AbstrakProvinsi Nusa Tenggara Timur (NTT) memiliki Total Fertility Rate (TFR) tertinggi (4,2 anak) dan yang terendah adalah Provinsi Yogyakarta (1,8 anak). Tujuan penelitian ini adalah mengidentifikasi faktor-faktor yang berhubungan dengan angka fertilitas total di kedua provinsi tersebut. Penelitian ini menggunakan metode kuantitatif berdasarkan sumber data sekunder berbagai survei meliputi Survei Demografi Kesehatan Indonesia (1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007); Survei Kesehatan Nasional dan Survei Kesehatan Rumah Tangga tahun 2003; dan Mini Survei tahun 2007 dan 2008. Metode kualitatif dilakukan dengan diskusi kelompok terarah pada wanita pasangan usia subur (PUS) dan wawancara mendalam dengan pengelola program di kabupaten/kota hingga ke desa/kelurahan. Ditemukan TFR di Yogyakarta sangat rendah dan sebaliknya di NTT sangat tinggi. Perbedaan TFR tersebut disebabkan oleh latar belakang demografi dan nondemografi seperti respons terhadap berbagai program penurunan fertilitas. Faktor budaya terhadap nilai anak berpengaruh besar terhadap jumlah anak yang ingin dimiliki. Tingkat pendidikan yang rendah berhubungan dengan faktor yang berpengaruh langsung terhadap pemakaian kontrasepsi, termasuk jenis kontrasepsi. Pelayanan Keluarga Berencana (KB) yang rendah memicu tingginya kebutuhan kontrasepsi yang tidak terpenuhi. Kesertaan ber-KB di NTT dan di Yogyakarta adalah 42,2% dan 66,9%. Wanita PUS yang keinginan ber-KB tidak terpenuhi masih tinggi di NTT (17,4%) dibandingkan dengan Yogyakarta (6,8%). Kata kunci: Angka fertilitas total, pasangan usia subur, keluarga berencana AbstractProvince of Nusa Tenggara Timur (NTT) have a total fertility rate (TFR) to the highest (4,2 children) and the lowest is the Province of Yogyakarta (1,8 children). This research is to identify factors that associated with total fertility rate in both provinces. This study uses qualitative method from the Indonesia Demography and Health Surveys (from 1991 to 2007), National Health Survey and Household Health Survey (2003), and Family Planning Mini Surveys (2007 and2008). The qualitative method were collected using focus group discussions with fertile couple and in-depth interviews with family planning fieldworkers in district to village . The research reveals that TFR of Yogyakarta is very low and NTT is very high. The differentiation of the TFR is due to the demographic and nondemographic background as well as the respond againts the program to decrease the fertility. Cultural factor is the important one againts the value of children that will be influenced to the number of children desired in one family. Low education will be directly related to the use of contraceptive including mix contraceptive. Low family planning services which triggers the high unmet need oc contraceprive. Family Planning participation in NTT is 42,2% and 66,9% in Yogyakarta. Women on childbearing age who wishes to use contraceptive but unmet need in NTT were still high (17,4%) compared with Yogyakarta ...

Background: Chickenpox caused by the varicella-zoster virus (VZV) in diabetes mellitus patients might exhibit similar clinical features with monkeypox, caused by monkeypox virus (MPXV). In May 2019, Singapore notified World Health Organization (WHO) of one laboratory-confirmed case of monkeypox. Considering Singapore is located near Indonesia, awareness about the possibility of an outbreak in Indonesia should be raised. Purpose: To report a case of chickenpox mimicking monkeypox in an adult with diabetes mellitus and acute kidney injury. Case: A 51-year-old male with poorly controlled diabetes mellitus was suspected to have a chickenpox differential diagnosis with monkeypox. His chief complaint was multiple blisters on his body and vomiting. There was a history of feeding a monkey. From dermatological status on facial, trunk, and extremities there were multiple pleomorphic vesicles. Laboratory results showed elevated renal function. Polymerase chain reaction (PCR) examination using VZV as primer revealed a positive result in the range of 810 bp. He was treated with intravenous acyclovir for 3 days and oral acyclovir for 7 days then discharged with improvement in skin lesions and normal renal function. Discussion: Chickenpox in adult and diabetes mellitus patients can give severe clinical manifestation mimicking monkeypox. PCR has a significant role especially when diagnosis could not be established from the physical examination. Acyclovir can be given as the therapy. Conclusion: Adult and poorly controlled diabetes mellitus are important risk factors associated with the severity and complication of chickenpox. A careful diagnostic approach and management are needed.

