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Hubungan Kadar Hemoglobin dan Ureum terhadap Tingkat Kematian Pasien Leptospirosis Zelindrah, Virgil; Mahmuda, Iin Novita Nurhidayati
Jurnal Keperawatan Vol 15 No 4 (2023): Jurnal Keperawatan: Supp Desember 2023
Publisher : Sekolah Tinggi Ilmu Kesehatan Kendal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32583/keperawatan.v15i4.2085

Abstract

Leptospirosis berasal dari bakteri genus leptospira yang dapat ditularkan dari hewan ke manusia. Setiap tahunnya, sekitar 1,03 juta kasus terjadi di seluruh dunia dengan 58.900 kematian. Di Indonesia, dilaporkan 920 kasus leptospirosis yang menyebabkan 112 kematian. Penelitian ini bertujuan untuk mengevaluasi hubungan antara kadar hemoglobin dan ureum dalam darah dengan tingkat kematian pada pasien leptospirosis. Menggunakan 80 sampel yang memenuhi kriteria inklusi dari rekam medis 45 bulan terakhir, penelitian ini menggunakan metode uji chi-square. Hasilnya menunjukkan adanya hubungan yang signifikan secara statistik (p < 0,05) antara kadar hemoglobin dan ureum dengan tingkat kematian pada pasien leptospirosis. Terdapat faktor-faktor tertentu yang dapat menjadi penyebab dari temuan ini.
STUDI KOMPARATIF INVITRO AKTIVITAS ANTIOKSIDAN EKSTRAK ETANOL, FRAKSI ETIL ASETAT DAN ISOLAT AKTIF KULIT DELIMA (PUNICA GRANATUM L.): In Vitro Comparative Study Antioxidant of Ethanol Extract, Ethyl Acetate Fraction And Active Isolate of Pomegranate Peel (Punica Granatum L.) Sri Wahyuni; Iin Novita Nurhidayati Mahmuda; Maryati; Aditya Putra Perdana; Maharotullaili Nur Azizah
Biomedika Vol 15, No 1 (2023): Biomedika Februari 2023
Publisher : Universitas Muhammadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v15i1.1751

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ABSTRACT Pomegranate (Punica granatum L) is widely used for health. Pomegranate peel is part of the pomegranate fruit which is often discarded and has not been widely used. Pomegranate peel is thought to contain antioxidants. One of the examinations for antioxidants is the 1,1 dipheyl-2-picrylhydrazyl (DPPH) method, by calculating the IC50 value, where the smaller the IC50 value means that the stronger of antioxidant potential. The purpose of this study was to compare the antioxidant activity of the ethanol extract, ethyl acetate fraction, and the active isolate from pomegranate peel. The antioxidant potency was tested using the DPPH, using the UV-Vis spectrophotometer, at 515 nm wavelength. Isolation of isolates was carried out by column chromatography shepadex and TLC with toluene as mobile phase; ethyl acetate : formic acid : methanol, with a ratio of 3:3:0.8:0.2. The purity of the isolate was detected by HPLC, with water-methanol as the mobile phase. The research results showed that 96% ethanol extract, ethyl acetate fraction and active isolate from pomegranate peel have potential as antioxidants with IC50 4.52 ± 0.00, 2.71 ± 0.01, and 0.979 x 10-5 ± 0.00 µg/mL, respectively, the positive control was vitamin C, had an IC50 3.66 ± 0.02 µg/mL. The conclusion of this study is that pomegranate peel isolate has the strongest antioxidant potential, compared to 96% ethanol extract and the ethyl acetate fraction of pomegranate peel, and even vitamin C. ABSTRAK Delima (Punica granatum L) banyak dimanfaatkan untuk kesehatan. Kulit delima merupakan bagian dari delima yang sering kali dibuang dan belum banyak dimanfaatkan. Kulit delima diduga memiliki kandungan antioksidan. Salah satu pemeriksaan antioksidan adalah dengan metode 1,1 dipheyl-2-picrylhydrazyl (DPPH), dengan menghitung nilai IC50, dimana semakin kecil nilai IC50 dapat diartikan bahwa semakin kuat potensi antioksidannya. Tujuan dari penelitian ini adalah untuk membandingkan aktivitas antioksidan dari ektrak etanol, fraksi etil asetat, dan isolat aktif kulit delima. Potensi antioksidan diuji dengan metode DPPH, dengan menggunakan spektrofotometer UV-Vis, pada panjang gelombang 515 nm. Isolasi isolat dilakukan dengan kromatografi kolom shepadex dan KLT dengan fase gerak toluene: etil asetat: asam format: metanol, dengan perbandingan 3:3:0.8:0.2. Kemurnian isolat di deteksi dengan HPLC, dengan fase gerak air-metanol. Hasil peneiltian menunjukan bahwa ekstrak etanol 96%, fraksi etil asetat dan isolat aktif dari kulit delima memiliki potensi sebagai antioksidan, dengan nilai IC50 masing-masing sebesar 4,52 ± 0,00; 2,71 ± 0,01; dan 0,979 x 10-5 ± 0,00 µg/ mL, sebagai kontrol positif vitamin C memiliki nilai IC50 3,66 ± 0,02 µg/ mL. Kesimpulan penelitian ini adalah bahwa isolat kulit delima memiliki potensi antioksidan terkuat, dibandingkan ekstrak etanol 96% dan fraksi etil asetat kulit delima, bahkan juga vitamin C.
Perempuan Usia Muda Penderita DM Tipe 2 dengan Multikomplikasi: Laporan Kasus Lian Adhalia; Iin Novita Nurhidayati Mahmuda
Cermin Dunia Kedokteran Vol 51 No 12 (2024): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i12.1090

