to study the influence of factors on patients suffering from Thalassemia Mayor and their parents which often causes the emergence of psychopathology. Special attention is placed upon the role of parents in developing mental disorders in their children who are thalassemics."

"Latar belakang. Spermatozoa harus mempunyai motilitas yang baik agar dapat tercapainya fertilisasi alami. Gangguan pada kelenjar assesori pria merupakan salah satu penyebab astenozoospermia, namun pemeriksaan pada kelenjar assesori pria jarang dilakukan. Kadar asam sitrat dalam plasma seminalis paling besar bila dibandingkan hasil sekresi kelenjar assesori lainnya, hal ini mendasari peneliti untuk melakukan penelitian terhadap asam sitrat dan produk utama yang dihasilkan kelenjar prostat lainnya yaitu fosfatase asam. Asam sitrat diduga berperan dalam proses viskositas, pH semen sehingga dapat mempengaruhi motilitas sperma, fosfatase asam diduga mempengaruhi pula motilitas sperma serta turut berperan dalam menjaga keseimbangan pH semen. Metodologi. Penelitian ini menggunakan desain potong lintang pada 57 sampel seminal plasma. Didapatkan 30 sampel seminal plasma kelompok motilitas normal dan 27 sampel seminal plasma kelompok astenozoospermia. Pemeriksaan pada analisa semen standar didapatkan viskositas, pH , volume, motilitas dan konsentrasi spermatozoa. Pemeriksaan kadar asam sitrat pada plasma seminalis dengan metode Flint, dan pemeriksaan aktivitas fosfatase asam pada seminal plasma menggunakan metode spektrofotometri. Hasil. Hasil perbandingan volume semen, konsentrasi sperma dan kadar asam sitrat pada sampel plasma seminalis dengan astenozoospermia lebih rendah dibandingkan sampel plasma seminalis dengan motilitas normal, sebaliknya hasil pebandingan viskositas dan aktivitas fosfatase asam pada sampel plasma seminalis dengan astenozoospermia lebih tinggi dibandingkan sampel plasma seminalis dengan motilitas normal. Hasil pemeriksaan pH pada kedua kelompok sampel menunjukkan kecenderungan karakteristik yang sama pada kedua kategori. Hasil perbandingan nilai rerata kadar asam sitrat pada semua kategori konsentrasi sperma menunjukkan kadar lebih rendah pada sampel plasma seminalis dengan astenozoospermia dibandingkan dengan kelompok motilitas normal, sebaliknya pada hasil perbandingan nilai rerata aktivitas fosfatase asam pada semua kategori konsentrasi sperma menunjukkan kadar lebih tinggi pada sampel plasma seminalis dengan astenozoospermia dibandingkan dengan kelompok motilitas normal. Kesimpulan. Kadar asam sitrat, volume dan konsentrasi dalam plasma seminalis pada sampel astenozoospermia lebih rendah dibandingkan sampel dengan motilitas normal, perbedaan ini signifikan secara statistik. Begitupun pada semua tingkat konsentrasi sperma nilai rerata kadar asam sitrat pada sampel astenozoospermia memiliki kecenderungan lebih rendah dibandingkan sampel dengan motilitas normal, perbedaan ini tidak signifikan secara spesifik. Aktivitas fosfatase asam dan viskositas pada sampel plasma seminalis dengan astenozoospermia lebih tinggi dibandingkan sampel dengan motilitas normal, perbedaan ini signifikan secara statistik, pada semua tingkat konsentrasi sperma aktivitas fosfatase asam pada plasma seminalis dengan astenozoospermia memiliki kecenderungan lebih tinggi dibandingkan dengan motilitas normal namun perbedaan ini tidak signifikan secara statistik. Penelitian ini menunjukkan kadar asam sitrat dan aktivitas fosfatase asam tidak mempengaruhi spermatogenesis.

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Background. Spermatozoa should have good motility in order to achieve a natural fertilization. Assesori male gland disorders are one of the causes astenozoospermia, but examination of the gland assesori rare Citric acid levels in the seminal plasma of the most substantial when compared to the results of other assesori gland secretions, it is the underlying researchers to conduct research on citric acid and primary products other prostate gland that is acid phosphatase. Citric acid is thought to play a role in the process viscosity, pH cement that can affect sperm motility, acid phosphatase is also thought to affect sperm motility as well as play a role in maintaining the pH balance of the semen.

