BackgroundCutaneous melanoma is a rare, aggressive skin malignancy with a high mortality rate. Although only contributing 7.6% of the cases worldwide, Asia is responsible for 18.6% of deaths from cutaneous melanoma. BRAF V600 mutation presents a potential prognostic predictor in melanoma. Unfortunately, studies on that mutation in melanoma, particularly nodular subtype, in Indonesia are still scarce. This research aimed to investigate the prevalence of BRAF V600 mutation in primary skin nodular melanoma in Yogyakarta and Central Java, Indonesia. Its association with clinicopathological parameters was also analyzed.MethodsForty paraffin-embedded tissue samples from primary skin nodular melanoma cases in 2011–2018 were collected from the two biggest referral hospitals in Yogyakarta and Central Java, Indonesia. The BRAF V600 mutation status was assessed using qualitative real-time PCR and its associations with age, sex, anatomic location, lymph node metastasis, tumor thickness, ulceration, mitotic index, necrosis, lymphovascular invasion, and tumor-infiltrating lymphocytes were analyzed.ResultsBRAF V600 mutations were found in 4 (10%) samples. These mutations were significantly associated with the central (non-extremity) region (p = 0.013) and presence of lymphovascular invasion (p = 0.005). However, it was not associated with any other variables analyzed in this study.ConclusionThe prevalence of BRAF V600 mutation in Indonesian primary skin nodular melanoma cases is low and significantly associated with anatomic location and lymphovascular invasion. It is lower than prevalences in other Asian populations as well as in Caucasian populations and suggests that melanoma cases in Javanese people may have distinct clinicopathological characteristics from other Asian ethnicities.
ABSTRAK Malaria merupakan salah satu penyakit yang terus endemik di beberapa daerah di Indonesia walaupun pemerintah telah melakukan berbagai usaha untuk mengobati dan mencegah malaria. World Health Organization (WHO) menargetkan insidensi kasus malaria pada tahun 2030 dapat turun hingga 90% dibandingkan tahun 2015.Asmat merupakan salah satu daerah endemik tinggi dan menjadi salah satu daerah target program eliminasi malaria, namun belum ada publikasi data rinci terkait malaria di Asmat, Papua. Penelitian ini bertujuan untuk mengetahui prevalensi malaria di Asmat pada tahun 2017 dan melihat tren kejadian malaria yang merupakan salah satu indikator evaluasi program eliminasi malaria di Indonesia. Penelitian ini merupakan penelitian deskriptif observasional yang dilakukan selama pelaksanaan kegiatan Kuliah Kerja Nyata - Peduli Bencana (KKN-PB) Universitas Gadjah Mada (UGM), pada tanggal 17 Maret hingga 30 April 2018 di Asmat, Papua. Penelitian dilakukan dengan analisis data sekunder dan observasi. Data sekunder diambil dari Dinas Kesehatasn Kabupaten Asmat, kemudian dianalisis dan dipaparkan secara deskriptif. Dilakukan pula observasi lingkungan di Distrik Agats, Atsj, dan Sawaerma untuk mengetahui kemungkinan faktor-faktor risiko malaria. Pada tahun 2017, prevalensi malaria di kabupaten Asmat yaitu 12,37% dengan 7,90 % kasus malaria klinis dan 4,46% kasus malaria yang telah tegak diagnosisnya berdasarkan hasil pemeriksaan laboratorium. Prevalensi tersebut meningkat dibandingkan tahun 2016. Pusat Kesehatan Masyarakat (Puskesmas) Atsj merupakan puskesmas dengan prevalensi malaria tertinggi, yaitu sebesar 27,70%. Kejadian malaria ini kemungkinan dipengaruhi oleh lingkungan fisik (suhu, kelembaban, kerapatan dinding rumah, pengunaan kawat kassa, curah hujan), lingkungan biologi (adanya semak dan rawa), lingkungan kimia (salinitas dan pH), serta kebiasaan masyarakat. Hasil penelitian ini menunjukkan bahwa penanganan malaria di Asmat masih menjadi tantangan besar bagi petugas kesehatan dan pemerintah. Diperlukan penelitian lebih lanjut untuk mengetahui faktor penyebab masih tingginya kejadian malaria agar kebijakan yang diambil lebih tepat. KATA KUNCI prevalensi; malaria; endemik; Asmat; Papua ABSTRACT Malaria is still an endemic disease in Indonesia, despite years of government efforts to cure and