Background: Vitiligo is a depigmenting disorder that causes a loss of melanocytes in the epidermis. Treatment preferences are based on the characteristics of the vitiligo lesions. Purpose: This study evaluates the clinical profiles of vitiligo treated with narrowband UVB (NB-UVB) radiation and topical corticosteroid therapy in Dr. Soetomo Hospital in 2017. Methods: This study is a retrospective study that uses data from the medical records of vitiligo patients who were treated with NB-UVB radiation and topical corticosteroids in Dr. Soetomo Hospital in 2017. The dependent variable was vitiligo treated with NB-UVB radiation or topical corticosteroids, while the independent variables were disease onset, precipitating factor, duration, stability, amount, affected area, location, and type of vitiligo. Results: Thirty-seven patients (19 females) were included, four of whom had been treated with NB-UVB radiation and 33 with topical corticosteroids. In the NB-UVB radiation group, 75% had stable lesions, 50% had a single lesion, 50% had multiple lesions, 75% had an affected area <10cm 2 , 40% had lesions around their face, 40% had lesions on their extremities, and 75% had focal vitiligo. In the topical corticosteroids group, 75.76% had active lesions, 81.82% had multiple lesions, 81.82% had an affected area <10 cm 2 , 28.21% had lesions around their upper extremities, 28.21% had lesions around their lower extremities, and 45.45% had segmental vitiligo.

Background: Leprosy is a chronic granulomatous infectious disease caused by Mycobacterium leprae that affects peripheral nerves and skin. The interaction between M. leprae and Schwann cells causes irreversible damage to peripheral nervous tissue afterward disability occurs. Involvement of the major nervous trunks of the extremities can produce sensory-motor deficits. The risk factors are delay in diagnosis, gender, age, type of leprosy, duration of disease, number of affected nerves, leprosy reaction, type of treatment, socioeconomic factors, education, ethnicity, and occupation. Purpose: The aim was to study the profile of leprosy patients with disability who seek treatment in Leprosy Division Dermatovenerology Outpatient Clinic RSUD Dr. Soetomo Surabaya. Methods: This was a descriptive retrospective study of leprosy patients with disability from January 2017 to December 2019. Result: The results of this study obtained a total of 275 leprosy patients with disabilities, which consisted of 76 patients (27.6%) with grade-1 disability and 199 patients (72.4%) with grade-2 disability. The majority were male (73.4%) and aged 25-44 years old (42.2%). Other dominant risk factors were MB type leprosy (92%), duration of disease more than 12 months (52.3%), no leprosy reaction (68%), and had received multidrug therapy (45.5%). Conclusion: Knowledge of disability risk factors can assist in improving management and education to prevent disability in leprosy patients.

Background. It is expected that a combination of amniotic membrane stem cell metabolite product (AMSC-MP) and vitamin E after fractional CO2 laser as laser-assisted drug delivery (LADD) will provide better effects in photoaging treatment as the combination reaches the target. This promises an option for photoaging therapy in the future. Materials and Methods. Sixty women with photoaged skins were involved in this experimental study. They were then divided into two groups. The treatment group received a topical combination of AMSC-MP and vitamin E, and the control group received AMSC-MP alone after fractional CO2 laser. The treatment was repeated three times. Result. The Janus assessment results showed a significant difference in pores in the third observation, and the average pore improvements in the treatment group were better than the control group. Wrinkle, UV spot, and polar spot did not show any significant difference. Conclusion. A combination of the amniotic membrane stem cell metabolite product (AMSC-MP) and vitamin E after fractional CO2 laser as LADD only improves pores in photoaged skins.

