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"Latar belakang: tumor kelenjar liur merupakan tumor yang jarang pada keganasan kepala leher. Histopatologinya sangat heterogen demikian juga kejadian dan klinik epidemiologinya. Perbedaan karakteristik dari tumor parotis di banyak pusat kesehatan memengaruhi survival rate. Metode: penelitian ini adalah uji retrospektif analitik dengan uji kesintasan. Data didapatkan dari rekam medik pasien tumor parotis ganas yang dirawat di RSUPNCM periode Januari 2005 sampai Desember 2011. Hasil: ada 75 kasus tumor parotis ganas. Laki-laki lebih banyak dibandingkan perempuan, dengan umur rata-rata 50 tahun. Delapan puluh persen ditemukan dalam stadium klinis lanjut. Mukoepidermoid karsinoma merupakan histopatologi yang paling sering ditemukan. Pembedahan merupakan terapi pilihan utama. Enam puluh persen kasus ditemukan penurunan indeks masa tubuh (IMT). Komplikasi tersering adalah paralisis nervus fasialis sekitar 30,7%. Mortalitas dalam 1 tahun didapati sebesar 25,3%. Rekurensi ditemukan sebesar 17,3%. Analisis bivariat antara tatalaksana dengan morbiditas menunjukkan signifikan dengan nilai p=0.001, dan dalam hubungannya dengan mortalitas didapati signifikan dengan tatalaksana, sedangkan stadium klinis dan histopatologi tidak. Histopatologi signifikan dalam hubungannya dengan rekurensi. Pada analisis multivariat antara stadium klinis I-II dengan status nutrisi dan mortalitas menunjukkan hubungan yang signifikan dengan nilai p = 0.006. Terdapat hubungan signifikan antara tatalaksana dengan survival rate, sedangkan untuk jenis kelamin, usia, histopatologi dan stadium klinis tidak ditemukan hubungan yang signifikan. Disease free survival untuk kasus keganasan ini adalah 61,5%. Kesimpulan: karakteristik tumor parotis ganas di RSUPNCM tidak berbeda dengan yang ditemukan pada literatur, hubungan yang signifikan ditemukan antara histopatologi dan tatalaksana sebagai faktor prognosis survival rate.

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Background: salivary gland tumor is a rare case found in head and neck tumor. The histopathology is very heterogeneous, as well as the incident and clinical epidemiology. Different characteristics of parotid gland tumor in many health centers affecting survival rate.

Method: This is a survival study with retrospective analytical method. Data is obtained from medical record in Cipto Mangunkusumo Hospital in period of January 2005 to December 2011.

Results: There are 75 patients with malignant parotid gland tumor. Male is affected more than female, the mean age is 50 years old. 80% of cases found are in late stage. Mucoepidermoid carcinoma is the most frequent histopathology found. Surgery remains the treatment of choice. 60% patients experienced a decreased of body mass index. Postoperative complication such as facial nerve paralysis occurred in 30.7%. One year mortality is found in 25.3% cases. Recurrence is found in 17,3%. Bivariate analysis between clinical management and morbidity has a significant correlation with p=0,001, and significant also found between clinical management with mortality but not for tumor stage and histopathology. Histopathology found significant in correlation with recurrence. Multivariate analysis between nutritional status and tumor stage showed significancy with p = 0.006 in stage I-II. There is significant relationship between clinical management and survival rate, but there is no significancy between sex, age, histopathology, and tumor stage. Disease Free Survival is among 61,5%.

Conclusion: malignant parotid gland tumor in Cipto Mangunkusumo Hospital contributes the same characteristics with those found in publications. There is significant relationship between variables from survival analysis of prognostic factors."