prevent malaria. World Health Organization (WHO) has a goal to reduce malaria case incidence globally at least 90% in 2030 compared with 2015.Asmat is one of the high endemic areas in Indonesia, making Asmat one of the target areas for malaria elimination programs. However, the published data regarding malaria in Asmat is limited. This study aimed to investigate the prevalence of malaria in Asmat in 2017 and assess the trend of malaria prevalence, as an indicator in evaluating malaria elimination programs. This study was descriptive observational research which was performed from March 17th until April 30th 2018, as part of Kuliah Kerja Nyata - Peduli Bencana (KKN-PB) Universitas Gadjah Mada (UGM), in Asmat Regency. This study was using secondary data analysis and environmental observation. Secondary data was obtained from Department of Health in Asmat Regency and presented descriptively. Environmental observation in Agats, Atsj, and Sawaerma District was also conducted to find out the possible risk factors of malaria. In 2017, malaria prevalence in Asmat was 12.37% with 7.9% cases being clinically diagnosed malaria, and the other 4.46% laboratory diagnosed malaria. The prevalence in 2017 was higher than in 2016. Among all the districts in Asmat, Atsj had the highest prevalence (27.70%). Malaria prevalence was possibly affected by multiple factors, such as physical environment (temperature, humidity, houses’ wall density, and the use of wire net), biological environment (house surrounded by bush or swamp), chemical environment (pH and salinity), and habits in community. These findings suggest that malaria control is still a big challenge for health-care workers and government. Further research is needed to study the exact causes of high malaria prevalence in Asmat, so that more appropriate policies can be done to overcome the problem.KEYWORDS prevalence; malaria; endemic; Asmat; Papua
<p>Residential area has been identified as a factor that influences the well-being of older people. This study aimed to compare the well-being of older people living in urban and rural areas in Yogyakarta province, Indonesia, and analyze the predictors of well-being. A total of 141 (79 rural and 62 urban) older people participated in this study. Well-being was assessed using the world health organization-five (WHO-5) well-being index. The factors measured included sociodemographic data (age, sex, educational level, living arrangements, and current employment status), physical function, cognitive function, depression, independence, and attitude towards aging. Data of the two groups were compared using t-tests and Chi-square analysis. Correlations with well-being were analyzed using univariate correlation and multivariate hierarchical regression. The urban group had slightly older age, higher education, lower mobility and balance, higher attitude scores, and higher well-being. Depression was a significant variable in well-being for both communities. Physical capacity was an important factor in urban populations, while well-being in rural areas was better predicted by independence and cognitive function. The results suggest that there are similar and different correlates of the well-being of rural and urban older people, recommending different programs to enhance the well-being of older people living in different areas.</p>
ABSTRAK Pada tahun 2013, terdapat 37% kasus anemia pada ibu hamil di Indonesia. Kejadiannya di Agats, Asmat, Papua masih merupakan fenomena gunung es yang belum banyak mendapat sorotan. Pusat Kesehatan Masyarakat (Puskesmas) Agats menjalankan Program 1000 Hari Pertama Kehidupan (HPK) sejak tahun 2016 untuk meningkatkan kualitas kehamilan dan kelahiran. Penelitian ini bertujuan untuk mengetahui prevalensi anemia pada ibu hamil peserta Program 1000 HPK serta menganalisis faktor-faktor yang berpengaruh terhadap anemia pada ibu hamil di Agats, Asmat, Papua. Penelitian ini merupakan penelitian deskriptif observasional, menggunakan data sekunder dari laporan evaluasi Program 1000 HPK Puskesmas Agats Oktober 2017, yang diambil pada periode pelaksanaan Kuliah Kerja