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"ABSTRACTThe social impact of the crisis in Indonesia, both monetary and natural disaster had been investigated by some studies. There is empirical evidence at national level that suggests the crisis impact is very heterogeneous both between urban and rural areas and across regions. It is also found that there is little connection between initial poverty levels and the extent to which an area had been hit by the crisis. The main objective of this study was to investigate the influence of the recent economic crisis and the benefit of the Social Safety Net Program for the nutritional status of under-five children during the economic crisis in selected poor areas of Indonesia. A cross sectional study to get information on the nutritional status of children and its determinants in urban poor area of Jakarta, and rural areas of Banggai in Central Sulawesi, and Alor-Rote in East Nusa Tenggara was followed by another cross sectional study in one selected poor urban area of Cilincing sub-district, Jakarta to see the changes of key determinant(s) of the under-five children's nutritional status after receiving the Social Safety Net intervention program for 1 year period. Two-stage cluster sampling was used to get 1078 households with under-five children in the urban poor area of Jakarta, and 262 and 631 households with under-five children each for the rural areas of Banggai and Alor-Rote, respectively as the subjects of the cross-sectional study-1; and 587 households with under-five children for the cross sectional study-2 in poor urban area of Cilincing sub-district. For both studies, general socio-demographic characteristics, socio-economic, health and nutritional status, and child feeding practices data were collected through interview and observation methods using structured questionnaires. Anthropometrical assessments (of weight, stature, and arm-circumference) were done both for children and their mothers in both studies. Hemoglobin assessment was done for sub-samples of approximately 50% of the total under-five children in both studies. Quality control procedures were performed during the course of the study. Data collection for both studies was performed from January 1999 to January 2001. It revealed that 34% of fathers in the study area of Jakarta had finished junior high school and even less for mothers (22%). More than 70% of the fathers had no regular income and 7% of the sample households had both the fathers and mothers work regularly. About 42 % of the sample households was classified as having sufficient purchasing power and less that 60% of sample households was classified as having appropriate luxury goods (mostly of electronic goods). For the study area in Banggai, 23% of fathers had finished junior high school and even only 10% for mothers. Approximately 14% of the fathers had no regular income and 24% of the sample households was classified as having appropriate employment status. About 45% of the sample households was classified as having sufficient food production/purchasing power in this study and less than 50% of the sample households was classified as having appropriate luxury goods (mostly of cultivated land). For the study area in Alor-Rote, 23% of fathers had finished junior high school and even only 10.9% for mothers. Approximately 21% of the fathers had no regular income and 47% of the sample households had both the fathers and mothers work regularly. About 48% of the sample households was classified as having sufficient food production/ purchasing power in this study and 26% of sample household was classified as having appropriate luxury goods (mostly of cultivated land). Besides having a high severity of anemia (>40%), under-five children in the urban poor area of Jakarta had a very high severity of wasting (>15%) as compared to the medium severity of stunting condition (20-29%). Similar findings were found for the rural area of Banggai. Different findings for the rural area of Alor-Rote were only for its very high severity in stunting condition (>40%). By multivariate and path analyses, it was shown that Jakarta as the study site contributed significantly to the variation of wasting indicator (WHZ value) as the recent-type of malnutrition, and Alor-Rote as the study site contributed significantly to the variation of stunting indicator (HAZ value) as the longterm-type of malnutrition. For hemoglobin value, both Jakarta and Alor-Rote as the study sites contributed to its variation. High prevalence of infectious diseases in all study areas were significantly related to the higher prevalence of wasting in the study areas of Jakarta and Banggai, and also significantly related to the higher prevalence of stunting and anemia in the study area of Alor-Rote. For Jakarta, besides infectious diseases, BMI status of mothers and the possession of motorcycle used for income earning were also significantly related to the prevalence of wasting. On the other hand, for Alor-Rote, besides infectious diseases, possession of luxury goods (access to electricity, possession of transportation facility and electronic goods), environmental sanitation (housing conditions), maternal nutritional knowledge and access to complete immunization were also significantly related to the prevalence of stunting. And, infectious diseases and households' employment status contributed to the variation of stunting (HAZ value). Furthermore, for anemia, access to health services (for complete immunization) was the only key determinant which contributed significantly to the variation of hemoglobin value in Jakarta. For Alor-Rote, besides infectious diseases, formal education of the parents, employment status (especially working mothers), environmental sanitation (especially access to safe drinking water), maternal nutritional knowledge and access to health services were also significantly associated with the prevalence of anemia. And, infectious diseases, environmental sanitation, access to health services and households' employment status contributed significantly to the variation of hemoglobin value in Alor-Rote. The Social Safety Net Intervention Program in the urban poor area of Cilincing sub-district, Jakarta resulted in significant improvement in the prevalence of wasting and anemia among under-five children but not for the prevalence of stunting. It was also found that maternal and childcare, access to health services and hemoglobin were still retained as determinants of child malnutrition besides households' employment status and variety of food intake. There is a need to improve the nutritional and health status of under-five children and their mothers through the existing health care system providing basic health services and improving the capacity of health staffs across Indonesia as part of the decentralization process. Besides, the private sector and communities may support the local government in the form of informal Social Safety Net intervention programs. The significant association found between mother's BMI and wasting status of their under-five children found in this study can be used to prioritize the appropriate type of intervention needed by the poor households. Furthermore, since anemia was highly prevalent, besides iron supplementation, chronic diseases such as tuberculosis and malaria, and the prevalence of thalasemic-trait should also be considered. Further operational and academic research in the area of health and nutrition are needed to be able to construct a model that provides indicators used to predict the nutritional condition in each community setting across Indonesia during any crisis. "

