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Abstrak :
ABSTRAK
Obesitas merupakan penyakit tidak menular dimana lemak berlebih mengarah pada gangguan metabolik, penyakit kardiovaskular, dan perubahan abnormal biomekanik tubuh. Orang dengan obesitas memiliki kekuatan otot 6-10% lebih rendah dari orang dengan berat badan normal. Penurunan kekuatan otot sejalan dengan penurunan ruang gerak sendi, kontrol postural, dan kecepatan gerak yang dapat menyebabkan seseorang mengalami kendala dalam melakukan aktivitas fisik. Tujuan dari penelitian ini yaitu untuk mengetahui pengaruh Hatha Yoga selama 12 minggu terhadap persentase lemak, lingkar pinggang, kekuatan otot genggam, fleksibilitas, kesiembangan, dan kecepatan gerak pada orang dewasa dengan overweightdan obesitas.

Tujuh puluh dua orang dengan overweightdan obesitas, berusia 18-60 tahun, dirandomisasi ke dalam kelompok perlakuan (n=36) dan kelompok kontrol (n=36). Persentase lemak, lingkar pinggang, kekuatan otot genggam, fleksibilitas, keseimbangan, dan kecepatan gerak merupakan variabel yang diukur. Pemeriksaan yang sudah terstandarisasi dilakukan sebelum dan sesudah intervensi.

Terdapat perbedaan signifikan di antara kedua kelompok (semua p <0,001). Persentase lemak dan lingkar pinggang memberikan hasil dengan arah berlawanan. Kekuatan otot genggam, fleksibilitas, keseimbangan, dan kecepatan gerak membaik pada kelompok perlakuan. Sementara itu, fleksibilitas dan kecepatan gerak menurun secara siginifikan pada kelompok kontrol. Tidak dilaporkan adanya efek samping serius pada kedua kelompok.

Secara umum, program latihan Hatha yoga selama 12 minggu terbukti efektif dalam memperbaiki komponen antropometri dan fungsional pada orang dengan overweight dan obesitas. Penemuan ini memiliki makna implikasi klinis yang penting karena yoga dapat diimplementasikan sebagai salah satu alternatif aktivitas fisik.

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ABSTRACT
Obesity is a non-communicable disease in which excess body fat may lead to metabolic disorder, cardiovascular disease, and abnormal mechanics in body movements. Obese people have 6-10% less muscle-strength than those in the normal weight range. That decline in muscle-strength, along with similar declines in the range of movement of major joints, in postural control, and in the speed of movement may result in impaired ability to engage in physical activity. The purpose of this study is to investigate the effects on obese people of a 12-week Hatha yoga intervention--specifically focused on fat percentage, waist circumference, muscle strength, flexibility, balance, and gait speed.

Seventy-two overweight and obese people, aged 18-60 years, were randomly allocated to the yoga group (n=36) or to a "no exercise" control group (n=36). The fat percentage, waist circumference, handgrip strength, flexibility, balance, and gait speed were defined as outcome variables. Standardized tests were administered at baseline and post intervention.

There were significant differences between the two groups in regard to the outcome variables (all p <0.001). Predictably, fat percentage and waist circumference had moved in the other direction. Handgrip strength, flexibility, balance, and gait speed had significantly improved in the yoga group. Meanwhile, flexibility and gait speed significantly declined in the control group. No serious adverse events were reported in either group.

Overall, the 12-week Hatha yoga program was found to be effective in improving functional and anthropometric variables in obese people. The findings have important clinical implications since yoga may well serve as an alternative form of physical activity.

Abstrak :
ABSTRAK
Penelitian ini bertujuan untuk mengetahui pengaruh pemberian makanan tinggi lemak yang dikonsumsi bersamaan dengan teh putih atau teh hijau terhadap kadar trigliserida serum pasca prandial. Penelitian ini menggunakan desain uji klinis, alokasi acak, cross over, dan tersamar ganda. Sebanyak 23 subjek hipertrigliseridemia borderline mengikuti penelitian dan mendapatkan dua kali perlakuan, yaitu mengonsumsi makanan tinggi lemak bersamaan dengan 7,5 gram teh putih atau teh hijau. Perlakuan dilakukan dalam dua hari dengan periode wash out 3 hari. Data yang dikumpulkan adalah karakteristik subjek, asupan energi dan lemak, serta kadar trigliserida serum puasa dan pasca prandial. Hasil penelitian menunjukkan bahwa rerata usia subjek adalah 32,96 8,04 tahun dengan rerata IMT sebesar 26,23 3,62 kg/m2 yang termasuk dalam kategori overweight dan obesitas 1. Kadar trigliserida puasa tidak menunjukkan perbedaan bermakna antara kedua kelompok perlakuan p=0,079 . Hasil dari pengukuran kadar trigliserida serum pasca prandial pada kelompok teh putih lebih rendah secara bermakna 231,43 76,49 mg/dL, p=0.024 . Dari penelitian dapat disimpulkan bahwa peningkatan kadar trigliserida serum pasca prandial setelah mengonsumsi makanan tinggi lemak bersama dengan meminum 7,5 gram teh putih lebih kecil dibandingkan meminum teh hijau. Kata kunci : hipertrigliseridemia borderline; teh putih; teh hijau; makanan tinggi lemak; trigliserida serum pasca prandial