Methodology. This study used a cross-sectional design of the 57 samples of seminal plasma. Obtained 30 samples of seminal plasma of normal motility group and 27 samples of seminal plasma astenozoospermia group. Examination of the standard semen analysis obtained viscosity, pH, volume, motility and concentration of spermatozoa. Examination of citric acid levels in seminal plasma by the method of Flint, and examination of acid phosphatase activity in seminal plasma using spectrophotometric method.

Result. The results of the comparison semen volume, sperm concentration and citric acid levels in seminal plasma samples with astenozoospermia lower than the seminal plasma samples with normal motility, otherwise Comparing the results of viscosity and acid phosphatase activity in seminal plasma samples with astenozoospermia higher than the seminal plasma samples with normal motility. PH probe results in both sample groups showed a trend similar characteristics in both categories. The results of comparison of the average levels of citric acid in all categories sperm concentration showed lower levels in seminal plasma samples with astenozoospermia compared with normal motility, whereas the mean value of the comparison results of acid phosphatase activity in all categories sperm concentration showed higher levels in seminal plasma samples with astenozoospermia compared with normal motility.

Conclusion. Citric acid content, volume and concentration in seminal plasma on astenozoospermia sample was lower than samples with normal motility, this difference was statistically significant. Likewise at all levels of sperm concentration of citric acid levels mean value in astenozoospermia samples have a lower propensity than samples with normal motility, this difference was not significant specifics. Acid phosphatase activity and viscosity in the seminal plasma samples with astenozoospermia higher than samples with normal motility, these differences are statistically significant, at all levels of sperm concentration of acid phosphatase activity in seminal plasma with astenozoospermia have a higher tendency than normal motility, but this difference was not statistically significant. This study showed levels of citric acid and acid phosphatase activity does not affect spermatogenesis."

"LATAR BELAKANG: Metode preparasi spermatozoa yang sering digunakan untuk reproduksi berbantu saat ini adalah metode swim-up dan density-gradient centrifugation. Namun demikian masih banyak didapatkan pertentangan mengenai metode mana yang lebih aman dan dapat menyeleksi spermatozoa dengan kualitas yang lebih baik. Pada penelitian ini dilakukan penilaian kembali pada kedua metode preparasi spermatozoa tersebut terutama dalam hal menyeleksi spermatozoa dengan tingkat integritas DNA tinggi dan apoptosis yang rendah. BAHAN DAN CARA KERJA: Sampel berjumlah 15 pasien yang menjalani preparasi spermatozoa untuk program inseminasi intra uterus di Klinik Yasmin RSCM Kencana, Jakarta. Sampel diambil sebelum dan setelah pencucian spermatozoa untuk dilakukan pemeriksaan konsentrasi dan motilitas spermatozoa menggunakan Makler®. Tingkat integritas DNA spermatozoa dinilai dengan indeks fragmentasi DNA spermatozoa (IFD) yang dilakukan dengan metode SCD. Pemeriksaan konfirmasi berupa viabilitas spermatozoa dengan eosin-Y dan analisis ekspresi protein kaspase 3 dilakukan dengan western blot yang dilanjutkan dengan analisis densitas pita kaspase 3 menggunakan ImageJ. HASIL: Penelitian ini menunjukkan penurunan tidak bermakna pada kelompok IFD > 15% dan peningkatan tidak bermakna pada kelompok IFD ≤ 15%. Ditambah pula, rerata viabilitas spermatozoa menunjukkan peningkatan tidak bermakna setelah pencucian. Aktivitas kaspase menunjukkan penurunan densitas tidak bermakna setelah dilakuan pencucian. Metode preparasi DGC dan SU dapat meningkatkan spermatozoa progresif dan viabilitas spermatozoa serta menurunkan aktivitas kaspase 3. KESIMPULAN: Metode swim-up dan density-gradient centrifugation berhasil menyeleksi spermatozoa dengan tingkat apoptosis dan fragmentasi DNA yang rendah. Metode DGC lebih baik daripada SU dalam hal penurunan aktivitas kaspase.