"ABSTRAKTujuan: Mengetahui status metabolisme penderita SHD rawat inap di rumah sakit, dan memperoleh rumus untuk menentukan kebutuhan energi yang sesuai dengan status metabolisme penderita.Tempat: Bagian Gizi dan Bagian Penyakit Dalam Rumah Sakit Sumber Waras, Jakarta.Metode Penelitian didisain Cross Sectional, pada 49 subyek SHD laki-laki atau perempuan 30-80 tahun yang diseleksi secara konsekutif, dan 40 kontrol sehat yang diseleksi secara random dari karyawan RSSW. Data REE diperoleh dari hasil pemeriksaan konsumsi O2 dan CO2 yang dikeluarkan tubuh, dengan mempergunakan Kalorimeler Indirek. Asupan makanan dicatat selama 3 hari berturut-turut sebelum pemeriksaan REE. Data antropometri (LLA, TLLBK, KAOLA, TB, dan BB) dan pengumpulan urin dilakukan satu hari sebelum pemeriksaan REE, pengambilan darah untuk pemeriksaan IGF-l dan GH dilakukan setelah pemeriksaan Kalorimetri Indirek. Uji Statistik: Univariat mempergunakan tes Kormogorov Smimov, Bivarial mempergunakan uji t tidak berpasang, uji Mann Whitney dan Korelasi Pearson. Uji multivariat mempergunakan uji regresi linier ganda.Hasil dari 49 subyek SHD yang masuk RS karena komplikasi: hematemesis (34,69%), malaria (46,94%), ikterus (55,1%), dan yang terbanyak asites (87,76%). Dari jumlah tersebut 67,35% tergolong Child C, sisanya Child B. Ditemukan 63,27 % subyek SHD mengeluh mual dan 75,52% anoreksia. Rerata asupan energi subyek SHD secara bermakna lebih rendah dari kontrol sehat (1282,04 ± 229,85 vs 1448,71 ± 325,56; p = 0,006), dan mempunyai korelasi dengan derajat penyakit. Proporsi asupan terhadap kebutuhan energi subyek SHD hanya mencapai 79,49% ± 17,60% REE. Proporsi asupan terhadap kebutuhan energi lebih besar pada subyek SHD yang tanpa keluhan mual dan anoreksia. Penelitian ini menemuken 73,57 % dari subyek SHD daiam keadaan malnutrisi, dan 58,26 % diantaranya (42,86% total subyek SHD) dalam keadaan muscle wasting (AOLA pada persentil < 5) dan menunjukkan korelasi dengan asupan energi (p=0,007). Meningkatnya mobilisasi lemak dan oksidasi substrat lemak ditandai oleh TLLBK pada lebih dari 67% subyek SHD pada persentil < 15 dan RQ = 0,7 ± 0,08, serta menunjukkan korelasi yang bermakna dengan kurangnya asupan energi (p = 0,005). Meningkatnya mobilisasi lemak dan lipolisis diduga mempunyai hubungan dengan rendah IGF-1 dan tingginya GH dalam darah. Walaupun oksidasi lemak diduga untuk mencegah berlanjutnya katabolisme otot, penelitian ini menunjukkan katabolisme otot berlanjut, hal ini ditandai dengan; imbang nitrogen negatif, rasio NUU/K.AOLA subyek SHD bermakna lebih tinggi dari kontrol sehat, dan RQ sekitar 0,43-0,86. Namun, pada penelitian ini tidak didapatkan perbedaan yang bermakna REE subyek SHD dengan kontrol sehat; hal ini disebabkan oleh menurunnya massa otot, dan meningkatnya oksidasi substrat lemak sehingga konsumsi oksigen dan REE rendah. Data menunjukkan rasio REE/K.AOLA bermakna lebih tinggi dari kontrol sehat. Keadaan ini menujukkan subyek SHD dalam kondisi hipermetabolisme disertai penyimpangan metabolisme yang dapat ditandai oleh berlanjutnya mobilisasi lemak; oksidasi substrat lemak (tak sempurna); dan oksidasi substrat protein berlangsung bersama. Asupan nutrisi, komposisi tubuh, dan status metabolisme penderita SHD telab diidentifikasi merupakan acuan penting untuk menentukan REE. Dengan menggunakan variabel; rerata asupan energi, komposisi tubuh (TB, BB, AOLA, dan lainnya) dan derajat penyakit (skor Child-Pugh, albumin, dan NUU) sebagai variabel independen. Melalui uji regresi linier ganda (metode STEPWISE) penelitian ini menemukan 3 variabel merupakan determinan kuat REE yaitu TB, AOLA dan kadar albumin. Dan uji tersebut diperoleh persamaan model yang merupakan model REE estimasi SHD yang reliabel, sehingga dapat direkomendasikan sebagai rumus estimasi REE atau kebutuhan energi penderita SHD yaitu :kebutuhan energi = -270,40+17,26*AOLA - 217,83*Albumin + 11,42*TB. Kesimpulan Pada penderita SHD, keadaan hipermetabolisme tidak dapat ditentukan hanya dengan indikator REE. Hipermetabolisme pada subyek SHD menjadi nyata dengan menentukan REE/K.AOLA dan NUU/K.AOLA. Nasib oksidasi makronutrien pada SHD berbeda dengan pada starvasi. Pada subyek SHD lerjadi rangsangan mobilisasi lemak, oksidasi substrat lemak, katabolisme protein otol, dan oksidasi substrat protein secara bersama. Keadaan yang membuktikan adanya penyimpangan metabolisme. Dengan uji regresi limier ganda (metoda STEPWISE), AOLA, albumin dan tinggi badan ditemukan sebagai determinan kuat dari REE atau kebutuhan energi pada penderita SHD rawat inap di RS.