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ABSTRACT
AbstractThe increase in postprandial triglycerides can be one risk factor for cardiovascular disease.The aim of this research is to evaluate the effect of consumption high fat diet with white tea or green tea on postprandial serum triglyceride level. This study was a clinical trial, random allocation, cross over, and double blind. Twenty three hypertriglyceridemia borderline subjects completed this study. Each subject got twice treatment, which are consumption high fat diet with white tea or green tea. This treatment held in two days with three days wash out period. Data obtained include subject characteristics, dietary assessment of energy and fat intake, fasting and postprandial serum triglyceride levels. The mean age of subject is 32,96 8,04 years with a mean BMI of subject is 26,23 3,62 kg m2, categorized in overweight and obese. Fasting serum triglyceride level didn rsquo t show significantly different p 0,079 . The result from post prandial serum triglyceride levels from white tea group were significantly lower 231,43 76,49 mg dL, p 0,024 . This study suggest that the increase of post prandial serum triglyceride levels after consumed high fat diet and white tea were lower than green tea. Keywords green tea high fat diet hypertriglyseridemia borderline postprandial serum triglyceride level white tea

Abstrak :
Prevalensi kelebihan berat badan dan obesitas di dunia meningkat dalam tiga dekade terakhir. Pada usia muda, lebih banyak laki-laki yang mengalami kelebihan berat badan daripada wanita. High-Intensity Interval Training adalah alternatif latihan fisik yang membutuhkan komitmen waktu lebih singkat. Pada penelitian ini dilakukan modifikasi protokol untuk mengetahui efektivitas latihan dalam memperbaiki komposisi tubuh dan kebugaran kardiorespirasi serta tingkat keamanan dan kesenangan yang ditimbulkan pada laki-laki dewasa muda dengan kelebihan berat badan. Penelitian ini memiliki desain eksperimental dengan uji pre-post. Subyek adalah laki-laki dengan berat badan berlebih sesuai klasifikasi WHO berusia 18-30 tahun yang sehat dan tidak terlatih. Durasi intervensi 12 minggu dengan jumlah latihan 3 kali per minggu. Dalam satu set, subyek melakukan 5 gerakan (lari lurus, zigzag, dan kotak serta jumping jackdan burpees) dalam waktu masing-masing 8 detik. Waktu istirahat aktif antar gerakan 25 detik dan antar set 2 menit. Jumlah set ditingkatkan per minggu dari 3 hingga 14 set. Hasil penelitian menunjukkan penurunan persentase lemak, lemak viseral, lingkar pinggang namun tidak bermakna. Indeks Massa Tubuh meningkat tidak bermakna dan massa otot meningkat bermakna {p-value 0,03; CI -1,7 (-3,21 – [- 0,19]}. VO2max meningkat namun tidak bermakna. Terdapat laporan 3 insiden yang digolongkan sebagai cedera musculoskeletal ringan dan intoleransi latihan. Rerata skor PACES adalah 83,79 ± 8,14 dengan tren skor yang menurun seiring peningkatan jumlah set. Kesimpulannya, High-Intensity Interval Training efektif dalam memperbaiki komposisi tubuh dan kebugaran kardiorespirasi pada laki-laki dewasa muda dan overweight, aman, dan menyenangkan. ......Worldwide prevalence of overweight and obesity is increasing in the last three decades. Prevalence overweight in young males is higher than females at the same age. High-intensity interval training is an alternative of exercise which need less time commitment. We modify the protocol to identify the its effect on body composition and cardiorespiratory fitness, its safety and enjoyment in overweight young males. This is an experimental study with pre-post assessment. Subjects are healthy untrained male aged 18 – 30 years old with overweight according to WHO classification. Duration of intervention is 12 weeks, 3 times per week. During one set, the subjects perform 5 movements (straight running, zig zag running, squared running, jumping jack, burpees) in 8 seconds interval, active recovery 25 seconds between movements and 2 minutes between sets. The number of sets is increased weekly from 3 to 14 sets. The fat percentage, visceral fat, and waist circumference are decreased after intervention. Body mass index is increased and muscle mass is increased significantly (p-value 0,03; CI -1,7 (-3,21 – (- 0,19)) after intervention. VO2max is increased but not significant. There are 3 reports of minor musculoskeletal injuries and exercise intolerance, all categorized as mild injuries. The average PACES score is 83,79 ± 8,14 and the score tends to decrease with weekly set increments. High-Intensity Interval Training is effective to improve body composition and cardiorespiratory fitness in overweight young males. It is also safe and provide enjoyment.