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BACKGROUND: The common methods for sperm preparation prior to assisted reproductive technique are swim-up (SU) and density gradient centrifugation (DGC). However, controversies regarding advantages and disadvantages of these two methods have been reported by many studies. The aim of this study was to reevaluate both methods in selecting better sperm in term of their quality, DNA integrity and apoptotic levels.

MATERIAL AND METHOD: Fifteen samples from insemination patients at Klinik Yasmin RSCM Kencana, Jakarta were used in this study. Samples were taken before and after preparation with SU and DGC. Makler® counting chamber and Eosin Y staining were used to analyze motility and viability, respectively. Sperm chromatin dispersion assay was used to determine sperm DNA integrity, while apoptotic levels was determined by Western immunoblotting.

RESULTS: This study showed no significant decrease in the group IFD> 15% and a non-significant increase in group IFD ≤ 15% after preparation with SU and DGC. Plus, the average viability of spermatozoa showed improvement after preparation with SU and DGC. Caspase activity was lower when spermatozoa was prepared with SU. DGC and SU preparation method can improve progressive motility and viability of spermatozoa and reduce the caspase activity.

CONCLUSIONS: Both swim-up and density-gradient centrifugation selected better sperm motility and viability. Furthermore. these two methods separated spermatozoa with low level of apoptotic and higher DNA integrity. DGC method is better than SU in reduce caspase activity"

"Ruang lingkup dan cara penelitian : Penggunaan kontrasepsi hormonal dapat menyebabkan beberapa efek samping, salah satunya adalah tromboemboli. Penetapan kadar F 1.2 dapat dipergunakan untuk menentukan resiko terjadinya tromboemboli karena kadar yang tinggi dari senyawa peptida ini menunjukkan adanya aktivasi sistem koagulasi.Tujuan utama penelitian ini adalah mengukur kadar F 1.2 pada akseptor implan levonorgestre yang telah menggunakannya > 4 tahun dengan menggunakan metode ELISA. Tujuan lain dari penelitian ini adalah untuk mengetahui apakah ada hubungan antara kadar F 1.2 dengan umur, lama pemakaian implan levonorgestrel dan besarnya paritas pada akseptor.Penelitian Cross Sectional ini dilakukan pada 100 akseptor yang telah memakai implan selama 4 tahun atau lebih. Subjek penelitian diambil dari Klinik Keluarga Berencana Pulogadung-Jakarta. Sebelum pengambilan darah tidak diperlukan persiapan khusus atau puasa yang dilakukan pada akseptor.Hasil dan Kesimpulan : Rentang kadar F 1.2 dari seluruh akseptor berkisar antara 0,06 - 9,69 nM. Pada 31 akseptor didapatkan kadar F 1.2 lebih tinggi dari 1,7 nM, yaitu kadar tertinggi yang didapatkan pada orang Indonesia sehat. Pada 24 akseptor dari 31 akseptor tersebut, kadar F 1.2 ternyata lebih tinggi dari 2,78 nM , yaitu kadar tertinggi yang didapatkan pada kelompok Caucasia sehat. Tujuh belas akseptor dari 24 akseptor tersebut diatas, memiliki kadar F 1.2 yang lebih tinggi dari 4,2 nM yang merupakan kadar rata-rata pada kasus tromboemboli.Hasil Spearman test, tidak didapatkan hubungan antara kadar F 1.2 terhadap umur, lama pemakaian implan levonorgestrel dan besarnya paritas. Kesimpulan pemeriksaan pada 100 akseptor implan levonorgestrei, didapatkan 24 % akseptor dengan kadar F 1.2 yang tinggi yang dapat menunjukkan adanya aktivasi sistem koagulasi. Karena hanya merupakan cross sectional studi tanpa kontrol, maka belum dapat menerangkan apakah kadar F 1.2 yang tinggi ini disebabkan karena penggunaan implan. Untuk itu masih diperlukan penelitian prospektif acak terkontrol penentuan kadar F 1.2 serta aktivitas AT III, Tidak didapatkan hubungan antara kadar F 1.2 dengan umur, lama pemakaian implan dan paritas.

