The aim of the study was to determine the effect of nutrition education in the form of DASH diet booklets on body mass index, waist circumference, mid-upper arm circumference, and blood pressure in obese adolescents. Methods: This study was quasi-experimental, which is pre-test and post-test with control group design. The number of subjects was 60 respondents. The groups in this study were divided into two; one treatment group and one control group. The first group was given a nutrition education intervention with a booklet and the second group was not treated. Data analysis used paired t-test and independent t-test (p=0.05; CI=95%), Wilcoxon test, Mann-Whitney test, and Spearman rank test. Results: There were differences in BMI, waist circumference, mid-upper arm circumference, and significant systolic blood pressure in the treatment group after the intervention. The mean average of the treatment group decreased significantly; BMI: 0.36±0.05 kg/m2; waist circumference: 0.84±0.14 cm; mid-upper arm circumference: 0.37±0.63 cm, and systolic blood pressure: 1.13±1.36 mmHg. In the control group the average BMI, waist circumference, mid-upper arm circumference, and systolic blood pressure were increased significantly. The treatment group experienced a decrease in energy intake by 524.65±85.77 kcal while physical activity increased by 0.635±0.09. Conversely, the control group experienced an increase in energy intake by 147.29±25.18 kcal, while physical activity decreased by 0.470±0.08. Changes in energy intake and physical activity between the treatment group and the control group were identified as significant correlations (p<0.001). Similar to it, the changes in the BMI, waist circumference, mid-upper arm circumference, and significant systolic blood pressure were identified as significant correlations (p<0.001). Application: The use of booklets can be a solution for the continuation of effective nutrition education as the nutritional information becomes easier to be comprehended and adapted by the booklet recipients and used in everyday life.
Multidrug-Resistant Tuberculosis (MDR-TB) with bacillary resistance to at least isoniazid and rifampicin in vitro is a worldwidephenomenon. For MDR-TB second-line antibiotic agents that are more potent and more toxic must be used. . One of them is kanamycingiven intravenously every day for six (6) months therapy. Kanamycin is nephrotoxic and can lead to hypokalemia. This study is carriedout to know the comparison between the potasium level before and after kanamycin therapy (2, 4 and 6 months after therapy). Thisstudy is a cohort retrospective design, comprising 34 patients who had a potassium baseline before therapy in Moewardi Hospital,Surakarta from January 2011–August 2012. The characteristic data included: age, sex, weight and comorbidity. The potassium levelafter 2, 4 and 6 months post therapy was compared with the potassium data baseline using One Way ANOVA test with p< 0.05, CI95%. The difference between the potassium level after 6 months therapy and potassium baseline was significant, p < 0.05. However,the difference of the kalium level after 2 and 4 months after therapy was not significant, p > 0.05. Hypokalemia occurred in 6 patientsafter 2 months therapy, 8 patients after 4 months therapy and 3 patients after 6 months therapy. There was a significant differencebetween the potassium level after 6 months therapy and potassium baseline. Further study should be continued to know the existenceof hypokalemia among MDR-TB patients
Invasive Fungal Infections (IFIs) can cause serious problems in cancer patients and may result in high morbidity andmortality. C-reactive protein levels increase in response to injury, infection, and inflammation. C-reactive protein increasesin bacterial infections (mean of 32 mg/L) and in fungal infections (mean of 9 mg/L). This study aimed to determineC-Reactive Protein (CRP) as a marker of fungal infections in patients with acute leukemia by establishing cut-off values ofCRP. This study was an observational analytical study with a cross-sectional approach and was carried out at the Departmentof Clinical Pathology and Microbiology of Dr. Moewardi Hospital in Surakarta from May until August 2019. The inclusioncriteria were patients with acute leukemia who were willing to participate in this study, while exclusion criteria were patientswith liver disease. There were 61 samples consisting of 30 male and 31 female patients with ages ranging from 1 to 70 years.Fifty-four patients (88.5%) were diagnosed with Acute Lymphoblastic Leukemia (ALL) and 30 (49.18%) were in themaintenance phase. The risk factors found in those patients were neutropenia 50-1500 μL (23.8%), use of intravenous line(22%), and corticosteroid therapy for more than one week (20.9%). The median of CRP in the group of patients with positiveculture results was 11.20 mg/L (11.20-26.23 mg/L) and negative culture results in 0.38 mg/L (0.01-18.63 mg/L). The cut-offvalue of CRP using the Receiver Operating Curve (ROC) was 9.54 mg/L (area under curve 0.996 and p. 0.026), with a sensitivityof 100%, specificity of 93.2%, Positive Predictive Value (PPV) of 33.3%, Negative Predictive Value (PPV) of 100%, PositiveLikelihood Ratio (PLR) of 1.08, Negative Likelihood Ratio (NLR) of 0 and accuracy of 93.4%. C-reactive protein can be used asa screening marker for fungal infections in patients with acute leukemia.