Abstrak :
Latar Belakang: Kanker nasofaring (KNF) adalah keganasan yang terjadi pada epitel mukosa daerah nasofaring dengan angka kejadian di dunia sekitar 1,2 per 100.000 penduduk. Perkembangan mekanisme penanda molekuler yang berhubungan dengan proliferasi, apoptosis, dan invasi tumor yaitu Ki-67 dan p16, dapat memberikan indikasi tentang tingkat proliferasi sel dan status penghambatan siklus sel. Metode: Penelitian ini menggunakan disain kohort retrospektif dengan subjek pasien KNF stadium local lanjut yang berobat di RSCM pada periode 2015-2020. Penelusuran data klinis dilakukan bersamaan dengan pewarnaan imunohistokimia p16 dan Ki-67 menggunakan antibodi monoklonal. Ekspresi dihitung secara manual menggunakan piranti imageJ. Analisis hubungan p16 dan Ki-67 terhadap progression-free survival (PFS) 3 tahun menggunakan kurva Kaplan Meier dan uji log rank dengan batas kemaknaan p<0,05. Hasil: Angka PFS 3 tahun pada subjek sebesar 44% dengan median 29 bulan. Ekspresi p16-negatif dideteksi pada 56 (56,0%) sampel, dan peningkatan ekspresi Ki-67 pada 53 (53,0%) sampel. Kurva Kaplan-Meier menunjukkan PFS 3 tahun untuk p16-negatif yaitu 8,9% (p<0,0001). PFS untuk peningkatan ekspresi Ki-67 11,3% (p<0,0001). Simpulan: Penelitian ini menunjukkan pasien KNF stadium ocal lanjut dengan peningkatan ekspresi Ki-67 dan p16-negatif memiliki progression-free survival 3 tahun yang lebih rendah. ......Background: Nasopharyngeal cancer (NPC) is a malignancy that occurs in the mucosal epithelium of the nasopharyngeal area with a worldwide incidence of around 1.2 per 100,000 population. To date, the development of molecular marker mechanisms, including Ki-67 and p16 which are related to proliferation, apoptosis, and tumor invasion can indicate the level of cell proliferation and status of cell cycle inhibition. Methods: A retrospective cohort study was conducted in subjects of NPC patients at RSCM from 2015 until 2020. Clinical data was collected from hospital registries, and immunohistochemistry staining of Ki-67 and p16 was perfomed by using monoclonal antibody. The expression of Ki-67 and p16 were calculated manually using the imageJ tool. Association of Ki-67 and p16 expression with 3 years- progression-free survival (PFS) was analyzed using Kaplan Meier with log-rank test p<0.05. Results: The 3-years PFS in subjects was 44% with a median of 29 months. p16-negative expression was detected in 56 (56,0%) samples, and Ki-67 overexpression in 53 (53,0%) samples. The Kaplan-Meier curve shown the 3-years PFS for p16-negative was 8,9 (p<0,0001). PFS for Ki-67 overexpression was 11,3%, (p<0,0001). Conclusion: This study shows that locally advanced NPC patients with Ki-67 overexpression and p16-negative have lower 3-year progression-free survival.