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The Levels of Prothrombin Fragmenti.2. (F 1.2 ) Among Levonorgestrel Implant UsersScope and Method of Study : The use of hormonal contraceptives has some potential side effects, one of them is thromboembolism. The levels of F 1.2 can be used to determine the risk of thromboembolism because the high level of this peptide can indicates that there is an activation of coagulation system.

The main objective of this study was to find out the level of F 1.2 among the levonorgestrel implant users by mean of an ELISA method. The other objectives were to know the correlation between the levels of F 1.2 with age, duration of use the implant, and the parity of the acceptors. The study was done in 100 acceptors who had been using these implants for four years or more. The subjects were recruited from the Family Planning Clinic Pulogadung - Jakarta. No special preparation or fasting of the acceptors is needed.

Results and Conclusions : The range of F 1.2 levels of all acceptors was between 0.06 - 9.69 nM, while in 31 acceptors the levels were higher than the upper limit level previously found in healthy Indonesian subjects (1.7 nM). In 24 out of 31 acceptors, the levels of F 1.2 were higher than the upper limit level of normal value in a Caucasian population (2.78 nM).

In 17 out of 24 acceptors the levels of F 1.2 were higher than 4.2 nM, which was the mean level detected in thromboembolic cases reported previously.

Using the Spearmans test, it was evident that there was no correlation between F 1.2 levels and age, the duration of implant use, and the parity of the acceptors.

Conclusions, among 100 levonorgestrel implant acceptors, 24 % of them showed high F 1.2 levels that could indicate the activation of coagulation system. Based on these limited data which was done only through a cross sectional study without control, the high F 1.2 levels could not be interpreted as the cause by of the implant. A further prospective randomized controlled study, is need to find out the correlation between F 1.2 level and AT III is needed. No correlations were observed between F 1.2 levels and age, duration of implant use, and parity.

"

"ABSTRAKPada pasien hemodialisis (HD), banyak penelitian di negara maju membuktikan hubungan yang erat antara inflamasi, komplikasi kardiovaskular, malnutrisi, dan mortalitas yang tinggi. Inflamasi yang ditandai dengan meningkatnya IL-6 dan CRP, serta berkurangnya sitokin anti-inflamasi IL-10, mempunyai peran utama dalam terjadinya berbagai komplikasi pada pasien HD di Indonesia, terdapat perbedaan pelaksanaan HD, yaitu HD yang lebih jarang (2 kali seminggu), banyak menggunakan dialiser selulosal diasetat, proses ulang, low flux, dan tanpa air yang sangat murni, yang kesemuanya menyebabkan risiko respons inflamasi yang tinggi. Pada kenyataannya, prevalensi inflamasi dan nilai rata-rata CRP di Indonesia lebih rendah. Polimorfisme gen IL-6-174G>C dan gen IL-10-1082G>A telah dibuktikan mempengaruhi tingkat produksi IL-6 dan CRP. Perbedaan proporsi alel G, C pada IL-6-174, dan alel G, A pada IL-1082, berbagai bangsa dan ras, mungkin menjadi penyebab perbedaan di atas. Sindrom inflamasi malnutrisi (SIM) pada pasien HD berbeda dengan malnutrisi pada populasi. Pada SIM, faktor inflamasi, uremia dan katabolisme protein lebih berperan. Hal ini memerlukan cara penilaian status malnutrisi yang berbeda. Penelitian ini dilakukan untuk mendapatkan frekuensi polimorfisme gen IL-6-174 dan IL-10-1082, mengetahui faktor yang berperan dalam SIM, mengetahui perbedaan prevalensi inflamasi pada pasien dengan malnutrisi dan sebagai validitas penilaian SGA.Telah dilakukan penelitian pada pasien yang menjalani HD 2 kali seminggu, 5 jam per kali HD, tanpa komplikasi penyakit lainnya, dan semua memakai dialiser selulosa diasetat yang diproses ulang. Dari 64 pasien yang diperiksa, didapatkan gen IL-6-74GG 95,31%, CC 3,13% dan GC 1,56%. Gen IL-1082AA 89,06%, GA 10,94%, dan GG tidak didapatkan. Proporsi alel ini hampir sama seperti yang didapatkan di Korea, Jepang dan Cina, berbeda dengan yang didapat di AS, ras Kaukasia, Amerika-Afrika, Hispanik dan Eropa (Kaukasia). Selain perbedaan pada proporsi gen, kami mendapatkan konsenlrasi CRP (6,23±5,57 mg/L), frekuensi malnutrisi (24,7%), dan skor MIS (6,7) yang lebih rendah dibanding dengan data dari AS dan Eropa. Mengingat sedikitnya alel C pada gen IL-6-174 dan alel G pada gen IL-10-1082, analisis statistik yang dilakukan tidak dapat memperlihatkan pengaruh perbedaan alel terhadap manifestasi klinik. Inflarnasi kronik mempengaruhi terjadinya malnutrisi (PR 3,03; 1K 95% 1,53-6,06; P = 0,012). Penilaian dengan skala SGA berkorelasi balk dengan parameter antropometri (IMT, LLA, LOLA, HGS), dan albumin serum. Albumin serum sebagai parameter inflamasi kronik berkorelasi balk dengan parameter nutrisi yang lain, sedangkan CRP tidak. Didapatkan kesan yang kuat bahwa pada pasien HD, gen IL-174GG bersifat protektif, sedangkan gen IL-1082AA tidak begitu berperan. Selain itu dibuktikan adanya pengaruh inflamasi terhadap malnutrisi dan SGA terbukti merupakan penilaian sindrom malnutrisi inflamasi yang cukup baik.