Abstract

Type 2 diabetes mellitus is a progressive chronic metabolic disease characterized by an increase in blood sugar due to insulin resistance. Uncontrolled diabetes will cause various acute and chronic complications. The case is a young DM patient with complications of hyperosmolar hyperglycemia status, cerebral ischemia, and pressure ulcers.
Early Diagnosis and Successful Treatment of Falciparum Malaria Yaasiin, Putri Isa Maharani; Mahmudah, Iin Novita Nurhidayati
Proceeding ISETH (International Summit on Science, Technology, and Humanity) 2024: Proceeding ISETH (International Summit on Science, Technology, and Humanity)
Publisher : Universitas Muhammadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/iseth.5533

Abstract

Purpose: Malaria remains a major global health challenge, especially in tropical and subtropical regions such as Indonesia. Plasmodium falciparum, the most dangerous species, is associated with severe complications. This report highlights the importance of early detection, appropriate treatment, and increased public awareness in reducing malaria's impact. Methodology: This case involves a 34-year-old male patient who presented with high fever, weakness, muscle pain, and nausea for two months. The patient had a history of residing in Papua, a malaria-endemic area, and had been treated previously only with fever medication. Laboratory tests confirmed Plasmodium falciparum infection. The patient received antimalarial therapy and supportive care at PKU Muhammadiyah Surakarta Hospital. Results: Following treatment, the patient's condition improved within 24 days. The laboratory findings confirmed the presence of Plasmodium falciparum malaria, and the administration of the appropriate therapy led to recovery. Applications/Originality/Value: This case emphasizes the critical need for early detection and timely intervention in malaria treatment, particularly in endemic regions. It also highlights the significance of public health measures aimed at preventing the spread of malaria and increasing awareness of its symptoms and available treatments. Prompt and effective treatment can significantly reduce the severity and prevent complications of malaria, making early intervention key to managing this disease effectively.
Correlation between Probable or Non-Probable Leptospirosis with Laboratory Findings: Based on Leptospirosis Case Definition and Faine Criteria Citra Saputra, Rada; Mahmuda, Iin Novita Nurhidayati; Utami, Musrifah Budi; Pinakesty, Angiesta; Mubaraq, Syahrun El; Srirojanakul, Sirada
Indonesian Journal of Tropical and Infectious Disease Vol. 13 No. 2 (2025)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v13i2.56564

