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Kadar Autoantibodi dan Manifestasi Klinis pada Pasien Nefritis Lupus Silent dan Nefritis Lupus Overt Kusworini Handono; Atma Gunawan; Rulli Rosandi
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 3 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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Autoantibodies level and clinical manifestation differences between patients with silent nephritis lupus and overt nephritis lupusBackground: One of the serious clinical manifestations of SLE is the occurrence of lupus nephritis (LN). The pathogenesis of LN is still unclear. Glomerular inflammation has been associated with high levels of autoantibodies. The purpose of this study was to assess the difference of ANA, anti ds-DNA, anti-Sm antibodies and the clinical manifestations between silent lupus nephritis (SLN) and overt lupus nephritis (OLN).Subject and Methods: Subjects were forty SLE patients (diagnosed according to ARA criteria of 1997). Autoantibodies ANA was assayed with IFA, anti-dsDNA and anti-Sm levels were assayed with ELISA. The diagnosis of LN was established using clinical signs, urinary sediments pattern and kidney biopsy, and then patients classified as a silent lupus nephritis (SLN) or overt lupus nephritis (ONL). Classification of NL histopathologic pattern was established according to WHO criteria. Differences in clinical manifestations, presence of ANA, anti-dsDNA and anti-Sm levels in the SLN and OLN and NL classes were analyzed by Chi squaretest and T test. Statistical significance determined when p<0.05.Results: OLN patients showed a edema, hypertension, anemia and autoantibodies more higher than in SLN patients. The mean level of anti-dsDNA was significantly higher in patients with OLN than in SLN (285.75±41.85 vs 179.01±61.81, p<0.000). Renal biopsy on 20 OLN patients showed: 6 patients with NL grade I/II, 9 patients with NL class III/IV and 5 patients with NL class V. Moreover on 11 SLN patients there were 7 patients with NL class I/II, 3 patients with NL class III/IV and 1 patient with NL class V. The NL classIII/IV NL patients showed anti-dsDNA level higher than the class V NL (p<0.05).Conclusion: OLN patients had clinical manifestations more severe than SLN patients. NL patients with class III/IV showed the presence of anti-dsDNA more frequently and with higher levels than the class V NL. Diagnosing NL based solely on clinical signs and laboratory often is inappropriate.Keywords: SLN, OLN, NL class, autoantibodies ABSTRAKLatar belakang: Salah satu manifestasi serius LES adalah terjadinya nefritis lupus (NL). Patogenesis NL hingga saat ini masih belum jelas. Terjadinya inflamasi di glumerulus telah dikaitkan dengan tingginya kadar autoantibodi. Tujuan penelitian ini mengetahui perbedaan ANA, anti ds-DNA dan anti-Sm pada pasien dengan NL tenang (silent lupus nephritis/SLN) dan NL manifes (overt lupus nephritis/OLN).Metode: Sampel penelitian adalah empat puluh penderita LES (didiagnosis berdasarkan kriteria ARA 1997). ANA diperiksa dengan metoda IFA, anti-dsDNA dan anti-Sm menggunakan metoda ELISA. Diagnosis NL didasarkan adanya tanda klinis, sedimen urin dan biopsi ginjal dan dikelompokkan sebagai silent lupus nephritis (SLN) dan overt lupus nephritis (ONL). Klasifikasi histopatologi NL ditegakkan berdasarkan kriteria WHO. Perbedaan manifestasi klinis, adanya ANA, kadar anti-dsDNA dan anti-Sm pada SLN dan OLN serta kelas NL dianalisis dengan uji Chi square dan T tes. Signifikansi statistik ditentukan bila p<0,05.Hasil: Penderita OLN menunjukkan adanya edema, hipertensi, anemia dan autoantibodi yang lebih tinggi daripada penderita SLN. Rerata kadar anti-dsDNA nyata lebih tinggi pada penderita OLN daripada SLN (285.75±179.01 vs 41,85±61,81; p<0,000). Biopsi ginjal 20 penderita OLN menunjukkan 6 penderita dengan NL kelas I/II, 9 penderita dengan NL kelas III/IV dan 5 penderita dengan NL kelas V. Pada 11 penderita SLN terdapat 7 penderita NL kelas I/II, 3 penderita dengan NL kelas III/IV dan 1 penderita NL kelas V. Penderita dengan NL kelas III/IV menunjukkan kadar anti-dsDNA yang lebih tinggi daripada NL kelas V (p<0,05).Simpulan: Penderita OLN mempunyai manifestasi klinis yang lebih berat daripada penderita SLN. Penderita NL kelas III/IV menunjukkan adanya anti-dsDNA yang lebih sering dan dengan kadar yang lebih tinggi daripada NL kelas V. Diagnosis NL hanya berdasarkan tanda klinis dan laboratoris seringkali menimbulkan kesalahan.