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ABSTRACT

Objective: To study the metabolic status of the Decompensated Liver Cirrhotic (DLC) patients who were hospitalized, and to formulate the equation of energy requirements equal to their metabolic status.

Places: The Department of Nutrition and the Department of Internal Medicine at Sumber Waras Hospital (SWH), Jakarta.

The cross sectional study was carried out on 49 DLC subjects, aged 30-80 years, selected consecutively, and on 40 healthy control subjects, selected at random, from SWH staff. The REE data was determined by assessing the Oz consumption (V02) and CO2 production (VCO2] using an Indirect Calorimeter. Food intake was recorded for 3 consecutive days before determining REE. The anthropometrics data (AC, TSF, C.AMA, Height and Weight) and urine samples were assessed one day prior to determining REE. The blood samples for determining IGF-1 and GH were taken after the Indirect Calorimetric assessment (REE data). The statistical tests: Univarian (using Kormogorof-Smimov), Bivarian (using unpaired T-tests, Mann-Whitney and Pearson Correlation), Multivariate (using multiple linear regression).

Results The 49 DLC subjects were hospitalized mainly due to complications of ascites (87.76%); many also suffered with hematemesis (34.69%), melena (46.94%), or icterus (55.1%). Of the 49 subjects, 67.35% were classified as Child C, the rest were Child B. The subjective findings were nausea (63.27%) and/or anorexia (75.52%). The mean energy intake of DLC subjects was significantly lower than the control (healthy volunteers) (1282.74 229.85 vs. 1448.71 * 325.56; p = 0.006), and had a correlation to the degree of disease, Their intake had only been 79.49 17.60% of REE. The proportion of food intake to energy requirements was larger in the DLC subject who had no symptoms of nausea and anorexia. This study has proved that 73.57% of DLC subjects had malnutrition, and 58.26 % of them (42.86 % of all DLC subjects) were in a muscle wasting condition (the percentile of AMA < 5). Il showed a correlation to a decrease in the energy intake (p = 0.007). The increase of fat mobilization and lipid substrate oxidation were shown by the DLC subjects' TSF of more than 67% with a percentile of less than 15 and the mean RQ = 0.7 ± 0.08. This also had a significant correlation to a decrease in the energy intake (p = 0.005). The increase of fat mobilization and lipolysis was assumed to have a correlation with the low level of blood IGF-1 and the high levels of blood GH. The increase of lipid substrate oxidation was assumed to prevent the subsequent of muscle catabolism, however this study showed that the process of muscle catabolism does not end, which was marked by a negative nitrogen balance, a significantly higher the UNUIC.AMA than the control and a RQ of 0.43 - 0.86. In this study, there was no significant difference between the REE of the DLC subjects and the control; this was due to the decrease of muscle mass and the increase of lipid substrate oxidation. This caused a low V02 consumption and a low REE. This study showed REEIC.AMA of the DLC subjects was significantly higher than the control. This condition indicated that the subjects were hyper metabolic with several abnormalities in metabolism such as: continued stimulation causing lipid mobilization from adipose tissue; incomplete oxidation of fatty acid and protein substrate oxidation running together. Energy intake, body composition, the metabolic status of DLC patients was an important reference for the identification of the REE. By using variables which influenced REE, i.e. the mean energy intake, body composition (height, weight, C.AMA, etc.) and the degree of disease severity (Child-Pugh score, albumin, and UNU), which were tested by the multiple linear regression of STEPWISE method, the equation model has been formulated and tested The final equation for estimating energy requirement is:

Energy requirements = -270.40 + 17.26*AOLA - 217.83*Albumin + 11.42?Height.

Conclusion RITE is not the only indicator of hyper metabolism in DLC patients. Hyper metabolism can be identified in DLC patients using REFIC.AMA and UNUIC.AMA. This study has proved abnormalities in metabolism of DLC patients as follows: continued stimulation causing lipid mobilization from adipose tissue; oxidation of fatty acid; muscle protein catabolism; and protein substrate oxidation running together. Through multiple linear regression analysis (the STEPWISE method), AMA, albumin level and height have been found as strong determiners of REE or determiners of energy requirements for DLC subjects."

