AbstrakUpaya penguatan karakter menjadi dasar dalam penerapan kurikulum 2013. Penerapan kurikulum 2013 ini memberikan perubahan paradigma, dimana pada hasil akhir pembelajaran siswa tidak hanya menguasai pengetahuan tetapi juga menguasai sikap dan keterampilan. Salah dua karakter yang dikembangkan adalah rasa ingin tahu dan peduli sosial. Untuk membentuk karakter tersebut maka dibutuhkan instrumen pendidikan seperti pengajar yang berkompeten, sumber belajar yang memadai, serta yang terpenting adalah tindakan pembelajaran berupa pendekatan, model, metode, ataupun strategi pembelajaran yang tepat. Sehingga digagaslah penerapan model discovery learning dengan pendekatan saintifik. Yang mana model tersebut efektif dan efisien dalam menumbuhkan karakter rasa ingin tahu dan peduli sosial. Kata kunciRasa Ingin Tahu; Peduli Sosial; Discovery Learning AbstractEfforts to strengthen the character become the basis in the implementation of the curriculum 2013. Application of the 2013 curriculum provides a paradigm shift, which in the end result of learning students not only master the knowledge but also master the attitude and skills. One of the two characters developed is curiosity and social care. To form the character, it needs an educational instrument such as a competent teacher, adequate learning resources, and the most important is the action of learning in the form of approach, model, method, or appropriate learning strategy. So the application of discovery learning model with scientific approach. Which model is effective and efficient in bring up the character of curiosity and social care. KeywordsCuriosity, Social Care, Discovery Learning A. PendahuluanPendidikan dalam arti luas adalah transmisi dan transformasi pengetahuan (knowledge), nilai-nilai (values), dan keterampilan-keterampilan (skils) yang berlangsung di dalam dan di luar sekolah yang berlangsung seumur hidup (Siswoyo, 2013:109). Oleh 1 Surel korespondensi: achmadryan@gmail.com karena itu, konten pendidikan yang dipelajari tidak semata berupa prestasi tetapi juga sikap. Sehingga aspek yang menjadi fokus utama dari kegiatan pembelajaran Sekolah Dasar berdasarkan tujuan pendidikan nasional adalah pembentukan karakter.

Background/AimsBiliary stone disease is one of the most common conditions leading to hospitalization. In addition to endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasonography (EUS) and magnetic resonance cholangiopancreatography (MRCP) are required in diagnosing choledocholithiasis. This study aimed to compare the sensitivity and specificity of EUS and MRCP against ERCP in diagnosing choledocholithiasis. MethodsThis retrospective study was conducted after prospective collection of data involving 62 suspected choledocholithiasis patients who underwent ERCP from June 2013 to August 2014. Patients were divided into two groups. The first group (31 patients) underwent EUS and the second group (31 patients) underwent MRCP. Then, ERCP was performed in both groups. Sensitivity, specificity, and diagnostic accuracy of EUS and MRCP were determined by comparing them to ERCP, which is the gold standard. ResultsThe male to female ratio was 3:2. The mean ages were 47.25 years in the first group and 52.9 years in the second group. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for EUS were 96%, 57%, 87%, 88%, and 80% respectively, and for MRCP were 81%, 40%, 68%, 74%, and 50%, respectively.ConclusionsEUS is a better diagnostic tool than MRCP for diagnosing choledocholithiasis.