Pola Kuman Pasien Pneumonia di Instalasi Rawat Intensif Anak (IRIA) RSUP Dr. Sardjito Amalia Setyati; Indah Kartika Murni
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 3 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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Bacterial pattern of pneumonia patient admitted in pediatric intensive care unit (PICU) Dr. Sardjito General HospitalBackground: Pneumonia is an inflammation of the lung parenchyma. The causative agent of pneumonia is difficult to determinate. This study was to attemp the pattern of bacteria and antibiotic sensitivity of pneumonia, and to see the risk of pneumonia mortality by age and bacteria obtained from cultures.Methods: Data of tracheal aspirate and blood cultures and its sensitivity to antibiotics of pneumonia patients who admitted to PICU of Sardjito General Hospital Yogyakarta in January-June 2011 were collected retrospectively from medical records. Analyzed by using chi-square test and the relative risk is expressed by odds ratio.Results: Ninety-four isolates of bacteria were obtained. There are 63 of tracheal aspirate and 32 of blood specimens. Gram (+) were 39.36% and gram (-) were 60.64%. The most cultures of tracheal aspirate was Pseudomonas, which the sensitivity of imipenem, amikacin, fosfomisin, netilmisin were 81.25%, 80.95%, 76.19%, 68.42%. The sensitivity of Klebsiella pneumoniae to fosfomisin, imipenem, amikacin were 92.31%, 84.62%, 76.92%. All isolates of coagulase negative Staphylococcus (CONS) were resistant to cephalosporin, likely 100% were sensitive to vancomisin. The sensitivity of Pseudomonas aeruginosa in the blood to ciprofloxacin, chloramphenicol, amikacin, cefepime and ceftazidim, gentamicin netilmisin and imipenem were 93.75%, 87.50%, 81.25%, 75%, 68.75%. The odds ratio (OR) of pneumonia death of age <1 year was 1.6, as well as the OR of pseudomonas was 2.5.Conclusion: The bacteria found were Pseudomonas aeruginosa, Klebsiella pneumoniae and CONS. The sensitivity of imipenem, amikacin, fosfomisin and ciprofloxacin were good to the three kind of bacteria. Patient under 1 year old and Pseudomonas aeruginosa are risk factors for death in pneumonia.Keywords: Pneumonia, culture, antibiotics ABSTRAKLatar belakang: Pneumonia adalah peradangan pada parenkim paru-paru. Penentuan penyebab pneumonia adalah sulit, Tujuan penelitian ini adalah melakukan pemetaan pola kuman dan kepekaan antibiotik pada pneumoni, melihat risiko kematian pneumonia berdasarkan umur dan kuman yang didapatkan dari kultur.Metode: Data kultur aspirat trakeal dan darah beserta kepekaan terhadap antibiotik pasien pneumonia yang dirawat di Instalasi Rawat Intensif Anak (IRIA) RSUP Dr. Sardjito Yogyakarta Januari- Juni 2011 diambil secara retrospektif dari catatan medik. Data dianalisis menggunakan uji x 2, risiko relatif dinyatakan dengan rasio odd.Hasil: Didapatkan 94 isolat kuman. Aspirat trakeal ada 63, isolat spesimen darah 32 isolat. Bakteri gram (+) 39,36% dan gram (-) 60,64%. Dari kultur aspirat trakeal terbanyak Pseudomonas, kepekaan terhadap Imipenem 81,25%, amikasin 80,95%, fosfomisin 76,19%, netilmisin 68,42%. Kepekaan Klebsiella pneumonia terhadap fosfomisin 92,31%, imipenem 84,62%, amikasin 76,92%. Semua isolat Staphylococcus coagulase negative (CONS) resisten terhadap sefalosporin, namun 100% peka dengan vancomisin. Kepekaan Pseudomonas aeruginosa dalam darah: ciprofloxacin 93,75%, kloramfenikol 87,50% amikasin, cefepime, ceftazidim 81,25%, gentamisin dan netilmisin 75%, imipenem 68,75%. Rasio odd (RO) kematian pasien pneumonia umur <1 tahun 1,6, RO kematian karena kultur pseudomonas 2,5.Simpulan: Kuman utama adalah Pseudomonas aeruginosa, Klebsiella pneumonia dan CONS. Kepekaan imipenem, amikasin, ciprofloksasin dan fosfomisin baik terhadap ketiga kuman tersebut. Umur <1 tahun dan pseudomonas merupakan faktor risiko kematian pada pneumoni

Pengaruh Larutan Ekstrak Siwak (Salvadora persica) Terhadap Streptococcus mutans: Studi In Vitro dan In Vivo Oedijani Santoso; Aini Pramoda Wardani; Nila Kusumasari
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 3 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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The influence of Siwak (Salvadora persica) extract solution on Streptococcus mutans, in vitro and in vivo studyBackground: Streptococcus mutans is the primary cause of dental caries. Siwak (Salvadora persica) may improve oral health with antibacterial effects and prevent decreasing of salivary pH. The aim of this research was to know the influence of siwak extract solution on the growth of S.mutans (in vitro) and salivary pH (in vivo).Method: I. Laboratory experimental with the post test only control group design using S.mutans as samples. The intervention groups were given siwak extract solution at various concentrations 3.1%, 6.2%, 12.5%, 25%, 50%, and 100%. The data was obtained by visually observing the growth of S.mutans colonies. Statistical test used the Kruskal-Wallis test followed by Mann-Whitney test. II. Clinical trial with the post test only control group design. 