"ABSTRAKPendahuluan: Paparan bising merupakan hal penting yang perlu diperhatikandampaknya terhadap ambang dengar seseorang yang bekerja di pabrik. Akibatpaparan bising dapat menyebabkan pergeseran ambang dengar yang bersifatsementara maupun menetap. Umumnya akibat paparan bising akan terjadi kerusakansel rambut luar di koklea. Tujuan: Melihat perubahan ambang dengar padapemeriksaan Audiometri maupun SNR (Signal to noise ratio ) pada OAE (OtoAccoustic Emission) akibat paparan bising. Metode: Penelitian ini mengevaluasiambang dengar dan fungsi sel rambut luar koklea pekerja di pabrik Baja pada periodetahun 2017 dan 2018.Data diperoleh dari data pekerja pabrik yang menjalanipemeriksaan Audiometri nada murni dan OAE pada periode tersebut.Penelitiandilakukan dengan metode kohort. Hasil: Jumlah pekerja yang menjalani pemeriksaanAudiometri dan OAE pada tahun 2017 sebanyak 221 orang, sedangkan pada tahun2018 sebanyak 241 orang. Data tersebut diatas hanya bisa dinilai sebanyak 144 orangyang menjalani pemeriksaan pada tahun 2017 dan 2018. Pada evaluasi terdapatperubahan secara signifikan baik pada hasil Audiometri maupun OAE.Oleh karena itudibutuhkan evaluasi yang lebih lama.

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ABSTRACTIntroduction : Exposure to noise is important because makes impact to hearing levelwhose works in factory. This noise exposure can result in temporary threshold shift orpermanent threshold shift. The principle cause of NIHL is damage to cochlear outerhair cells. Purpose : To see the change of hearing level in Audiometric measurementand SNR (signal to noise ratio) in (Oto Accoustic Emission) caused by noiseexposure. Methode : This research evaluated hearing level and fuction of cochlearouter hair cell factory worker in a steel mill periode 2017 until 2018. This data offactory worker collect from data who undergo pure tone Audiometry and OAE at thisperiode. This research done by cohort method.Result: The number of workersundergoing Audiometric and OAE measurement in 2017 was 221 people, while in2018 there were 241 people. The data above can only be assessed as many as 144people undergoing inspection in 2017 and 2018. In evaluation there were significantchanges in both Audiometric and OAE result, therefore a longer evaluation time wasneeded."

"Latar Belakang. Kuesioner Boston Carpal Tunnel Syndrome (BCTQ) merupakan kuesioner yang dikembangkan untuk menilai keluhan pasien sindrom terowongan karpal dalam melakukan aktifitas sehari-hari. Penelitian ini bertujuan untuk melakukan uji validasi dan reliabilitas kuesioner BCTQ ke dalam bahasa Indonesia. Metode. Melakukan adaptasi dan translasi transkultural, kemudian dilakukan uji validitas dan uji reliabilitas kuesioner BCTQ versi bahasa Indonesia. Populasi dari penelitian ini adalah semua pasien dewasa dengan sindrom terowongan karpal yang datang ke Poliklinik Neurologi RSUPNCM yang memenuhi kriteria inklusi. Hasil. Tiga puluh lima pasien memenuhi kriteria inklusi. Sebagian besar adalah perempuan (88,6%). Usia berkisar antara 45 tahun sampai 71 tahun, dengan prevalensi tertingi > 50 tahun (91,4%), pekerjaan sebagian besar subjek adalah sebagai ibu rumah tangga (77,1%). Pada uji validitas domain derajat keparahan gejala pada uji pertama memiliki nilai antara 0,484-0,781, pada retes didapatkan nilai 0,482 sampai 0,760, untuk domain status fungsional didapatkan nilai antara 0,495 sampai 0,825, dan nilai 0,615 sampai 0,783 pada retes. Hasil uji reliabilitas domain derajat keparahan gejala 0,876 pada uji pertama dan 0,874 pada uji kedua, untuk uji reabilitas domain status fungsional pada uji pertama sebesar 0,857 dan pada retes 0,854. Waktu yang dibutuhkan untuk mengisi kuesioner oleh semua subjek kurang dari 10 menit, Kesimpulan. Kuesioner BCTQ versi Bahasa Indonesia valid dan reliabel dalam mengevaluasi keluhan serta gejala pada pasien dengan sindrom terowongan karpal.

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Introduction. Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) is a questionnaire developed to assess complaints and symptoms of carpal tunnel syndrome patients in carrying out daily activities. Aim of this study is to gain a valid and reliable Indonesian version of BCTQ. Methods. Trancultural adaptation and translation from the original version to Indonesian version, then validation and reliability test are carried out. The population of this study was adult patients with carpal tunnel syndrome who came to the neurology department RSUPNCM and met the inclusion criteria. Thirty-five patients met the inclusion criteria, majority are women (88,6%). Age ranged from 45-71 years, with the highest prevalence >50 years old. Most of the subjects were housewife. The value of symptoms severity scale domain between 0,484-0,781 for first test, 0,482-0,760 on the retest. For domain functional status 0,495-0,825 in the first tests, and 0,615-0,783 for the retest. The reliability test for symptoms severity scale domain for the first test is 0,876 and 0,874 for the retest. The realiability test value for functional status 0,857 for the first test and 0,854 for the retest. The time needed to complete the questionnaire is under 10 minutes. Conclusion. Indonesian version of BCTQ is a valid and reliable instrument to be used as instrument in evaluate complaint and symptoms in patients with carpal tunnel syndrome."