Abstract

The incidence of leptospirosis is increasing globally, and developing countries are no exception. Leptospirosis cases are called the tip of the iceberg phenomenon, even though misdiagnosis, underdiagnosis, and underreporting still occur in health services. Thus, it leads to delays in leptospirosis treatment and may result in increased mortality rate from severe leptospirosis infection (Weil's disease). This study was to establish an accurate diagnosis by optimizing the Faine criteria. This study used an analytical observational design with a cross-sectional approach to examine faine criteria and laboratory examinations. We collected data from medical records from the Karanganyar General Hospital and the PKU Muhammadiyah Surakarta Hospital. We processed the data using SPSS version 25. The total number of samples was 42. They were divided into women (19%) and men (81%). Based on the definition category of leptospirosis cases, there were 2.4% probable group (score criteria faine part A 20-25) and 97.6% not-probable group (score criteria faine part A <20). Bivariate analysis (Chi-Square test) showed that there was no significant correlation between Faine Part A criteria and serological tests in both groups (p=0.874) as well as Hb (p=0.522), thrombocytopenia (p=0.265), leukocytosis (p=0.197), and neutrophilia (p=0.710). Loss of sodium and potassium didn’t show significant data (hyponatremia p=0.174; hypokalemia p=0.311; hypocalcemia p=0.131) not as in tropical diseases. The approach to diagnosis of leptospirosis cannot be performed using only Part A criteria, Faine, even though the patient was included in the probable definition category, even though the Faine Part A criteria score is 20-25 or ≥26.
FAKTOR-FAKTOR YANG MEMPENGARUHI JUMLAH CD4 PASIEN HIV AIDS YANG DITERAPI ANTIRETROVIRAL: STUDI LITERATUR Mahmuda, Iin Novita Nurhidayati; Herdiana, Nandya; Pinakesty, Angiesta; Ruswandi, Poetrie Wulandari; Juwita, Triana Rahma
Prosiding University Research Colloquium Proceeding of The 13th University Research Colloquium 2021: Kesehatan dan MIPA
Publisher : Konsorsium Lembaga Penelitian dan Pengabdian kepada Masyarakat Perguruan Tinggi Muhammadiyah 'Aisyiyah (PTMA) Koordinator Wilayah Jawa Tengah - DIY

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Abstract

Salah satu cara untuk menurunkan angka kesakitan, angka kematian, membatasi penularan serta penyebaran penyakit, dan mengurangi dampak negatif yang ditimbulkan HIV/AIDS adalah dengan terapi antiretroviral, yang salah satu keberhasilannya dinilai dari perbaikan imunologis dan diketahui bahwa cluster of differentiation 4 (CD4) sebagai penanda status kesehatan sistem imun, maka pemeriksaan CD4 dapat digunakan untuk menentukan pasien yang memerlukan pengobatan profilaksis infeksi oportunistik (IO) dan terapi antiretroviral. Untuk mengetahui faktor-faktor yang mempengaruhi jumlah CD4 pada pasien HIV/AIDS yang diterapi antiretroviral. Penelitian ini menggunakan desain penelitian literature review atau kajian literatur. Sumber penelitian diambil dari beberapa database dengan kata kunci “("increase CD4" AND "decrease CD4" AND "hiv" OR "human immunodeficiency virus" AND "acquired immunodeficiency syndrome" AND "antiretroviral")”. Dari 612 artikel, terdapat 8 artikel yang sesuai dengan kriteria retriksi. Dari beberapa artikel tersebut didapatkan faktor-faktor yang mempengaruhi angka CD4 adalah jenis kelamin, usia, stadium klinis, jumlah CD4 awal, kepatuhan dalam terapi antiretroviral (yang dipengaruhi oleh beberapa faktor, seperti dukungan sosial, tingkat pendidikan, penggunaan ponsel, jenis kelamin, waktu kunjungan ke tempat pelayanan kesehatan, faktor ekonomi), jumlah viral load, ada tidaknya koinfeksi tuberkulosis (TB), dan infeksi hepatitis C (HCV). Faktor yang mempengaruhi jumlah CD4 pada pasien HIV/AIDS yang diterapi antiretroviral adalah jenis kelamin,, usia, stadium klinis, kepatuhan pasien dalam terapi antiretroviral, jumlah CD4 awal, jumlah viral load, dan ada tidaknya infeksi oportunistik (TB, HCV).
Obesitas Sebagai Faktor Risiko Keparahan Pada COVID-19 Aqmarina, Nadia Wdihi; Risanti, Erika Diana; Mahmudah, Iin Novita Nurhidayati; Jatmiko, Safari Wahyu
Prosiding University Research Colloquium Proceeding of The 13th University Research Colloquium 2021: Kesehatan dan MIPA
Publisher : Konsorsium Lembaga Penelitian dan Pengabdian kepada Masyarakat Perguruan Tinggi Muhammadiyah 'Aisyiyah (PTMA) Koordinator Wilayah Jawa Tengah - DIY