74 samples divided randomly into two groups they were control and test group. The test group rinse the mouth with 25% the siwak extract solution. Salivary pH was measured using Hanna digital pH meter with 0,1 sensitivity. The data analyzed by Shapiro-Wilk test continued by Mann-Whitney test.Result: I. Test group with concentrations of 50% and 100% were no visible growth of S.mutans, however another group still appeared the growth of S.mutans. Kruskal-Wallis test revealed a significant difference (p=0.003), Mann-Whitney test which also showed a significant difference (p=0.025). II. There was significant different on salivary pH at the test group compared to the control group (p<0.05).Conclusion: I. Siwak extract solution can inhibit the growth of S.mutans, concentration of 50% is the lowest concentration that effective to inhibit the growth of S. mutans. II. Giving the solution of siwak extract 25% can increase salivary pH significantly.Keywords: Siwak extract solution, S. mutans, salivary pH ABSTRAKLatar belakang: Streptococcus mutans merupakan penyebab utama karies. Siwak (Salvadora persica) mampu meningkatkan kesehatan mulut dengan efek antibakterial dan mencegah penurunan pH saliva. Tujuan penelitian untuk mengetahui pengaruh larutan ekstrak siwak terhadap pertumbuhan S.mutans (in vitro) dan pH saliva (in vivo).Metode: I. Eksperimental laboratorik rancangan the post test only control group design, S.mutans sebagai sampel. Perlakuan diberikan larutan ekstrak siwak konsentrasi 100%, 50%, 25%, 12,5%, 6,2%, dan 3,1%, penilaian pertumbuhan koloni S.mutans secara visual. Analisis data dengan uji Kruskal-Wallis dilanjutkan dengan uji Mann-Whitney. II. Uji klinis rancangan the post test only control group design. Sampel 74 orang, secara random dibagi dua kelompok kontrol dan perlakuan diberikan larutan ekstrak siwak 25% untuk kumur. pH saliva diukur dengan pH meter digital Hanna dengan sensitivitas 0,1. Analisis data dengan uji Shapiro- Wilk dilanjutkan dengan uji Mann-Whitney.Hasil: I. Kelompok perlakuan konsentrasi 50% dan 100% tidak tampak adanya pertumbuhan S. mutans, namun kelompok yang lain masih tampak adanya pertumbuhan S. mutans. Uji Kruskal-Wallis didapatkan perbedaan signifikan (p=0,003), uji Mann-Whitney juga didapatkan perbedaan signifikan (p=0,025). II. Terdapat perbedaan bermakna pada pH saliva antara kelompok perlakuan dibanding kontrol (p<0,05).Simpulan: I. Larutan ekstrak siwak dapat menghambat pertumbuhan S. mutans, konsentrasi 50% adalah konsentrasi terendah yang efektif menghambat pertumbuhan S. mutans. II. Kumur larutan ekstrak siwak 25% dapat meningkatkan pH saliva secara bermakna.

Konseling Laktasi Intensif dan Pemberian Air Susu Ibu (ASI) Eksklusif Sampai 3 Bulan Ria Ambarwati; Siti Fatimah Muis; Purwanti Susantini
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 3 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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Intensive lactation counseling and exclusive breastfeeding up to 3 monthsBackground: In 2010 within the area of Semarang Municipality, exclusive breastfeeding by mothers to their babies reaches up to only 20,06%. One of the problems is the lack of lactation counseling especially by the health service institutions.Objectives: To reveal the effect of intensive lactation counseling on exclusive breastfeeding up to 3 months.Method: This research study is designed as a quasi-experiment of non-equivalent control group. The population of this study is a group of mothers who were in the 7th to 8th months of pregnancy bearing the second child or more. The number of the subjects is 25 mothers who were grouped into 2, that is the experimental groups of 12(n=12) and control group of 13 (n=13). The group underwent a treatment of intensive lactation counseling of 9 times on 2 stages, the first was four-time treatments during the medical examination on their pregnancy of 7th-8th months. The second stage of treatments was done by home visit for 5 times during week 1, 2, 4, 8, and 12 after giving birth by sertified lactation counselors for 40 workhours. These counselors had the experience of at least 5 clients counseling. The control group got the usual counseling that they normally received from the midwives at the Health Primary Center and private midwives nearby.Results: The group without intensive lactation counseling shows no gain of knowledge, attitude towards early initiation of breastfeeding, exclusive breastfeeding, breastmilk and no increase of the number of exclusive breastfeeding on their babies prior to and during the study. The group with intensive lactation breastfeeding shows a significant gain in every aspects being studied and significant increase (five fold) of the number of exclusive breastfeeding on their babies that born prior to and during the study from2(16.7%) to 