"Di berbagai bagian dunia termasuk Indonesia, individu dengan berat badan berlebih dipandang memiliki performa yang lebih buruk dibandingkan individu dengan status gizi baik. Dengan adanya stigma tersebut dan tingginya prevalensi berat badan berlebih di Indonesia, timbul pertanyaan di benak peneliti mengenai hubungan dari keduanya. Walau berbagai penelitian telah dilakukan untuk meneliti hubungan antara berat badan berlebih dan performa akademik, hasil dari penelitian-penelitian tersebut masih terbagi menjadi dua. Oleh karena itu, peneliti memutuskan untuk melihat apakah terdapat hubungan antara berat badan berlebih dan performa akademik individu pada remaja 16- 18 tahun di Jakarta Selatan. Penelitian dengan metode potong lintang dilakukan pada 373 siswa dari dua sekolah di Jakarta Selatan pada bulan Desember 2017-Januari 2018. Data diperoleh dengan mengukur berat badan dan tinggi badan siswa untuk menghitung status gizi serta mencari rerata hasil Ujian Harian dan Ujian Akhir Semester semester gasal tahun ajaran 2017/2018 untuk melihat bila siswa memiliki performa di atas Kriteria Ketuntasan Minimal. Hasil analisis data dengan uji kai kuadrat menunjukkan bahwa tidak terdapat hubungan yang signifikan antar berat badan berlebih dan performa akademik (p = 0,452 untuk Bahasa Indonesia, p = 0,476 untuk Matematika) meski siswa dengan berat badan berlebih cenderung memiliki performa yang lebih baik pada beberapa komponen ujian. Pada akhirnya, disimpulkan bahwa baik berat badan berlebih maupun performa akademik merupakan kejadian yang multifaktorial sehingga sulit untuk ditentukan hubungan antar keduanya.

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In different parts of the world, Indonesia included, overweight and obese people are seen to have worse performance compared to their healthy counterparts. With that stigma and the high prevalence of overweight and obesity in Indonesia, the researcher wondered if there was a relationship between the two. Although there were research that had been done to observe the relationship between overweight, obesity, and academic performance, the results obtained were still divided into significantly and non-significantly related; thus, the researcher decided to see if there was a relationship between overweight, obesity, and academic performance in 16-18 years old teenagers. A cross-sectional study was done to 373 students from two different schools in South Jakarta on December 2017-January 2018. Data was obtained by measuring height and weight of the participant to get his/her nutritional status and the average of participant`s odd semester Continual Assessment and Semestral Assessment of Academic Year 2017/2018 to see if the result was higher or equal to the passing grade. Data analysis with chi square test shows that there is no significant relationship between overweight, obesity, and academic performance (p = 0.452 for Indonesian Language and p = 0.476 for Mathematics) although overweight and obese students tend to have better performance in some exam. In the end, it is concluded that the events that lead to overweight, obesity, and one`s academic performance are all multifactorial that the relationship between the two is difficult to be determined."

"Penyakit jantung koroner merupakan salah satu penyakit kardiovaskular yang paling umum ditemukan pada populasi pekerja dengan salah satu faktor risiko adalah jam kerja yang panjang terutama pada laki-laki. Tinjauan literatur ini bertujuan untuk mengevaluasi hubungan antara jam kerja yang panjang dan peningkatan risiko penyakit jantung koroner pada pria dewasa. Metode pencarian literatur yang digunakan adalah melalui pencarian daring sesuai dengan pedoman PRISMA di PubMed dan Scopus dari awal hingga 15 Mei 2020 dengan istilah pencarian berikut: 'pria', 'jam kerja panjang', 'lembur', dan 'risiko penyakit jantung koroner' di Medis Subject Heading Terms (MeSH Terms), judul, kata teks, abstrak, dan semua bidang. Pencarian manual dilakukan dengan mencari bagian referensi dari semua makalah yang diambil sebagai sumber potensial artikel relevan yang memiliki populasi yang tumpang tindih (n=4). Pada akhir proses pencarian literatur, sebuah artikel penelitian dipilih untuk proses penilaian kritis dan ditemukan valid dan penting bagi pasien kami. Peningkatan risiko Infark Miokard Akut sebanyak dua kali lipat ditemukan pada pria dengan jam kerja tambahan sama dengan atau lebih dari 3 jam per hari. Rekomendasi tempat kerja dapat berupa penilaian kembali bekerja, program rehabilitasi, termasuk penilaian beban kerja dan modifikasi jam kerja. Studi intervensi lanjutan diperlukan untuk mendapatkan tingkat bukti yang lebih tinggi. 