"Introduction: This study aims to know the performance of the Vascular – Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity (V-POSSUM) score as a predictor of 30-day mortality after the Endovascular Aortic Aneurysm Repair (EVAR) – Thoracic Endovascular Aortic Repair (TEVAR) procedure in Abdominal Aortic Aneurysms (AAA) and Thoracic Aortic Aneurysms (TAA) patients in Cipto Mangunkusumo Hospital. Method: This was a retrospective cohort study using data from medical records. Data were taken according to the variables contained in the V-POSSUM scoring system in the patient who undergone EVAR – TEVAR procedure, on the period of 2013 to July 2018. Results: The study involved 85 patients who met the study requirements. It was known that physiological scores, morbidity risk, and mortality risk could be used as a model to predict mortality outcomes because they had good accuracy and discrimination performance, while the severity of the operation score cannot. The result of the goodness of fit model’s physiological score, morbidity risk, and mortality risk was significant (p <0.001), while the severity score of the operation was 0.18 (p >0.05). The Area Under the Curve (AUC) was 94%, 93%, 93%, with the cut points at 31, 68.8, and 10.6 for the physiological score, morbidity risk, and mortality risk, respectively. Conclusion: The V-POSSUM score had good accuracy and discrimination for the physiological score, morbidity risk, and mortality risk."

"ABSTRAKLatar belakang: Penelitian ini bertujuan untuk mengetahui mortalitas danmorbiditas pada pasien elektif dalam daftar tunggu serta gambaran waktu tunggupasien elektif dalam daftar tunggu operasi bedah pintas koroner dikaitkan denganketersediaan sumber daya (sistem, sumber daya manusia dan fasilitas) UPF BedahJantung Dewasa, RS Jantung dan Pembuluh Darah Harapan Kita.Metode : Penelitian ini menggunakan desain studi kuantitatif dan kualitatif. Datakuantitatif dikumpulkan secara prospektif selama 2 bulan sejak bulan Agustus-September 2010.Hasil : Dari 58 pasien tersebut, 1 pasien meninggal selama menunggu dan 1pasien terkena stroke selagi menunggu. Tidak terdapat sistem khusus atau skoringuntuk menentukan waktu tunggu pada pasien. Belum terdapat sistem penjadwalan,termasuk metode memasukan pasien kedalam daftar, memutuskan statuskegawatan, menjadwalkan tanggal masuk dan memindahkan pasien dari daftaryang adekuat.Kesimpulan : Kejadian mortalitas dan morbiditas selama waktu tunggu tidakditemukan sebagai kejadian yang sering terjadi selama menunggu operasi bedahpintas koroner pada studi ini. Namun sulit mengabaikan kerjadian yang terjadipada kedua pasien pada penemuan, apalagi hasil penelitian menguatkan bahwabelum terdapat sistem penentuan waktu tunggu dan penjadwalan yang adekuat diUPF Bedah Jantung dan Intermediate Bedah Dewasa RS.Jantung dan PembuluhDarah Harapan Kita walaupun sementara ini sumber daya yang ada (baik fisikmaupun sumber daya manusia) masih dirasakan cukup mengakomodir jumlahkasus yang ada.

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ABSTRACTBackground: This study is aimed to find out mortality and morbidity in electivepatient while waiting and description of waiting time in elective patient related toresources needed (system, human resources and facility) at department ofcardiovascular surgery, Harapan Kita Hospital.Method : This study is use quantitative and qualitative desain study. Thequantitative data collected prospectively within 2 months since August untilSeptember 2010.Result : From 58 patients, 1 patient was died while waiting and 1 fall into stroke.There?s no adequate system in scheduling patient, including put the patient intothe list of que, decide the urgency and remove the patient from the list.Conclusion : It?s known that morbidity and mortality is not found as a significantevent happened while waiting for CABG in this study. It?s difficult to ignore thethings happened to the 2 patient, especially after knowing there?s no adequatesystem to decide wait time and scheduling at Department of cardiovascularsurgery, Harapan Kita Hospital, while resources is still"