10(83.3%).Conclusion: Intensive lactation counseling increases the practice of exclusive breastfeeding up to 3 months and should be performed by health care delivery system.Keywords: Intensive lactation counseling, exclusive breastfeeding, 3 months ABSTRAKLatar belakang: Ibu yang memberikan ASI eksklusif di Kota Semarang Tahun 2010 hanya mencapai 20,06%. Salah satu penyebabnya adalah kurangnya konseling laktasi di sarana pelayanan kesehatan.Tujuan: Mengetahui pengaruh konseling laktasi intensif terhadap pemberian ASI eksklusif sampai 3 bulan.Metode: Penelitian dengan rancangan quasi experiment non equivalent control group. Populasi adalah ibu hamil trimester 3 dengan usia kehamilan 7-8 bulan pada anak kedua atau lebih. Jumlah sampel 25 ibu hamil yang dikelompokkan menjadi 2 yaitu kelompok perlakuan (n=12) dan kelompok kontrol (n=13). Kelompok perlakuan mendapat konseling laktasi intensif sebanyak 9 kali yaitu 4 kali pada saat pemeriksaan kehamilan umur 7-8 bulan dan kunjungan rumah sebanyak 5 kali pada minggu ke-1, 2, 4, 8, 12 setelah kelahiran oleh konselor laktasi yang memiliki sertifikat pelatihan konselor laktasi. Kelompok kontrol mendapat konseling pada pemeriksaan kehamilan yang selama ini dilakukan oleh bidan di Puskesmas dan Bidan Praktik Swasta.Hasil: Pada kelompok yang tidak mendapat konseling laktasi intensif tidak ada perubahan skor pengetahuan, sikap terhadap inisiasi menyusu dini, ASI eksklusif, ASI, menyusui dan tidak ada peningkatan jumlah ibu yang memberikan ASI eksklusif sampai 3 bulan pada anak yang dilahirkan sebelum dan selama penelitian. Kelompok yang mendapat konseling laktasi yang intensif menunjukkan ada perubahan skor pada semua anak dan peningkatan jumlah ibu yang memberikan ASI eksklusif sampai 3 bulan pada anak yang dilahirkan selama penelitian menjadi 5 kali lipat.Simpulan: Konseling laktasi intensif dapat meningkatkan jumlah ibu yang melaksanakan ASI eksklusif sampai 3 bulan dan perlu dilaksanakan oleh semua sarana pelayanan persalinan.

Gamelan Music and Physiological Responses in Patients with Ventilator Support Suhartini Suhartini; Charuwan Kritpacha; Ploenpit Thaniwattananon
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 3 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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Background: Music is a non-pharmacological nursing intervention that can be used complementarily in the care of patients receiving ventilator support. The study aim was to explore the effects of music intervention on physiological responses for patients receiving ventilator support in intensive care units in Indonesia.Methods: It was a quasi experimental study using a non-equivalent control group and pre-test/post-test design. Forty subjects were assigned into either a control or experimental group (20 subjects/group). The outcome measures were physiologic responses, including systolic and diastolic blood pressure, heart rate, and respiratory rate obtained every 10 minutes for 20 minutes of music intervention. Data analysis used Chi-square test, Fisher-exact test, independent t-test, and paired sample t-test.Result: The findings showed that the subjects who received music intervention demonstrated statistically significant reductions in sympathetic physiological responses (p<0.05). Specifically, there was a significant difference in systolic blood pressure, but there was no significant difference in diastolic blood pressure, heart rates, and respiratory rate between the two groups. In the between groups comparison, it was only diastolic blood pressure that showed the reduction of mean score from pretest to posttest in the experimental group and in the control group.Conclusion: Gamelan intervention gives positive impact to patients with ventilator.Keywords: Music intervention, ventilator support, physiological responses ABSTRAK Musik gamelan dan responfisiologi pada pasien dengan ventilatorLatar belakang: Musik adalah intervensi keperawatan secara non farmakologikal yang dapat digunakan secara komplementari dalam merawat pasien yang menggunakan ventilator. Riset ini bertujuan untuk mengeksplorasi efek intervensi musik dalam menurunkan respon fisiologis pasien dengan ventilator di ruang perawatan intensif di Indonesia.Metode: Penelitian adalah penelitian semu dengan rancangan grup kontrol non-equivalen, pre dan post pengukuran. Ada 40 subyek penelitian yang dikelompokkan dalam grup kontrol dan grup eksperimen. Hasil yang diukur adalah tekanan darah sistolik dan diastolik, denyut jantung, dan frekuensi pernafasan, yang didapatkan dari pengukuran setiap 10 menit dalam 20 menit pemberian intervensi musik. Data diukur dengan menggunakan uji Chi-square, uji Fisher-exact, uji t-independen, dan uji t-berpasangan.Hasil: Hasil menunjukkan bahwa subyek yang menerima intervensi musik secara signifikan menurunkan respon simpatetik fisiologis (p<0,05). Secara spesifik, ada perbedaan yang bermakna dalam tekanan darah sistolik, tetapi tidak ada perbedaan yang signifikan dalam tekanan darah diastolik, denyut jantung, dan frekuensi pernafasan diantara kedua grup. Pada kelompok kontrol, hanya tekanan darah diastolik yang menunjukkan menurunkan skor rerata dari pretes ke postes dalam grup eksperimen dan grup kontrol.Simpulan: Intervensi gamelan memberi dampak positif pada pasien dengan ventilator