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ABSTRACT

Many studies on HD patients in developed countries have conferred strong evidence of closed correlation between inflammation, cardiovascular complication and high mortality rates. Inflammation, indicated by high levels of CRP and IL-6, has a major role in initiating and sustaining complications. Adapting to high cost, HD in Indonesia is conducted in a little different ways. Patients are dialyzed twice a week, 5 hours each, using reprocessed cellulose/diacetate membrane dialyzer, and without ultrapure water. All of these contribute to a high risk of inflammation, but in fact the prevalence of inflammation in Indonesia is relatively low. IL-6-174G>C and IL-10-1082G>A polymorphic gene have been proven to influence the production of IL-6 and CRP. The difference in the proportion of allele G, C in IL-6-174, allele G, A in IL-1082 in a variety of people's races might cause the difference in the prevalence and the level of inflammation. Malnutrition inflammation syndrome (MIS) on HD patients is different from malnutrition in general population. In MIS, the inflammatory factors, uremia, and protein catabolism of protein are more dominant. These matters probably require a different assessment method of malnutrition status. The purpose of this study was to obtain the frequency of polymorphic gene IL-6-174 and IL-10-1082 to find out the prominent factors in MIS, and to find out the difference in the inflammation prevalence in patients with malnutrition and to serve as validity of SGA assessment.

A study on patients who were on hemodialysis twice a week, 5 hours each session has been conducted. The subjects had no other co-morbidities and all of them used reprocessed diasetat cellulose dialyzers. Out of 64 patients examined, IL-6-174GG was obtained 95.31%, CC 3.13% and GC 1.56%, IL-1082AA 89.06%, GA 10.94%, but absence of GG genotype. The proportion of these alleles was almost similar to that obtained in Korea, Japan and China, but it was different from that obtained in the US for the Caucasian race, African Americans, Hispanic people, and the Caucasian people in Europe_ Besides the difference in gene proportion, it was obtained that CRP (6.23±5.57 mg/L), malnutrition (24.7%), and malnutrition inflammation score (6.7) were lower compared with the data from Europe and the United States. Considering the scanty amount of allele C in IL-6-174 gene and G allele in IL-10-1082 gene, based on the statistic analysis performed it did not revealed the influence of the difference in allele on the clinical manifestation. It was found that chronic inflammation influenced the occurrence of malnutrition (PR 3.03; CI 95% 1.53-6.06; P = 0,012). The scoring by the SGA scales correlated well with the anthropometric parameters (body mass indes, mid arm circumtance, midarm muscle circumference, hand grip strength and serum albumin. A very resolute impression was obtained in HD patients that IL-6-174GG gene was protective in nature whereas IL-10-1082 AA gene had a less considerable role. In addition to that, it was proven that there was influence of information on the occurence of malnutrition and SGA consitutes a good enough assessment for malnutrition inflammation syndrome."