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Abstract

Obesitas diketahui sebagai peradangan kronis derajat rendah. Hal ini menjadi faktor yang dapat menyebabkan keparahan pada gejala COVID-19. Gejala COVID-19 dinyatakan dalam asimptomatis hingga kritis dan obesitas dicurigai memiliki peran dalam tingkat keparahan COVID-19. Tujuan penelitian ini adalah untuk mengetahui hubungan antara obesitas dengan tingkat keparahan COVID-19. Penelitian ini dilakukan pada 13 Desember 2020 pada mesin pencarian Pubmed, Science Direct dan Google Scholar dengan memasukkan kata kunci (obesity OR overweight) AND risk factor AND (severe OR severity) AND fatality rate AND (COVID-19 OR SARS-CoV-2 OR Novel coronavirus). Selanjutnya dilakukan skrining sesuai dengan kriteria restriksi yang telah ditetapkan dan mengelompokkan artikel penelitian dalam tabel lalu diurutkan sesuai alphabet nama peneliti. Data yang sudah terkumpul selanjutnya dilakukan penarikan kesimpulan, sehingga didapatkan sampel sebanyak 11 artikel berasal dari Negara Italia, China, New York, USA dan Prancis. Berdasarkan hasil penelitian didapatkan adanya hubungan antara BMI dan nilai risiko yang menyebabkan keparahan pada COVID-19. Semakin tinggi kenaikan angka BMI akan memberikan nilai risiko yang lebih tinggi pula. Keparahan penyakit ditandai dengan penggunaan alat bantu pernafasan (IMV, NIV, oksigenasi dan ECMO), penggunaan ruang ICU, penurunan PaO2 dan SaO2 serta hipoksemia.
Antiviral and Symptom Free Days for Confirmed Covid-19 Students Mahmuda, Iin Novita Nurhidayati; Sifak, Sheila Faadhila
Prosiding University Research Colloquium Proceeding of The 17th University Research Colloquium 2023: Bidang MIPA dan Kesehatan
Publisher : Konsorsium Lembaga Penelitian dan Pengabdian kepada Masyarakat Perguruan Tinggi Muhammadiyah 'Aisyiyah (PTMA) Koordinator Wilayah Jawa Tengah - DIY

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Abstract

Introduction: The limitations of health service facilities mean that Covid-19 case services are only for moderate and severe cases, while asymptomatic/mild cases are advised to selfisolate. The availability of antivirals for self-isolation patients is often limited, so the patient's recovery rate can be longer. The purpose of this study was to determine the difference in symptom-free days in Covid-19 patients who received and did not receive antivirals. Method: This type of analytic research is observational with a cross sectional approach. The research sample was 93 UMS students who were confirmed to have COVID-19 in March 2020 - August 2021. The research data was obtained by an online questionnaire. Data analysis was performed using the Mann Whitney test. Results: There were 32 self isolation Covid-19 patients who received antivirals (34.4%). In these patients, the symptom free days were 8.9 days; while the 61 patients (65.6%) who did not receive antivirals reported a symptom free day of 12.2 days. The Mann Whitney test obtained a p value = 0.023 indicating that there was a difference in symptom free days between Covid- 19 patients who received and did not receive antivirals. Conclusion: Giving antivirals to self isolation Covid-19 patients shortens symptom free days.
COMPARISON OF GRAM-BACTERIAL RESISTANCE PATTERNS OF PNEUMONIA IN THE ELDERLY AND NON-ELDERY Mahmuda, Iin Novita Nurhidayati; Dewi, Listiana Masyita; Jatmiko, Safari Wahyu; Faizah, Ishmah Nur; Kania, Yulia Intan; Affifah, Fathiyya Noor; Prasetyo, Andri Sugeng
Prosiding University Research Colloquium Proceeding of The 19th University Research Colloquium 2024: Bidang MIPA dan Kesehatan
Publisher : Konsorsium Lembaga Penelitian dan Pengabdian kepada Masyarakat Perguruan Tinggi Muhammadiyah 'Aisyiyah (PTMA) Koordinator Wilayah Jawa Tengah - DIY