Pengembangan Sistem Kewaspadaan Dini Malaria Berbasis Sistem Informasi Lingkungan (EIS-EWSM) Bagi Pengambilan Kebijakan di Daerah Endemis Pedesaan Pulau Ambon Salakory Melianus
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 3 YEAR 2012
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Development of malaria early warning system based environmental information systems (EIS-EWSM) to policy making in endemic areas of rural Ambon IslandBackground: The study on the incidence of malaria by using environment risk approach that emphasizes the linkage relationship between the host (host), agent (agent), and the environment (environment) need to be used more widely in public health in controlling the prevalence, incidence and distribution in an effort to prevent an increase in malaria cases/outbreaks of malaria. Were assessing the environmental parameters that can be used in the preparation of the environmental information system for decisionmaking in malaria endemic areas of Ambon Island, developed a model (prototype) environmental information system test the model (prototype), develop The EWSM, based on existing environmental information.Method: The design of this study was retrospective and prospective study design with time series observational approach; since March-November 2009 (for 9 whole months: dry season, early rain, the peak rainy, early dry/transition).Result: The results of a retrospective study, determined two potential areas of endemic malaria on the island of Ambon, namely: the village of Passo Baguala district city of Ambon, and the village of Hila-Kaitetu Leihitu district of district Central Molluca. Significant environmental risk factors included as model parameters are: density of larvae, ways of handling waste, drainage conditions, the proportion of forest, swamp proportion, the proportion of water bodies, the state of salinity, pH conditions, wind conditions, the state of precipitation, air humidity conditions, the state of air temperature, and density of the vector (Anopheles mosquito).Conclusions: Prepared by GIS, and maps of malaria distribution and map of priority malaria endemic in the village of Passo and Hila village. The EIS-EWSM, is a software that gives early warning outbreaks of malaria on the basis of environmental information. The program is also equipped with installation guide, and guide the application operates.Keywords: Development, malaria early warning system, based environmental information systems (EIS-EWSM), endemic areas, Rural Ambon Island ABSTRAKPendahuluan: Kajian terhadap kejadian malaria dengan menggunakan pendekatan lingkungan risiko yang menitikberatkan pada keterkaitan hubungan antara inang (host), agen (agent), dan lingkungan (environment) perlu digunakan secara lebih luas pada kesehatan masyarakat dalam melakukan pengontrolan terhadap prevalensi, insidensi dan distribusinya sebagai upaya untuk mencegah terjadinya peningkatan kasus Malaria/KLB Malaria. Tujuan khusus yang ingin dicapai dalam penelitian ini sebagai berikut adalah mengkaji parameter lingkungan yang dapat digunakan dalam penyusunan Sistem Informasi Lingkungan Malaria bagi pengambilan kebijakan di daerah Endemis Pulau Ambon, mengembangkan model (prototype) sistem informasinya, melakukan uji coba model (prototype) sistem informasi tersebut, kemudian mengembangkan EWSM.Metode: Rancangan penelitian ini adalah rancangan penelitian retrospektif dan diteruskan secara prospektif dengan pendekatan Time Series observational sejak Maret- Nopember 2009 (musim kemarau, awal hujan, puncak hujan, awal kemarau/pancaroba).Hasil: Hasil studi retrospektif dipakai untuk menentukan dua daerah potensi endemis malaria di pulau Ambon yaitu desa Passo (wilayah Puskesmas Passo) kecamatan Baguala Kota Ambon, dan desa Hila-Kaitetu (wilayah Puskesmas Hila) Kecamatan Leihitu Kabupaten Maluku Tengah. Hasil studi secara prospektif, ditemukan faktor lingkungan risiko yang signifikan dimasukkan sebagai parameter model adalah kepadatan jentik, cara penanganan sampah (konteiner), keadaan drainase, proporsi hutan, proporsi rawa, proporsi tubuh air, keadaan salinitas, keadaan pH, keadaan angin, keadaan curah hujan, keadaan kelembaban udara, keadaan suhu udara, dan kepadatan vektor (nyamuk anopheles).Simpulan: Olahan dengan SIG, menghasilkan peta distribusi malaria serta peta prioritas endemis malaria di desa Passo dan di desa Hila. EIS-EWSM, merupakan software yangmemberikan peringatan dini terjadinya KLB malaria dengan basis informasi lingkungan. Program tersebut dilengkapi pula dengan panduan penginstalan, dan panduan mengoperasikan aplikasi.