Abstrak :
Uji klinis acak tersamar ganda paralel ini merupakan penelitian pendahuluan, bertujuan mengetahui pengaruh suplementasi serat larut dan diet rendah kalori seimbang (DRKS) selama 4 minggu terhadap kadar kolesterol low-density lipoprotein (LDL) serum pada obes I usia 30−50 tahun. Sejumlah 31 subyek dipilih dengan kriteria tertentu dan dibagi menjadi dua kelompok dengan randomisasi blok, 15 orang kelompok perlakuan (KP) dan 16 orang kelompok kontrol (KK). Subyek KP mendapat serat larut psyllium husk (PH) 8,4 g/hari dan DRKS 1200 kkal/hari, sedangkan subyek KK mendapat plasebo dan DRKS 1200 kkal/hari. Data terdiri atas usia, indeks massa tubuh (IMT), asupan zat gizi, serta kadar kolesterol LDL serum. Pemeriksaan kolesterol LDL dilakukan pada awal dan akhir penelitian. Analisis data menggunakan uji t tidak berpasangan dan Mann-Whitney, batas kemaknaan 5%. Karakteristik data dasar dan sebaran subyek kedua kelompok sebanding. Analisis lengkap dilakukan pada 28 subyek (KP dan KK masing-masing 14 subyek). Suplementasi ditoleransi baik dan tidak ditemukan efek samping serius. Median usia subyek KP dan KK berturut-turut 35,0 (30−45) tahun dan 34,50 (30−48) tahun serta rerata IMT 28,0 ± 1,1 kg/m2 dan 27,2 ± 1,4 kg/m2. Rerata kadar kolesterol LDL serum awal KP 137,0 ± 37,0 mg/dL dan KK 134,4 ± 29,1 mg/dL. Defisit energi KP lebih rendah tidak signifikan (p = 0,62) dibandingkan KK, berturut-turut -282,0 ± 482,6 kkal/hari dan -331,8 ± 578,3 kkal/hari. Persentase asupan energi terhadap anjuran KP (94,2 ± 18,5%) lebih tinggi signifikan (p = 0,02) daripada KK (85,4 ± 22,9%). Asupan karbohidrat (KH) total KP (613,1 ± 134,5 kkal/hari) lebih tinggi signifikan (p = 0,02) dibandingkan KK (545,4 ± 161,1 kkal/hari). Asupan protein, lemak total, dan kolesterol KP dan KK sesuai rekomendasi NCEP-ATP III. Pada kedua kelompok, asupan asam lemak jenuh cenderung tinggi, tetapi asupan asam lemak tak jenuh tunggal dan jamak rendah. Asupan serat subyek KP 17,2 ± 2,8 g/hari dan KK 8,6 (5,2−15,2) g/hari. Dengan suplementasi PH tidak tercapai rekomendasi asupan serat. Persentase asupan KH sederhana terhadap energi total KP 11,5±5,4% lebih tinggi signifikan (p = 0,00) dibandingkan KK 6,0 (1,2524,2)%. Penurunan kadar kolesterol LDL serum KP -2,1 ± 16,2 mg/dL lebih sedikit tidak signifikan (p = 0,15) dibandingkan pada KK -10,9 ± 15,3 mg/dL. Penelitian ini belum dapat membuktikan suplementasi PH 8,4 g/hari dan DRKS 1200 kkal/hari selama 4 minggu lebih baik dalam menurunkan kadar kolesterol LDL serum dibandingkan plasebo pada subyek obes I. ...... This parallel double blind randomized clinical trial is a preliminary study that aims to investigate the effect of soluble fiber supplementation 8.4 g/day and lowcalorie balanced diet (LCBD) for 4 weeks on serum low-density lipoprotein (LDL) cholesterol level in obese I, aged 30−50 years old. A total of 31 subjects were selected using certain criteria and randomly allocated to one of two groups using block randomization; 15 subjects for treatment (T) group and 16 subjects for control (C) group, respectively. The T group received psyllium husk (PH) 8.4 g/day and LCBD 1200 kcal/day, and the C group received placebo and LCBD 1200 kcal/day. Data include age, body mass index (BMI), intake of energy, macronutrient, and fiber, as well as serum LDL cholesterol level. Serum LDL cholesterol level was examined before and after treatment. Statistical analyses include independent t-test and Mann-Whitney with significance level of 5%. Subjects characteristics of the two groups at baseline was not statistically different. Twenty eight subjects (14 subjects in each group) completed the intervention. Supplementation was well tolerated and there were no serious adverse events. The mean age in T and C group was 35.0 (30.0−45.0) and 34.5 (30.0−48.0) years, respectively, and BMI was 28.0 ± 1.1 and 27.2 ± 1.4 kg/m2, respectively. The pretreatment serum LDL cholesterol level in T and C group was 137.0 ± 37.0 and 134.4 ± 29.1 mg/dL, respectively. Energy deficit in T group was insignificantly lower (p = 0.62) than in C group; -282.0 ± 482.6 and -331.8 ± 578.3 kcal/day, respectively. Percentage of energy intake to recommendation in T group (94.2 ± 18.5%) was significantly higher (p = 0.02) than that in C group (85.4 ± 22.9%). Total carbohydrate (CHO) intake in T group (613.1 ± 134.5 kcal/day) was significantly higher (p = 0.02) than in C group (545.4 ± 161.1 kcal/day). Total protein, fat, and cholesterol intake were similar to the NCEP-ATP III recommendation in both groups. Intake of SAFA was higher than recommended, meanwhile PUFA and MUFA intake were lower than those recommended in both groups. Dietary fiber intake in T and C group was 17.2 ± 2.8 and 8.6 (5.2−15.2) g/day, respectively. During the intervention, PH supplementation did not meet the recommendation. Percentage of simple CHO to total energy in T group 11.5±5.4% was significantly higher (p = 0.00) than in C group 6.0 (1.2524.2)%. PH supplementation decreased serum LDL cholesterol level (-2.1 ± 16.2 mg/dL) lower than placebo (-10.9 ± 15.3 mg/dL), but not significant different (p = 0.15). This study shows that PH supplementation 8.4 g/day in combination with LCBD 1200 kcal/day for 4 weeks in obese I aged 30−50 years old is not proven to decrease the serum LDL cholesterol level.