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Coronary heart disease is one of the most common cardiovascular diseases in worker population and may have resulted from long working hours especially in male population. This review aims to evaluate the relationship between long working hours and increased risk of coronary heart disease in adult males. We did online search in accordance with the PRISMA guidelines in PubMed and Scopus from inception to May 15th, 2020 with the following search terms: 'male', 'long working hours', ‘overtime’, and ‘coronary heart disease risk' in Medical Subject Heading Terms (MeSH Terms), title, textword, abstracts and all fields. Manual search was done by hand-searched the reference sections of all the retrieved papers as a potential source of relevant articles that have overlapping population (n=4). At the end of searching process, one study was chosen for critical appraisal process  that is valid and substantial for our patient. We found Acute Myocardial Infraction risk in male (additional work hours equal to or more than 3 hours per day) increased twofold. Workplace reccomendations that can be made for this patient are return to work assessment, rehabilitation program, work load assessment and modified- working hours. Further intervention studies required to gain higher evidence. "

"Adenocarsinoma Mammae adalah jenis kanker terbanyak pada wanita. Berbagai upaya telah dilakukan  untuk mengatasi, namun hasilnya belum maksimal. Harapan kedepan dalam mengatasi kanker terletak pada pemahaman patogenesis, dasar molekuler dan imunologis dari kanker. Penelitian ini adalah penelitian eksperimental dengan desain RCT pada mencit C3H model Adenocarsinoma Mammae. Dilakukan dengan menghitung luas permukaan nekrosis jaringan tumor tingkat seluler paska tindakan Elektroakupunktur (EA) menggunakan program Image-J. Diharapkan hasil dari penelitian dapat menjadi dasar pengetahuan biomolekuler peran akupunktur dalam terapi  kanker. Terdapat peningkatan nyata luas permukaan nekrosis jaringan tumor pasca tindakan antara kelompok kontrol dengan EA-1 x (1,08%); antara kontrol dengan EA-2x (41,06%0) dan antara kelompok kontrol dengan EA-3x (58,92%). Namun perhitungan statistik tidak memperlihatkan hasil yang signifikan (p=0.258). Kesimpulan: Elektroakupunktur pada titik-titik ST36, BL18 dan BL20 menyebabkan peningkatan luas permukaan nekrosis, namun perhitungan statistik belum bermakna. Kemungkinan dibutuhkan jumlah tindakan EA lebih banyak dan waktu lebih lama untuk bermakna secara statistik, mengingat tindakan EA pada penelitian ini hanya dilakukan tiga kali dalam waktu 21 hari.

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Adenocarsinoma Mammae is a cancer type that occurs most on women. Numerous attempts have been done to overcome the cancer, but the results have not yet been at saticfactory level. Expectations ahead in overcoming the cancer lies in understanding the pathogenesis, molecular and immunological basis of cancer. This study is an experimental research with RCT design on mice C3H models with adenocarsinoma mammae. Done by calculating the necrosis surface area of tumor tissues on cell level of post-action electroacupuncture (EA) using Image-J program. Expected results of the research could be basic knowledge of biomolecular on the role of acupuncture in cancer treatment. There are noticeable increases in the necrosis surface area of tumor tissue post-action between the control group and EA-1 x (1.08%); and EA-2x (41.06% 0); and EA3x (58.92%). However, the calculations showed no statistically significant results (p= 0258). Conclusion: electroacupuncture at points ST36, BL18 and BL20 causes an increase in the surface area of necrosis, but the statistical calculation is not meaningful. EA may be required more actions and takes longer to reach statistical significance, considering the EA action in this research is only done three times within 21 days."

"Pendahuluan: Malunion adalah komplikasi jangka panjang yang sering terjadi pada fraktur suprakondiler humerus yang bila tidak ditatalaksana dengan tepat dapat menimbulkan komplikasi yang dapat menurunkan kualitas hidup pasien. Osteotomi korektif dengan teknik lateral closed wedge osteotomy, merupakan teknik yang sering digunakan karena sederhana dan relatif mudah. Studi mengenai luaran klinis, fungsional dan radiologis pasca osteotomi korektif masih sedikit, khususnya di Indonesia. Metode: Penelitian ini menggunakan desain kohort retrospektif, dengan metode totalsampling pada tahun 2012-2017 di Rumah Sakit Pusat Nasional Cipto Mangunkusumo. Dilakukan penilaian luaran klinis dengan Mitchell and Adams Criteria, luaran fungsional dengan Mayo Elbow Performance Score (MEPS), dan luaran radiologis dengan Baumann Angle, Metaphyseal-diaphyseal angle, Humero-ulnar angle, Humero-capitellar angle, dan anterior humeral line pra dan pascaoperasi. Hasil: Terdapat 15 pasien yang diikut sertakan dalam penelitian dengan umur rata-rata 7,7 tahun, mayoritas laki-laki dan pada sisi sebelah kiri. Median interval waktu antara fraktur hingga osteotomi korektif adalah 11,2 bulan dengan rata-rata followup adalah 24,9 bulan. Luaran klinis berdasarkan Mitchell and adams criteria didapatkan kriteria good hingga excellent sebanyak 14 pasien (93,3%) dan hanya 1 pasien (6,7%) dengan hasil unsatisfactory. Luaran fungsional berdasarkan MEPS didapatkan kategori good hingga excellent sebanyak 14 pasien (93,3%), dan kategori fair sebanyak 1 pasien (6,7%). Terdapat perbaikan parameter radiologis yang bermakna yang diukur dengan baumann angle, metaphyseal-diaphyseal angle, humero-ulnar angle, humero-capitellar angle dan anterior humeral line. Terdapat korelasi yang kuat antara perbaikan baumann angle dengan Mitchel and Adams criteria dan terdapat korelasi yang moderat antara perbaikan metaphyseal-diaphyseal angle dengan MEPS. Kesimpulan: Tindakan osteotomi korektif dengan teknik lateral closed wedge osteotomy pada malunion fraktur suprakondiler humerus memberikan luaran klinis, fungsional dan radiologis good hingga excellent. Baumann angle dan Metaphyseal-diaphyseal angle dapat digunakan sebagai parameter untuk memprediksi luaran klinis dan fungsional pasca osteotomi korektif.