Pemberian Stimulasi Selama Satu Jam pada Perkembangan Anak Usia 12-24 Bulan Mira Irmawati; I Gusti Ayu Indah Ardani Ayu Indah Ardani; Dewi Astasari; Irwanto Irwanto; Ahmad Suryawan; Moersintowarti B Narendra
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 3 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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The influence of one hour stimulation in children aged 12-24 monthsIntroduction: Early stimulation plays an important role to reach optimal growth and development in children, especially cognitive, affective, and psychomotor developments. Stimulation has to be done continuously because this is important to maintain the connection between brain cells (synapse). Lack of stimulation can influence loss of brain cells functions. The aim of this study is to determine the influence of one hour stimulation on the development of children aged 12-24 months.Methods: An experimental analytic study with cohort prospective was conducted on children aged 12-24 months in Gubeng district, Surabaya, from September 2008-February 2009. Seventy healthy children were randomly divided into two groups, stimulation group and control group. Denver II was used to evaluate children’s developmental status, conducted before and after stimulation. Data analysis using McNemar and Chi Square test.Result: There were improvement on development in both groups, from 85.7% become to 94.3% in the stimulation group and 68.6% to 77.1% in the control group. There was a significant influence on children development, only 10% children did not have any development delay anymore in the stimulation group, but in the control group still 30% (p=0.042). After 3 months, there was an improvement of development in the stimulation group from suspect to normal in 80%, and 63.6% in the control group, but notsignificant (p=0.375 vs p=0.549).Conclusion: Early stimulation improves the development of children aged 12-24 months.Keywords: Children, aged 12-24 months, early stimulation, Denver II ABSTRAKPendahuluan: Stimulasi mempunyai peran penting untuk meningkatkan pertumbuhan dan perkembangan anak, terutama fungsi kognitif, afektif dan psikomotor. Stimulasi yang terus menerus mengakibatkan hubungan antar sel otak (sinapsis) bisa berjalan dengan baik. Kurangnya stimulasi akan mengakibatkan hilangnya fungsi sel-sel otak ini. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian stimulasi selama 1 jam pada perkembangan anak usia 12-24 bulan.Metode: Penelitian dilakukan secara analitik prospektif kohort pada anak usia 12-24 bulan di Kecamatan Gubeng, Surabaya, mulai bulan September 2008 hingga Februari 2009. Tujuh puluh anak sehat secara acak dibagi dalam 2 kelompok, kelompok stimulasi dan kelompok kontrol. Denver II digunakan untuk menilai status perkembangan anak, sebelum dan sesudah perlakuan. Analisis data menggunakan uji McNemar dan Chi Square.Hasil: Didapatkan perbaikan perkembangan pada kedua kelompok, dari 85,7% menjadi 94,3% pada kelompok stimulasi, dan 68,6% menjadi 77,1% pada kelompok kontrol. Terdapat perbedaan bermakna pada kemampuan perkembangan, hanya 10% tidak mengalami keterlambatan pada kelompok stimulasi, sedangkan kelompok kontrol 30% (p=0,042). Setelah 3 bulan, terjadi peningkatan perkembangan pada kelompok stimulasi dari subyek yang suspek menjadi normal sebesar 80%, dan kelompok kontrolsebesar 63,6%, tetapi tidak bermakna (p=0,375 vs p=0,549).Simpulan: Pemberian stimulasi satu jam meningkatkan kemampuan perkembangan anak usia 12-24 bulan.

Efek Ekstrak Etanol Morinda Citrifolia L (Mengkudu) Terhadap Kadar Gula Darah, Jumlah Neutrofil, dan Fibronektin Glomerulus Tikus Diabetes Mellitus Indranilla Kustarini; Sri Sinto Dewi; Ika Pawitra M
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 3 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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Ethanol extract of Morinda citrifolia L (mengkudu), blood glucose, neutrophyl count, and glomerulus fibronectin in diabetes mellitus ratBackground: Diabetes mellitus is a metabolic disease which caused by the present of insulin abnormality. Diabetes is shown by hyperglycemia to release free radical, superoxide, that induce oxidative stress. This stress will increase mesangial matrix production in glomerulus such as fibronectin. Ethanol extract Morinda citrifolia contain fenolat and flavonoid which have antioxidant system toblock the oxidative stress. This research purpose was to analyze the effect of ethanol extract Morinda citrifolia to blood glucose, neutrophyl count, glomerulus fibronectin of diabetes mellitus rats.Method: Using the post test only control group design, diabetic Sprague Dawley rats induced streptozotocin dose 40mg/kgBW, were divided into 4 groups of grading doses (10, 20, 40, 80mg/dl) of ethanol extract Morinda group and 1 control group. Each group used 6 male rat. Blood glucose, neutrophyl count and glomerular fibronectin were examined. Data analyze with Kruskall Wallis and ANOVA using SPSS ver 15.0Result: The mean of blood glucose before and after treating with extract ethanol Morinda were 553.04mg/dl and 408.81mg/dl respectively. Different score of neutrophyl count was p=0.0574 and fibronectin expression was p=0.000. Ethanol extract Morinda citrifolia can reduce blood glucose, and the fibronectin expression in glomerulus of diabetic rats significantly, but not for neutrophyl count. The lowest fibronectin expression occurred on dose 20 mg/dl.Conclusion: Extract ethanol Morinda citrifolia L (Mengkudu) improve diabetic nephtopathy through reducing blood glucose, netrophyl count, and fibronectin.Keyword: Morinda citrifolia, blood glucose, neutrophyl count, glomerular fibronektin ABSTRAKLatar belakang: Diabetes