Coronary Artery Disease has a high prevalence and is frequently occurred and associated with the high mortality and morbidity. Dyslipidemia is one of the risk factors of Coronary Heart Disease (CHD). ApoB contained in very low-density lipoproteins (VLDL), intermediate-density lipoproteins (IDL), LDL and small dense LDL (sd-LDL), with one molecule of apoB in each particle. Apo A-I is the major apolipoprotein in HDL particles. The ratio of apoB/apoA-I is a balance between apoB-containing particles and potentially atherogenic apoA-I that is antiaterogenik. This study is carried to know the determination whether there are differences between apoB/ apoA-I ratio in patients dyslipidemia with ACS and non ACS. The research used a cross-sectional study design with patients dyslipidemia subjects suffering Acute Coronary Syndrome (ACS) and non ACS who enter to the Laboratory of Pathology Clinic at Dr. Moewardi Hospital between July and November 2011. To determine the pattern of data distribution, the researchers used Kolmogorov Smirnov test. For the analysis of differences in mean apoB/apoA-I ratio in the two population groups is used the T test, using a computer program, with the significance level p<0.05, 95% confidence interval. From 74 samples examined the mean age is 56.42 year old. This patients consisted of 33 males (44.6%) and 41 women (55.4%). All subjects are grouped into two groups, dyslipidemia ACS and non dyslipidemia ACS. The results showed apoB/apoA-I ratio significantly different in patients with dyslipidemia with ACS and non ACS. The mean apoB/apoA-I ratio of women and men subjects in both groups, including groups at high risk of myocardial myokard and higher than the cut-off ratio of apoB/ apoA-I (men 0.9 and women 0.8). It can be concluded that the apoB/apoA-I ratio of women and men subjects in both groups, included the high risk category for infarct myokard although lipid abnormalities are still not demonstrated to the risk of infarct myokard.
Hepatitis B Virus (HBV) infection cause damage to the liver parenchym and continuous injury resulting in liver fibrosis. The neutrophil-lymphocyte ratio is a non-invasive marker of inflammation. Type IV collagen is a direct marker of hepatic fibrosis indicating transformation of the extracellular matrix of the liver, and its concentration is proportional to the degree of damaged liver cells and impaired liver function. APRI score and FIB-4 index are non-invasive methods for determining the degree of liver fibrosis. This study aimed to determine the performance of the neutrophil lymphocyte ratio, type IV collagen and fibrosis score on liver fibrosis in chronic hepatitis B. The study design was analytical observational with cross-sectional approach. The subjects included 42 chronic hepatitis B patients who admitted to Internal Medicine Department of Dr. Moewardi Hospital Surakarta from September to November 2020. The subject were grouped into fibrosis 21(50%) and non fibrosis groups 21(50%) based on transient elastography. Neutrophil lymphocyte ratio, type IV collagen and fibrosis score cut off point was determined with receiver operating curve (ROC) and diagnostic test was performed with 2x2 table. The cut-off point of 1.89 from the neutrophil lymphocyte ratio obtained sensitivity 61.9% and specificity of 38.1% with an AUC value of 0.524, while type IV collagen with a cut off point of 18.32 ng/mL obtained sensitivity 80.9% and specificity of 42.6% with an AUC of 0.642, a cut off 0.25 from the APRI score obtained a sensitivity of 81% and specificity of 61.9% with an AUC of 0.857, and cut-off FIB-4 of 0.68 obtained a sensitivity of 85.7% and specificity of 71.4 with AUC of 0.827. Neutrophil lymphocyte ratio with cutoff point of 1.89 has a weak diagnostic value on liver fibrosis in chronic hepatitis B. Further study by comparing or combining with other markers are needed. Type IV collagen with a cut off of 18.32 ng/mL, APRI score with a cut off of 0.25 and a FIB-4 index with a cut off of 0.68 can be used for screening liver fibrosis in chronic hepatitis B patients
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