BACKGROUND An increasing trend in colorectal cancer (CRC) occurring at younger ages has been observed worldwide, even though incidence is declining in the general population. Most currently available guidelines still recommend CRC screening for older populations, despite an alarming rise in early-onset CRC incidence. Risk stratification is necessary to further determine the population most at risk for early-onset CRC. However, epidemiological data on related clinical characteristics and potential risk factors, especially in developing countries, have not been widely reported. AIM To investigate the prevalence, demographics, clinicopathologic features, and associated factors of young-onset CRC patients in a tertiary hospital in Indonesia. METHODS Patients undergoing colonoscopy examination between 2008 and 2019, yielding a diagnosis of CRC were identified from medical records. The subjects were classified into two groups according to their age at diagnosis, namely early-onset (18-49 years old) and late-onset (≥ 50-years-old). Demographic data, characteristics, and risk factors of both onset age groups were evaluated using the chi-square and Fisher’s exact test. RESULTS Among 495 CRC patients confirmed by histopathology, 205 (41.4%) were classified as early-onset and 290 (58.6%) as late-onset. Most subjects in the early-onset CRC group were male (53.7%), with 89.8% displaying adenocarcinoma histopathology. A majority (78%) of the early-onset CRC patients had left-sided tumors, with the rectum (41%) and rectosigmoid (17.6%) being the most common sites. Abdominal pain was the most frequent symptom in the early-onset CRC patients (55.6%), which was significantly higher than that in the late-onset CRC patients (43.8%, P < 0.05). Early-onset CRC cases were more likely to be underweight (34.6% vs 20.0%, P < 0.001) compared to late-onset CRC cases. The proportion of subjects with suspected hereditary nonpolyposis colorectal cancer (HNPCC) was also higher in the early-onset CRC group than in the late-onset age group (9.3% vs 4.1%, P < 0.05). However, no difference was observed in the parental or family histories of CRC cases. CONCLUSION Early-onset CRC patients were more likely to have abdominal pain, underweight status, and HNPCC suspicion than late-onset CRC patients.

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Aims To evaluate the success rate and related factors of endoscopic ultrasound guided-biliary drainage (EUS-BD). Material and Methods We conducted a retrospective study among 24 patients with malignant biliary obstruction who underwent EUS-BD after failed ERCP from January 2015 to December 2016 in a tertiary health center. The bilirubin levels before and after the procedure were used to define the clinical success rate, while the stent deployment was used to define the technical success rate. We placed either transluminal biliary stents or transpapillary biliary stents. Results Among 24 patients, choledochoduodenostomy technique was conducted in 23 patients (95.8%) and hepaticogastrostomy technique in 1 patient (4.2%). Transluminal stent placement was conducted in 23 patients, while transpapillary stent placement was conducted in 1 patient. The clinical success rate was 78.2% (18) in choledochoduodenostomy route and 100% (1) in hepaticogastrostomy route. EUS-BD was 2.37 times and 2.11 times more likely to be successful in reducing the bilirubin level in patients with tumor of the head of pancreas and periampullary tumor, respectively, but not in cholangiocarcinoma. Conclusions EUS-BD is an effective and efficient procedure to achieve biliary drainage among patients with malignant biliary obstruction after ERCP failure.

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A high incidence of tuberculosis (TB), especially in endemic countries, makes this infectious disease a concern. Abdominal TB contributes to 10% of extrapulmonary TB. Due to nonspecific clinical, radiological, and endoscopic findings, diagnosing abdominal TB continues to be a challenge. Hence, a precise diagnosis is needed. The diagnosis of gastrointestinal disease using endoscopic ultrasound (EUS) is often performed due to its high resolution and ability to provide a real-time visual representation of the gastrointestinal tract and extramural structures. EUS-guided fine-needle aspiration (FNA) and fineneedle biopsy (FNB) have helped diagnose TB as they offer an adequate specimen for cytology or histopathological examination. This method is considered safer, more effective, and more efficient. The capacity of EUS to diagnose abdominal TB based on the affected organs was examined via a literature search. We reviewed the role of EUS in diagnosing esophageal, gastric, pancreatic, peripancreatic, hepatosplenic, peritoneal, and intestinal TB. Generally, EUS aids in diagnosing abdominal TB. In some organs, it is superior to other diagnostic modalities. However, further examinations, such as cytology or histopathology and microbial, are still needed. We also studied the roles of EUS-FNA and EUS-FNB. EUS-FNA has shown a high diagnostic yield in esophageal (94.3-100%), pancreatic and peripancreatic (76.2%), and intestinal TB (84.1%). As minimally invasive methods, EUS-FNA and EUS-FNB can successfully provide sufficient samples. EUS is a functional diagnostic modality for abdominal TB. EUS-FNA and EUS-FNB provide sufficient samples safely and efficiently for further cytology, histopathology, and microbial examinations. Esophageal tuberculosisEsophageal TB is uncommon and has nonspecific clinical, laboratory, radiological, and endoscopic features. With prevalence

Objective To determine the correlation between hypertensive retinopathy (which is the end-organ damage of the vessels due to chronic hypertension) with sensorineural hearing loss.Methods Pure tone hearing threshold of 56 hypertensive patients were compared with 56 normal age and sex matched control. Comparisons of pure tone hearing threshold are made among different group (grade) of hypertensive retinopathy patients and control (non-hypertensive patients).