mellitus merupakan penyakit metabolik yang disebabkan karena adanya kelainan sekresi atau kerja insulin. Diabetes mellitus ditandai dengan adanya hiperglikemi, dimana pada kondisi ini akan melepaskan radikal bebas, superoksid, yang akan menyebabkan stres oksidatif, dengan akibat kerusakan sel baik sel neutrofil, sel mesangial ginjal yang akan mengeluarkan matrik ekstra sel berupa fibronektin. Ekstrak etanol Morinda citrifolia L memiliki kandungan fenolat dan flavonoid, dapat membantu sistem antioksidan dalam tubuh yang dapat mengatasi stres oksidatif. Penelitian ini bertujuan untuk menganalisis efek ekstrak etanol Morinda citrifolia L terhadap kadar gula darah, jumlah neutrofil, dan ekspresi fibronektin glomerulus tikus diabetes mellitus.Metode: Penelitian ini menggunakan pendekatan post test only control group design pada tikus Sprague Dawley yang diinduksi Streptozotozin (dosis 40mg/kgBB) sehingga menjadi DM, kemudian dikelompokkan menjadi 4 kelompok perlakuan ekstrak etanol Morinda citrifolia L (Mengkudu) dengan dosis 10, 20, 40, 80mg/dl dan 1 kelompok kontrol DM. Data dianalisis menggunakan uji Kruskal Wallis dan ANOVA dengan SPSS ver 15.0.Hasil: Rerata kadar gula darah sebelum 553,04 mg/dl dan sesudah diberi Morinda 408,81 mg/dl. Hasil menunjukkan perubahan jumlah neutrofil diperoleh nilai p=0,0574, dan ekspresi fibronektin glomerulus diperoleh nilai p=0,000. Ekstrak etanol Morinda citrifolia L menurunkan kadar gula darah dan ekspresi fibronektin secara bermakna, namun tidak bermakna pada jumlah neutrofil. Dosis 20 mg/dl merupakan dosis yang paling baik menurunkan ekspresi fibronektin glomerulus.Simpulan: Ekstrak etanol Morinda citrifolia L (Mengkudu) memperbaiki fungsi ginjal diabetes nefropati melalui penurunan gula darah, jumlah neutrofil dan fibronektin.

Kecemasan pada Penderita Penyakit Ginjal Kronik yang Menjalani Hemodialisis di RS Universitas Kristen Indonesia Luana NA; Sahala Panggabean; Joyce VM Lengkong; Ika Christine
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 3 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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Anxiety in chronic renal failure patients underwent hemodialysis at Christian University of Indonesia HospitalBackground: Anxiety is a pathological condition, characterized by fear and somatic signs. Anxiety is also a response to unidentified, internal, vague threads and conflicts. One of the etiologies of anxiety is biological disorder, such as chronic renal failure (CRF) which needs hemodialysis. Hemodialysis patients experience anxiety, which probably due to its chronicity. The aim of this study is to identify the difference of frequency and period of hemodialysis in various level of anxiety in CRF patients underwent hemodialysis atChristian University of Indonesia Hospital.Methods: This is an observational study with cross-sectional design, conducted during October-December 2011. Anxiety level was measured using the Hamilton Rating Scale for Anxiety (HRSA). Kruskall Wallis test was used to analyze the difference of frequency and period of hemodialysis in three levels of anxiety (mild, moderate, and severe).Results: Twenty eight (51.9%) men and 26 (48.1%) women with CRF who underwent hemodialysis at Christian University of Indonesia Hospital were included in this research. There were 42 (77.78%) among them who experienced anxiety. Patients with the longest mean of period and frequency of hemodialysis experienced mild anxiety, whereas patients with the shortest mean of period and frequency of hemodialysis experience moderate anxiety. There are significant differences found between period and frequency of hemodialysis and levels of anxiety (p=0.002 and p=0.003, respectively).Conclusion: There are significant differences found between period and frequency of hemodialysis and levels of anxiety.Keywords: Hemodialysis, anxiety, HARS ABSTRAKLatar belakang: Cemas (ansietas) adalah suatu keadaan patologik yang ditandai oleh perasaan ketakutan diikuti dan disertai tanda somatik. Kecemasan juga merupakan respon terhadap suatu ancaman yang sumbernya tidak diketahui, internal, samar-samar, atau konfliktual. Kecemasan salah satunya disebabkan oleh gangguan biologik, seperti penyakit ginjal kronik (PGK) yang membutuhkan hemodialisis. Penderita hemodialisis mengalami kecemasan, salah satunya dapat diakibatkan oleh kronisitas penyakit. Penelitian ini bertujuan untuk mengetahui perbedaan frekuensi dan periode menjalani hemodialisis pada berbagai derajat kecemasan pada penderita penyakit ginjal kronik yang menjalani hemodialisis di RS Universitas Kristen Indonesia.Metode: Penelitian ini adalah penelitian observasional dengan rancangan cross-sectional, dilakukan selama bulan Oktober- November 2011. Pengukuran derajat cemas menggunakan instrument Hamilton Rating Scale for Anxiety (HRSA). Dilakukan analisis uji beda Kruskall Wallis untuk menganalisis perbedaan frekuensi dan periode hemodialisis pada tiga derajat kecemasan (ringan, sedang, dan berat).Hasil: Dua puluh delapan (51,9%) laki-laki dan 26 (48,1%) perempuan penderita PGK yang menjalani hemodialisis di Universitas Kristen Indonesia ikut serta dalam penelitian ini. Terdapat 42 (77,78%) di antaranya yang mengalami kecemasan. Penderita dengan rerata periode dan frekuensi hemodialisis terpanjang mengalami kecemasan ringan, sedangkan penderita rerata periode dan frekuensi hemodialisis terpendek mengalami kecemasan sedang. Terdapat perbedaan yang bermakna antara frekuensi dan periodehemodialisis dan derajat kecemasan pada penderita hemodialisis (p=0,002 dan p=0,003, secara berurutan).Simpulan: Terdapat perbedaan yang bermakna antara frekuensi dan periode hemodialisis dan derajat kecemasan pada penderita hemodialisis.