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Abstract

Pneumonia is an infectious disease of the lungs caused by various microorganisms that cause inflammation of the lung parenchyma. This infectious disease is more likely to affect elderly patients. Most of the microorganisms that cause pneumonia are bacteria, both gram-positive and gram-negative bacteria. The main management for patients with pneumonia is to use antibiotic therapy. The irrational use of antibiotics can increase the occurrence of antibiotic resistance. This study aimed to compare the resistance patterns of Gram-positive and Gram-negative bacteria causing pneumonia in elderly and non-elderly patients. This study used a descriptive method with secondary data in the form of medical record data and antibiotic sensitivity test data. based on this study, it was found that the bacteria that caused pneumonia were mostly gram-negative bacteria. The most common gram-negative bacteria was Klebsiella pneumoniae, while the most common gram-positive bacteria was Streptococcus sp. The results of antibiotic sensitivity tests on gram-positive bacteria showed that the majority were resistant to fluoroquinolones, namely Ciprofloxacin (64%), Levofloxacin (59%). Meanwhile, gram-negative bacteria were mostly resistant to Ampicilin (84%) and Cefadroxil (83%). Conclusion: The bacteria that cause pneumonia, both gram-positive and gram-negative, experienced antibiotic resistance to the tested antibiotics. The selection of antibiotic therapy can be adjusted according to the causative bacteria and their resistance patterns.Keywords: Pneumonia; Antibiotic resistance pattern; Gram-positive bacteria; Gram-negative bacteria
GAMBARAN FAKTOR RISIKO HIPERTENSI DAN DIABETES MELLITUS PADA PASIEN HEMODIALISA DI RSUD DR HARJONO PONOROGO Mahmuda, Iin Novita Nurhidayati; Bahrodin, Bahrodin; Ilhami, Afiq Zakie; Nugraheni, Frida Asfarina; Marhamah, Nisrinah; Izzati, Sofi Filda
Jurnal Ilmiah Kesehatan Vol 23 No 1 (2024): Jurnal Ilmiah Kesehatan Terbitan Maret Volume 23 Nomor 01 Tahun 2024
Publisher : UIMA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33221/jikes.v23i1.1863

