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Background. Multiple sclerosis (MS) is an autoimmune disease characterized by inflammation and demyelination of the central nervous system which often involves the optic nerve even though only 20% of the patients experience optic neuritis (ON). Objective. This study aims to compare the retinal structure and optic nerve function between patients with MS and healthy controls (HCs), evaluate optic nerve alterations in MS over 1-year follow-up, and analyze its correlations with disease duration, number of relapses, degree of disability, and different subtypes. Methods. This is a prospective cohort study involving 58 eyes of MS patients. Optic nerve function was evaluated with best-corrected visual acuity (BCVA), contrast sensitivity, and P100 latency, while the retinal structure was evaluated from the GCIPL and RNFL thickness measured with optical coherence tomography (OCT) and fundus photography. Results. The MS group had lower BCVA ( p = 0.001 ), contrast sensitivity ( p < 0.001 ), mean GCIPL thickness ( p < 0.001 ), and mean RNFL thickness ( p < 0.001 ) than HC. At 6 and 12 months of observations, GCIPL and RNFL (nasal quadrant) of MS patients decreased significantly ( p = 0.007 and p = 0.004 , respectively). Disease duration and the number of relapses correlated with delayed P100 latency (r = −0.61, p < 0.001 and r = −0.46, p = 0.02 ). GCIPL and RNFL in the SPMS subtype were thinner than in RRMS. Conclusions. The retinal structure and optic nerve function of MS patients are worse than those of normal individuals. GCIPL and RNFL thinning occurs at 6 and 12 months but do not correlate with disease duration, the number of relapses, and degree of disability.

Value Added Tax (VAT) for Drinking Water Supply System (DWSS) in Indonesia has not been formulated impartially, holistically and comprehensively by involving related institutions/ ministries. There are disputes that causes a high cost of taxation that discourages the achievement of Millennium Development Goals target. It is notably significant to put the VAT policy on DWSS in the paradigm of national interests and fulfillment of human rights. This study used the paradigm of constructivism with data collection technique through in-depth interviews and Focused Group Discussion (FGD). An evidence based policy was adopted to conduct a better outcome of the study to promote amendment of related VAT regulations. The results of the study indicate an inconsistency between VAT policy and Government Regulations, both Minister of Health Regulations and other Ministries Regulations on Drinking Water Supply System. The impact of the inconsistency was the tax dispute that ultimately causes a high cost of taxation on both sides as well as VAT treatment inconsistency within the drinking water providers (PDAMs) themselves. A practical implication of this study generates the enactment of Government Regulation Number 40/2015 as an amendment of prior regulation concerning VAT exemption on DWSS.

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Introduction: to determine the effect of citicoline 1000 mg oral supplementation given for 4 weeks on electroretinography abnormalities in patients with NPDR (non-proliferative diabetic retinopathy).Methods : prospective, double blind, randomized clinical trial. Thirty-eight patients who matched the inclusion and exclusion criteria were randomized into two groups: the placebo (P-NPDR) and citicoline (C-NPDR). In the end, there were 18 eyes in citicoline group and 16 eyes in placebo group. The primary outcome was P50 and N95 amplitude in PERG within group and intergroup which were taken at the baseline and 4 weeks after treatment.Results : at the end of treatment, the N95 amplitude in C-NPDR showed improvement, 4.85 (1.9-10.3) µV, before treatment to 5.7 (1.9-17.1) µV, after treatment with P = 0.04. Median P50 amplitude improved in both groups, with C-NPDR: 3.1 µV to 3.8 µV (p = 0.89), and P-NPDR: 3.5 µV, to 4.5 µV (p = 0.10). Delta ∆N95 amplitude is higher in C-NPDR, while delta ∆P50 amplitude is higher in P-NPDR, with P values 0.35 and 0.45. Conclusion :Oral citicoline may induce a significant improvement in mean N95 amplitude before and after the treatment. P-NPDR showed positive trend in P50 amplitude while in C-NPDR showed positive trend in N95 amplitude, but these values were not statistically significant (P = 0.45; P= 0.35).

Latar belakang : Mengetahui karakteristik demografis pasien, hasil terapi yang diberikan dan menemukan faktor prediktor keberhasilan terapi pasien NOT di RSCM. Metode : Penelitian deskriptif menggunakan data sekunder dari telusur rekam medis pasien yang terdiagnosis NOT dari poliklinik Divisi Neuro-Oftalmologi (NO) Departemen Medik Mata FKUI/RSCM pada periode Januari 2014 hingga Desember 2015. Hasil : Karakteristik demografik pasien NOT di RSCM ialah 82,4% laki-laki, dan rerata usia adalah 22,47 ± 10,68 tahun. Sebanyak 50% datang dalam rentang kurang dari 24 jam pasca trauma. Penurunan tajam penglihatan berat (58,8% NLP), 67,6% dengan RAPD positif, dan papil nervus optik yang bervariatif. Sebanyak 67,6% ditatalaksana dengan metilprednisolon intravena (1 g/hari selama 3 hari), 26,5% dengan metilprednisolon oral (0,8mg/kgBB/hari). Perbaikan tajam penglihatan dijumpai pada 32,4% pasien yang mendapatkan pengobatan selama satu bulan. Pasien close globe injury yang mendapat terapi < 24 jam secara statistik terjadi perbaikan tajam penglihatan (p = < 0.05). Kesimpulan : Faktor prediktor seperti awitan trauma, awitan terapi inisial dan hasil pencitraan pada penelitian ini belum kuat untuk menjadi acuan dalam memprediksi keberhasilan terapi. Akan tetapi, pasien dengan closed globe injury yang diobati kurang dari 24 jam menunjukkan perbaikan tajam penglihatan yang signifikan. Dosis metilprednisolon IV 1 gram/hari selama 3 hari yang dilanjutkan dengan penirusan dosis per inggu maupun pemberian preparat oral dengan dosis 0.8 mg/KgBB/hari dapat digunakan. Pengobatan dilakukan setidaknya sampai dengan 1 bulan pasca pengobatan karena kurang baiknya kepatuhan pasien neuropati optik traumatic.

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The impact of logistics performance on global competitiveness and its consequences for economic growth are investigated in this study. Customs, infrastructure, international shipping, logistics service quality, monitoring and tracing, and timeliness are among the six criteria of the World Bank's Logistics Performance Index. The purpose of this study is to describe the causal relationship and test the hypothesis using an explanatory method (hypothesis testing study). The secondary data studied is panel data between 17 countries, namely ASEAN countries, several South Asian countries and several East Asian countries in the period 2007, 2010, 2012, 2014, 2016, 2018 according to the year of publication of the Logistics Performance Report The study model was built as a recursive linear model and analyzed with panel data using multiple linear regression analysis. According to the findings, exchange rates, interest rates and Net Export that simultaneously affect global competitiveness.