Citra Tubuh, Pendidikan Ibu, Pendapatan Keluarga, Pengetahuan Gizi, Perilaku Makan dan Asupan Zat Besi pada Siswi SMA Santi Dwi Rahayu; Fillah Fithra Dieny
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 3 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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The body image, mother’s education, family income, nutritional knowledge, eating behavior and iron intake among senior high school female studentsBackground: The concept of ideal body shape in female adolescent is tall and slim that oftenly to lead restriction of the food intake especially the food sources of iron that are considered as foods with high fat. This study aimed to identify factors association between body image, mother’s education, family income, nutritional knowledge, and eating behavior with iron intake among senior high school female students.Method: This study used cross sectional design, and it was conducted on female students at SMA Negeri 1 Tangerang Selatan. The selection of 80 subjects was performed by stratified random sampling technique. Data on body image was obtained by body shape questionnaire, family income, mother’s education, nutritional knowledge and eating behavior were collected by questionnaire, and iron intake was obtained by 24-hour food recall. Data were analyzed by Rank Spearman.Result: Subjects aged in 15-17 years old. The subjects had a dissatisfaction of their body image were 41.25% subjects and 40% subjects had deficit iron intake. Subjects had inappropriate eating behavior 47.5% and 66.3% were classified as intermediate level of family income. The level of mother’s education at SMA/MA were 53.8% subjects and only 7.5% subjects had good nutritional knowledge. The subjects had a dissatisfaction of their body image would be had inappropriate eating behavior so they had lower iron intake too. The good mother’s education of subjects would be had good iron intake, moreover the higher family income that increased food expenditure so subjects had adequate iron intake. The nutritional knowledge was not correlated with iron intake.Conclusion: Body image was associated with eating behavior. Eating behavior, mother’s education, and family income were correlated with iron intake.Keywords: Body image, eating behavior, iron intake ABSTRAKLatar belakang: Konsep tubuh ideal tinggi langsing menimbulkan remaja putri melakukan pembatasan asupan makanan terhadap sumber zat besi yang dianggap sebagai makanan dengan lemak tinggi. Tujuan penelitian untuk mengidentifikasi hubungan antara citra tubuh, pendidikan ibu, pendapatan keluarga, pengetahuan gizi dan perilaku makan dengan asupan zat besi pada siswi SMA.Metode: Rancangan penelitian cross sectional. Populasi adalah siswi SMA Negeri 1 Tangerang Selatan. Pemilihan 80 subyek dilakukan secara stratified random sampling. Data citra tubuh dengan body shape questionnaire, pendapatan keluarga dengan angket, pendidikan ibu, pengetahuan gizi dan perilaku makan dengan kuesioner serta asupan zat besi dengan kuesioner food recall 24 jam. Data dianalisis dengan korelasi Rank Spearman.Hasil: Subyek berusia 15-17 tahun. Subyek dengan ketidakpuasan citra tubuh sebanyak 41,25% dan 40% subyek mempunyai tingkat asupan zat besi defisit. Subyek dengan perilaku makan tidak sesuai sebanyak 47,5% dan 66,3% subyek mempunyai tingkat pendapatan keluarga ekonomi menengah. Tingkat pendidikan ibu subyek tamat SMA/MA sebanyak 53,8% dan hanya 7,5% yang mempunyai tingkat pengetahuan gizi baik. Subyek dengan citra tubuh yang tidak puas cenderung mempunyai perilaku makan yang tidak sesuai sehingga asupan zat besinya rendah. Subyek dengan ibu berlatar belakang pendidikan tinggi cenderung mempunyai asupan zat besi baik, selain itu makin tinggi pendapatan keluarga, maka pengeluaran belanja pangan makin meningkat sehingga asupan zat besi pada subyek terpenuhi. Namun pengetahuan gizi tidak berhubungan dengan perilaku makan.Simpulan: Citra tubuh berhubungan dengan perilaku makan. Perilaku makan, pendidikan ibu, dan pendapatan keluarga berhubungan dengan asupan zat besi

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Journal Mail Official
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Kota semarang,

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