Abstract

Gagal ginjal kronis merupakan kondisi progresif yang memengaruhi >10% populasi seluruh dunia. Di Indonesia, prevalensi gagal ginjal kronik sebesar 0,5% dengan komorbid yang sering dijumpai adalah hipertensi (40,8%) dan diabetes mellitus (3,3%). Hemodialisis merupakan pilihan terapi pada gagal ginjal kronik dengan hipertensi sebagai salah satu komplikasinya. Kontrol glikemik dan penyesuaian terhadap agen diabetes dibutuhkan untuk menghindari efek samping hemodialisis pada pasien diabetes mellitus. Penelitian ini bertujuan mengetahui gambaran kejadian faktor risiko hipertensi dan diabetes mellitus pada pasien gagal ginjal kronik yang menjalani hemodialisis di RSUD dr Harjono Ponorogo. Metode penelitian adalah desain studi deskriptif observasional dengan pendekatan cross-sectional. Penelitian dilakukan di RSUD dr Harjono Ponorogo dengan sampel penelitian adalah seluruh pasien hemodialisis pada bulan Desember 2021 sejumlah 145 pasien. Data penelitian berupa data sekunder dari rekam medis pasien hemodialisis di RSUD dr Harjono Ponorogo. Analisis data penelitian menggunakan teknik deskriptif tabel frekuensi. Penelitian menunjukkan bahwa sebagian besar pasien hemodialisis di RSUD dr Harjono Ponorogo berjenis kelamin laki-laki (51,7%). Penyakit penyerta yang paling dominan dimiliki pasien gagal ginjal kronik yang melakukan hemodialisis adalah hipertensi (61%), disusul diabetes mellitus (25%). Kesimpulan penelitian adalah jumlah kejadian hipertensi lebih banyak dibandingkan kejadian diabetes mellitus pada pasien gagal ginjal kronik di RSUD dr Harjono Ponorogo.
Co-Authors Adhalia, Lian Aditya Putra Perdana Affifah, Fathiyya Noor Akbar Wardhana Andri Sugeng Prasetyo Angiesta Pinakesty Anis Nuristiqomah Aqmarina, Nadia Wdihi Arifin Arifin Arum Dyah Ripdianti Aulida Azkia Kamila Azahra Khansa Muza Azarine Marwah Bahrodin, Bahrodin Busyra, Busyra Cahyo, Febrian Dwi Citra Saputra, Rada Dahlia Winda Nurarifah Denny Bimatama Pradita Dessy Dessy Desty Triza Pratiwi Devi Usdiana Rosyidah Devi Usdiana Rosyidah Doni Priambodo Dwi, Raafika Studiviani Em Sutrisna Erika Diana Risanti Fairuz Ulfah Faizah, Ishmah Nur Fakhri Nofaldi Fathiyya Noor Afifah Fauziah, Nida Faradisa Febrian, Rizky Ferika Dian Syafitri Flora Ramona Sigit Prakoeswa Fuad Gandhi Torizal Harioputro, Dhani Redhono Herdiana, Nandya Ilhami, Afiq Zakie Indriyati Oktoviano R Ishmah Nur Faizah Iwan Setiawan Izzati, Sofi Filda Jati, Izzah Tsaqoofah Juwita, Triana Rahma Kania, Yulia Intan Khairunnisa, Reza Khotik, Laisa Kurnia Retnowati Kurnia Retnowati, Kurnia Lian Adhalia Listiana Masyita Dewi Maharotullaili Nur Azizah Marhamah, Nisrinah Maryati Maslahah, Syah Fillia Nurul Maulana, Yudrik Maya Monica Manurung Metana Puspitasari Mubaraq, Syahrun El Muhammad Adnan Nadia Wdihi Aqmarina Nanda Dhea Ayu Sawitri Nanda Dhea Ayu Sawitri Nanda Nurkusumasari Nandya Herdiana Naruma, Anteng Nining Lestari Nisa, Faridita Khoirun Nor Hilyati Nugrahaeni, Sarwasri Fajra Nugraheni, Frida Asfarina Oktafiani, Niken Sari Oktoviano R, Indriyati Olivia Bunga Putri Pinakesty, Angiesta Poetrie Wulandari Ruswandi Prasetyo, Andri Sugeng Prihatin Puji Astuti Priscillah, Wildan Putra, Catur Permana Putriyantiwi, Idoviari R. Satriyo Budhi Susilo Raafika Studiviani Dwi Binuko Rada Citra Saputra Rajendra, Hafish Harfian Raniah, Siti Fairuz Ratnasari Bondan Wijayanti Rezki, Yuniana Nur Riandini Aisyah Rochmadina Suci Bestari Roro Flaviana Bayu Adistyani Roro Flaviana Bayu Astiyani Ruswandi, Poetrie Wulandari Safari Wahyu Jatmiko Sahilah Ermawati Sahilah Ernawati Santi, Tika Melandya Sifak, Sheila Faadhila Siti Soekiswati Sri Wahyu Basuki Sri Wahyuni Srirojanakul, Sirada Subekti, Tyas Hanurita Sulistyani Sulistyani , Sulistyani Sulistyani Sulistyani Sulistyani Sulistyani Sutanto, Bambang Syah, Devan Adil Taroeno, Suryo Aribowo Tatar Sumandjar Tri Agustina, Tri Triana Rahma Juwita Tyas Hanurita Subekti Utami, Musrifah Budi Vitania Marsya Wibowo, Muhammad Irfan Sulystyo Wildan Priscillah Wulan Kadarsih Yaasiin, Putri Isa Maharani Yamsun, Rahmat Dani Yudrik Maulana Yulia Intan Kania Yuniana Nur Rezki Zelindrah, Virgil