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Introduction: Malunion is a late complication that often occurs after supracondylar humeral fractures This condition if not managed properly will cause such complications that potentially reduce the patient's quality of life. Corrective osteotomy by lateral closed wedge osteotomy is a technique that is often used due to it simplicity and relatively easy. Only few studies have reported clinical, functional and radiological outcomes in cases of malunion of supracondylar humeral fractures after corrective osteotomy, particularly in Indonesia. Methods: This study used a retrospective cohort design, with a total sampling method in period of 2012-2017 at the Cipto Mangunkusumo Central National Hospital. We assess clinical outcome by Mitchell and Adams Criteria, functional outcome by Mayo Elbow Performance Score (MEPS), and radiological outcomes by Baumann Angle, Metaphyseal-diaphyseal angle, Humero-ulnar angle, Humero-capitellar angle, and anterior humeral line, pre and postoperatively Results: There were 15 patients included in the study with an average age of 7.7 years, the majority were men and affected on the left side. The median of time interval between fracture to correction osteotomy was 11.2 months with a mean time of follow-up was 24.9 months. Clinical outcome after correction osteotomy based on Mitchell and adams criteria showed good to excellent criteria as many as 14 patients (93.3%) and only 1

patient (6.7%) with unsatisfactory results. While the functional outcomes based on MEPS showed good to excellent categories of 14 patients (93.3%), and the fair category was 1 patient (6.7%). There were a significant radiological improvement measured by baumannn angle, metaphyseal-diaphyseal angle, humero-ulnar angle, humero-capitellar

angle and anterior humeral line. There was a strong correlation between baumann angle improvement with Mitchel and Adams criteria and there was a moderate correlation

between the improvement of Metaphyseal-diaphyseal angle and MEPS. Conclusion: Corrective osteotomy by lateral closed wedge osteotomy on malunion supracondylar humeral fracture showed good to excellent clinical, functional and radiological outcomes. Baumann angle and Metaphyseal-diaphyseal angle can be used as parameter to predict clinical and functional outcomes after corrective osteotomy.

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"Latar belakang: Coronavirus Disease 2019 (COVID-19) adalah penyakit yang disebabkan oleh infeksi virus SARS-CoV-2 dengan gejala ringan hingga berat seperti komplikasi paru dan kematian. Derajat keparahan penyakit merupakan salah satu faktor yang dapat memperberat kondisi pasien yang direncanakan operasi. Karakteristik klinis serta komplikasi pascaoperasi pasien dengan COVID-19 cukup banyak diteliti di negara lain. Namun Indonesia belum memiliki data terkait yang dapat dijadikan panduan dalam menjalani tindakan pembedahan pada pasien dengan COVID-19.Metode: Penelitian ini merupakan kohort retrospektif dengan pengambilan data sekunder pasien COVID-19 yang menjalani pembedahan di RSCM dan RSUI dari Maret 2020 sampai September 2021. Hasil luaran yang dinilai adalah komplikasi paru dan mortalitas.Hasil: Total 458 pasien COVID-19 menjalani pembedahan di RSCM dan RSUI, dengan operasi elektif 62% dan emergensi 38%. Angka kejadian komplikasi paru pascaoperasi sebesar 21,8% dan mortalitas 30 hari pascaoperasi sebesar 26%. Karakteristik klinis pasien yang mengalami komplikasi paru dan mortalitas yaitu berjenis kelamin laki-laki, berusia >65 tahun, memiliki jumlah komorbid dua atau lebih, gejala klinis awal batuk, sesak dan demam, nilai NLR ≥5,9 yang dikategorikan derajat berat COVID-19, gambaran CXR konsolidasi atau opasitas, serta menggunakan ventilasi mekanik praoperasi. Pasien dengan Early Warning Score (EWS) >10 memiliki risiko 2,98 kali lebih besar untuk terjadinya komplikasi paru. Sedangkan risiko terjadinya mortalitas dapat meningkat 31,8 kali pada pasien yang memiliki ASA 3-5 dan 6,91 kali pada penggunaan ventilasi mekanik praoperasi.Simpulan: Pasien COVID-19 yang menjalani pembedahan memiliki risiko terjadinya komplikasi paru dan mortalitas pascaoperasi. Kejadian komplikasi paru memberat pada pasien dengan EWS >10, dan pada mortalitas memberat pada pasien dengan ASA 3-5 serta menggunakan ventilasi mekanik praoperasi. Faktor lain yang turut berperan diantaranya usia, jumlah komorbid, jenis operasi dan penggunaan topangan intraoperasi.