Penelitian ini dilakukan untuk menilai sejauh mana pengaruh pemberian layanan KB terhadap unmet need pada wanita menikah usia 15-49 tahun. Unmet need merupakan fenomena dalam bidang kependudukan yang memerlukan penanganan serius dan segera karena dapat menghambat peningkatan CPR dan penurunan TFR. Pemberian layanan KB merupakan hal penting dalam memenuhi kebutuhan seseorang untuk memilih dan menggunakan alat KB yang tepat sesuai dengan kebutuhannya (tidak terjadi unmet need). Penelitian ini merupakan analisis lanjut data SDKI 2017, yang merupakan penelitian potong lintang pada wanita menikah usia 15-49 tahun. Jumlah sampel tersedia sebanyak 35.681 wanita. Analisis hubungan antara varaibel dependen dengan independen menggunakan uji chi square, dan pengaruh pemberian layanan KB terhadap unmet need diuji dengan regresi logistik ganda. Hasil penelitian menunjukkan bahwa pemberian layanan KB yang kurang terakses oleh wanita berpeluang 2,27 untuk mengalami kejadian unmet need dibandingkan dengan mereka yang mempunyai akses (95% CI: 1,95-2,64). Penelitian ini merekomendasikan, peningkatan akses ke pemberian layanan KB bagi wanita untuk memperoleh informasi KB dan layanan alat KB, terutama bagi mereka yang tidak bekerja, tinggal di perkotaan dan memiliki banyak anak.

Background: Batik has been declared as a humanitarian heritage for oral and non-cultural culture. The increasing demand for batik may have a negative impact as the industry utilizes chemical agents. Hazardous chemical exposure to the skin in the batik industry may result in a high risk of occupational contact dermatitis. This study was conducted to find out the social determinants of health. Purpose: This study aims to assess the level of knowledge of the batik workers before and after health education about occupational contact dermatitis. Methods: This was an observational interview study, and the data were collected using questionnaires. This study involved 30 batik workers.  We assessed the level of knowledge before and after the health education about occupational contact dermatitis. Result: There were 4 (13.3%) male participants and 26 (86.7%) female participants. The mean score of the pre-test was 66.98±10.10, and the post-test was 77.77±13.53 (p<0.05). Conclusion: The result showed a significant difference between batik workers' knowledge before and after health education about contact dermatitis.

Background: Cutaneous adverse drug reaction (CADR) is the most common manifestation of drug hypersensitivity in humanimmunodeficiency virus (HIV), which presented as maculopapular rash. The incidence of CADR is found to be more commonin untreated HIV patients, and the frequency is higher in severe immunodeficiency status. Early diagnosis and appropriatetreatment give better outcomes. Purpose: To evaluate the incidence and management of CADR in HIV and acquired immunedeficiency syndrome (AIDS) patients. Methods: A retrospective descriptive study of HIV/AIDS patients with CADR whowere hospitalized at Intermediate Care and Infectious Disease Centre Dr. Soetomo General Academic Hospital. Result: Therewere more CADR cases in 2017, accounted 2.35% of the total Intermediate Care and Infectious Disease Centre RSUD Dr.Soetomo General Academic Teaching Hospital ward patients. There were more male patients (62.5%), with the mostcommonly found at the age of 25-44 years (64.3%), and which mostly (89.3%) originated from Surabaya. The most commondiagnosis was morbiliform eruption (60.7%), main complaint was red spots all over the body (45%), all of which are obscureerythematous macules. The most common causes were Duviral + Neviral antiretroviral (46%) and the most common treatmentwas dexamethasone injection. Conclusion: The incidence of CADR increased in 2017. The most frequent manifestation wasmorbilliform eruption due to Duviral+Neviral as the first line ARV treatment. Skin management varies widely in form oftopical, oral, and intravenous injection drugs, mostly using steroid class, dexamethasone intravenous injection in particular.