Abstrak :
Latar Belakang. Obesitas merupakan faktor risiko luaran buruk pada pasien COVID-19. Sampai saat ini studi penilaian hubungan parameter obesitas berupa nilai lemak viseral, lingkar pinggang (LP), indeks massa tubuh (IMT), dan persentase lemak tubuh secara bersamaan dengan luaran COVID-19 menggunakan metode sederhana berupa bioimpedance analyzer (BIA) masih terbatas. Keempat variabel tersebut akan dinilai kemampuannya untuk memprediksi luaran buruk selama perawatan pasien COVID-19. Metode. Penelitian ini merupakan kohort prospektif dari 261 pasien COVID-19 ringan-sedang di RSUPN Cipto Mangunkusumo rawat inap sejak Desember 2020 hingga Maret 2021. Pasien dilakukan pemeriksaan BIA, LP, dan IMT saat admisi. Dilakukan analisis multivariat regresi logistik untuk menilai kemampuan nilai lemak viseral, persentase massa tubuh, IMT dan LP untuk memprediksi luaran buruk komposit yang mencakup ARDS dan mortalitas. Hasil. Didapatkan median nilai lemak viseral 10 (setara 100 cm2 ), lingkar pinggang 93 cm, IMT 26,1 kg/m2 , dan persentase lemak tubuh 31,5%. Berdasarkan multivariat regresi logistik, lingkar pinggang secara statistik bermakna sebagai faktor yang berpengaruh terhadap luaran buruk pada pasien COVID-19 [RR 1,04 (IK 95% 1,01-1,08)] bersama dengan derajat COVID-19 [RR 4,3 (IK 95% 1,9- 9,9)], skor NEWS [RR 5,8 (IK 95% 1,1-31)] saat admisi, dan komorbiditas [RR 2,7 (IK 95% 1,1-6,3)]. Kesimpulan. Luaran buruk COVID-19 selama perawatan pasien COVID-19 terkonfirmasi dapat dipengaruhi oleh lingkar pinggang. ......Background. Obesity is a risk factor for adverse outcomes in COVID-19 patients. Until now, studies on assessing the relationship between obesity parameters in the form of visceral fat, waist circumference (WC), body mass index (BMI), and body fat percentage simultaneously with COVID-19 outcomes using a simple method such as bioimpedance analyzer (BIA) are still limited. The four variables will be assessed for their ability to predict adverse outcomes during the treatment of COVID-19 patients. Method. This study is a prospective cohort of 261 mild-moderate COVID-19 subjects at Cipto Mangunkusumo General Hospital who were hospitalized from December 2020 to March 2021. Patients underwent BIA, WC, and BMI examinations upon admission. Multivariate logistic regression analysis was performed to assess the ability of visceral fat, body mass percentage, BMI, and WC to predict poor composite outcomes, including ARDS and mortality. Results. The median value of visceral fat was 10 (equivalent to 100 cm2 ), WC was 93 cm, BMI was 26.1 kg/m2 , and body fat percentage was 31.5%. Based on multivariate logistic regression, WC was statistically significant as a factor influencing poor outcomes in COVID-19 patients [RR 1.04 (95% CI 1.01-1.08)] along with COVID-19 degree of severity [RR 4.3 (95% CI 1.9-9.9)], NEWS score [RR 5.8 (95% CI 1.1-31)] at admission, and comorbidities [RR 2.7 (95% CI 1.1) - 6.3)]. Conclusion. During the hospitalization of confirmed COVID-19 patients, poor outcomes can be affected by waist circumference.