Nyata - Peduli Bencana (KKN-PB) Universitas Gadjah Mada (UGM), 17 Maret sampai 30 April 2018. Sebanyak 97 ibu hamil dari 230 peserta Program 1000 HPK dilibatkan dalam penelitian ini. Data yang diambil meliputi umur kehamilan, kadar hemoglobin (Hb), lingkar lengan atas (LLA), berat badan, dan pemberian suplemen zat besi. Kadar Hb < 11 g/dL pada trimester I atau < 10.5 g/dL pada trimester II dan III digolongkan sebagai anemia. Dilakukan pula analisis kemungkinan faktor risiko anemia berdasarkan hasil observasi di Agats dengan tinjauan pustaka. Dari total 97 ibu hamil peserta Program 1000 HPK, sebanyak 45.4% orang menderita anemia, meskipun 43.4% di antaranya telah mendapatkan suplementasi zat besi. Sebanyak 24.7% ibu hamil memiliki LLA < 23 cm. Beberapa kemungkinan faktor risiko anemia pada ibu hamil di Agats meliputi letak geografis Asmat, rendahnya tingkat pendidikan masyarakat, minimnya tenaga kesehatan serta fasilitas pelayanan kesehatan, kurangnya perhatian masyarakat terhadap kesehatan, keadaan sosioekonomi rendah, dan status gizi ibu hamil. Prevalensi anemia pada ibu hamil peserta Program 1000 HPK di Agats, Asmat, Papua pada Oktober 2017 lebih tinggi dari prevalensi nasional. Penelitian lebih lanjut dibutuhkan untuk mengetahui kaitan pasti antara kejadian anemia pada ibu hamil di Agats dengan faktor-faktor risiko tersebut.KATA KUNCI anemia; kehamilan; 1000 hari pertama kehidupan; Asmat; Papua ABSTRACT In 2013, it was found that 37% pregnant women in Indonesia suffered from anemia. However, in Agats, Asmat, Papua, this phenomenon has not gained enough attention. In order to improve the quality of birth and pregnancy, Pusat Kesehatan Masyarakat (Puskesmas) Agats is currently implementing the First 1000 Days of Life (1000 HPK) Program since 2016. This study aimed to discover the prevalence of anemia in pregnancy of the 1000 HPK participants in Agats and to understand the possible contributing risk factors. This study was descriptive observational study using secondary data from the evaluation report of 1000 HPK Program in Puskesmas Agats during October 2017. From 230 participants of 1000 HPK Program, 97 of them who were pregnant, were taken as the sample. The data (gestational age, hemoglobin level, upper arm circumference, body weight, and history of iron supplementation) were obtained during the implementation of Kuliah Kerja Nyata - Peduli Bencana (KKN-PB) Universitas Gadjah Mada (UGM), from March 17th to April 30th, 2018. Hemoglobin level in the first trimester < 11 g/dL or in the second and third trimester < 10.5 g/dL were classified as anemia. The observed risk factors were then analyzed using literature review. From 97 participants of 1000 HPK Program, 45.4% suffered from anemia, even though 43.4% of them had received iron supplementation. Moreover, 24.7% of the pregnant women had mid-upper arm circumference < 23 cm. Several observed influencing risk factors included the geographic profile of Asmat, low educational status, lacking of health personnels, facilities and the general awareness of the citizens regarding maternal health, low socio-economical status, and low maternal nutritional status. The prevalence of anemia in the pregnant participants of 1000 HPK Program in Agats, Asmat, Papua, during October 2017 was higher than the national prevalence. Further study needs to be conducted in order to find the correlation between the prevalence of anemia in the pregnant participants of 1000 HPK Program in Agats and the suspected risk factors.KEYWORDS anemia; pregnancy; first 1000 days of life; Asmat; Papua
Objective: We aimed to investigate the prevalence and type of BRAF V600 mutations and the associations with clinicopathological variables in primary skin nodular melanoma cases in Yogyakarta and Central Java, Indonesia using pyrosequencing. Results: BRAF V600 mutations of the V600E type were found in 21 (53.85%) specimens. The variant allele frequencies (VAFs) ranged from 5.07 to 94.70%, averaging 29.05%. However, most cases had low VAFs, with 13 (61.9%) specimens below 20% and 4 (19.05%) below 10%.
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