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Background: Coronavirus Disease 2019 (COVID-19) is a disease caused by SARS-CoV-2 infection with mild to severe symptoms such as pulmonary complications and death. The severity of disease is one of the factors that can aggravate the condition of patient who is planned for surgery. The clinical characteristics and postoperative complications of COVID-19 patients have been extensively studied in other countries. However, Indonesia does not yet have relevant data that can be used as a guide for COVID-19 patients in undergoing surgery.

Methods: This study is a retrospective cohort with secondary data collection of COVID-19 patients undergoing surgery at RSCM and RSUI from March 2020 to September 2021. The primary outcomes were pulmonary complications and mortality.

Results: A total of 458 COVID-19 patients underwent surgery at RSCM and RSUI, with 62% elective surgery and 38% emergency. The incidence of postoperative pulmonary complication was 21,8% and 30-day mortality was 26%. Clinical characteristics of patients with pulmonary complications and mortality were male, aged >65 years, had two or more comorbidities, initial symptoms of cough, dyspnea and fever, NLR value ≥5,9 which was categorized as severe COVID-19, consolidated CXR or opacity, and used preoperative mechanical ventilation. Patients with Early Warning Score (EWS) >10 had risk for pulmonary complications about 2,98 times. While, the risk of mortality can increase 31,8 times in patients with ASA 3-5 and 6,91 times in the use of preoperative mechanical ventilation.

Conclusions: COVID-19 patients undergoing surgery are at risk for pulmonary complications and mortality. The incidence of pulmonary complications was severe in patients with EWS >10, and mortality was severe in patients with ASA 3-5 and using preoperative mechanical ventilation. Other factors that play a role include age, number of comorbidities, type of surgery and use of intraoperative support."

"Latar Belakang. Pemberian obat anti epilepsi (OAE) generasi pertama dalam jangka waktu lama sering menimbulkan efek samping seperti perubahan kadar lipid plasma yang akan meningkatkan resiko penyakit kardiovaskular dan serebrovaskular. OAE ini banyak digunakan di poli neurologi RSCM. Diharapkan dengan diketahuinya gambaran kadar lipid plasma pada penggunaan OAE generasi pertama tunggal dan prevalensi dislipidemia, dapat dilakukan penapisan dini dan preventif timbulnya penyakit kardio dan serebrovaskular. Metode. Desain penelitian berupa studi potong lintang (cross sectional). Subyek penelitian adalah orang dengan epilepsi yang mendapat karbamazepin, fenitoin, fenobarbital dan valproat tunggal minimal 6 bulan. Subyek diperoleh secara konsekutif, kemudian dilakukan wawancara data medis, recall makanan, pemeriksaan fisik dan kadar lipid darah. Pemeriksaan kadar lipid dilakukan setelah puasa minimal 8 jam. Hasil. Diperoleh 59 subyek, 27 karbamazepin, 16 fenitoin, 10 fenobarbital dan 6 valproat. Prevalensi dislipidemia sebesar 20.3%. Rerata kadar kolesterol total 193.5 ± 31.9; LDL 115.3 ± 23.9; HDL 59.5 ± 18.8 dan trigliserida 117.0 ± 63.6. Rerata kadar kolesterol total, LDL dan trigliserida fenitoin lebih tinggi dari OAE lain. Rerata HDL terendah ditemukan pada valproat. Didapat perbedaan bermakna secara statistik rerata kolesterol total, LDL dan trigliseria berdasarkan jenis OAE. Didapat hubungan bermakna secara stastistik antara durasi penggunaan OAE dengan tingginya kadar HDL pada karbamazepin dan fenobabital. Kesimpulan. Rerata kadar lipid dibawah rerata kadar lipid populasi. Dislipidemia lebih banyak ditemukan pada kelompok fenitoin. Durasi penggunaan OAE berhubungan dengan kadar HDL tinggi.

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Background. Longterm therapy with first generation of antiepileptic drugs (AED) has been associated with adverse effects, such as serum lipid profile changes which can increase the risk of cardiovaskular and cerebrovascular disease. These AEDs are commonly used in outpatient clinic at Cipto Mangunkusumo hospital. The aim of this study is knowing lipid profile in first generation AEDs consumption.

Method. This was cross sectional study. The subjects of this study were epilepsy patiets receiving carbamazepine, phenytoin, phenobarbital and valproate as monotheraphy for more than 6 months. This study used concecutive sampling. All subjects were interviewed, food recalled and underwent physical examination and measurements serum lipid profile. Blood samples for serum lipid profile were collected at least after 8 hours overnight fasting.

Result. There were 59 patients, 27 with carbamazepine therapy, 16 phenytoin, 10 phenobarbital, 6 valproate. Prevalence of dyslipidemia is 20.3%. Mean of total cholesterol is 193.5 ± 31.9; LDL 115.3 ± 23.9; HDL 59.5 ± 18.8 and triglyseride 117.0 ± 63.6. Patients with phenytoin showed the highest mean of total cholesterol, LDL and triglyseride. Patients with valpoate showed the lowest mean of HDL. There was significant difference in mean of cholesterol total, LDL and triglyseride according to AEDs. The duration of AEDs therapy was significantly associated with higher HDL in patents with carbamazepine and Phenobarbital.

Conclusion. Mean of lipid profile among people with epilepsy was lower than population. Dyslipidemia were more frequent in phenytoin. The duration of AEDs therapy was significantly associated with higher HDL."