"ABSTRACTThe study aimed to investigate the impact of 12 weeks supplementation with multi-micronutrient and iron-folate supplements on hematological status, morbidity and work productivity. Female factory workers were selected as the subjects because: high prevalence of anemia found in this group which might have health and economic consequences since anemia was related to decrease work productivity and decrease resistance to infection, and the increasing number of female workers in developing country.A preliminary study was conducted to investigate the bioavailability of iron from a multi~micronutrient supplement compared to watery ferrous(II)-sulfate solution. In a randomized cross over design, 14 volunteers received 108 mg elemental iron as four tablets of multi-micronutrient supplements (each tablet contained 27 mg elemental iron) or as a solution of 537.60 mg Ferrous(Il)-sulfate. Serum iron concentrations were measured at 0, 2, 4, 6 and 8 hours after dosing. The maximum serum iron level was significantly lower with multi-micronutrient supplement compared to ferrous sulfate solution but the time to reach the peak" serum iron level was not significantly different between those two treatments. The median relative bioavailability of iron in multi-micronutrient supplement was 32.22%The main study was conducted in a shoe factory, West Java. A total of 308 subjects were selected and divided randomly into three groups that respectively received multi-micronutrient (each tablet contained 27 mg elemental iron), iron-folate supplements (each tablet contained 200 mg ferrous sulfate equal to 60 mg elemental iron) and placebo. Multimicronutrient supplements and placebo were given time times per week and iron-folate supplements were given once a week. All of the supplementations were supervised and last for 12 weeks. Hematological assessed in sub sample of each group based on Willingness; making a total of 140 subjects.Significant increments in the levels of hemoglobin, serum ferritin, and serum retinol were observed in multi-micronutrient group (0.6 g/dl, 13.44 ug/l, and 0_6 pmol/l respectively) and iron-folate group (0.3 g/dl, 11.26 ug/l, and 0.4 umolfl respectively); the increments were higher in multi-micronutrient group but not statistically different from iron-folate group. In the placebo group, hemoglobin level was decreased by 0_3 g/dl, serum ferritin was increased by 4.28 ug/1, and serum retinol was relatively constant. The prevalence of anemia and low iron status were decreased after treatment with multi-micronutrient (7% and 20.5%, respectively) or iron-folate supplements (91% and 12.8%, respectively). The anemia prevalence in placebo group was increased by 6.6% while the prevalence of low iron status was decreased by 2.5%. The morbidity was increased in all groups with the lowest increment was observed in multi-micronutrient group (65% in multi-micronutrient group compared to 14.1% in iron group and 22.4% in placebo group). The work productivity was increased by 6.3% in iron group and 3.6% in multi-micronutrient group while it was relatively constant in placebo group. In conclusion, multi-micronutrient supplement had better impact on hematological status and reducing morbidity level compared to iron-folate supplement that had better impact on work productivity."

"Kekurangan gizi dapat mempengaruhi pertumbuhan fisik, intelektual dan juga dianggap sebagai penyebab utama morbiditas dan mortalitas pada anak. Penelitian ini bertujuan untuk mengetahui faktor dominan yang berhubungan dengan kejadian underweight pada anak usia 6-23 bulan di Kecamatan Babakan Madang, Kabupaten Bogor. Desain penelitian yang digunakan adalah cross-sectional. Penelitian ini menggunakan data sekunder yang diperoleh dari penelitian payung Hibah PITTA B tahun 2019. Hasil penelitian menunjukkan bahwa 17,3% anak usia 6-23 bulan di Kecamatan Babakan Madang mengalami underweight, dan 6,1% di antaranya mengalami severly underweight. Dari 214 anak, 63,6% anak berusia 12-23 bulan, 50,5% laki-laki, 7% mengalami BBLR, 75,7% lahir dari ibu berpendidikan rendah, 47,7% memiliki ibu dengan pengetahuan kurang, 68,7% tidak memperoleh ASI eksklusif, 25,2% mengalami diare, 46,7 % mengalami defisit energi, dan 46,7% defisit protein. Hasil analisis chi-square menunjukkan bahwa tidak satupun variabel berhubungan dengan kejadian underweight. Namun, hasil uji regresi logistik menunjukkan bahwa usia anak (p value = 0,014), pendidikan ibu (p value =0,029) berhubungan signifikan dengan kejadian underweight. Adapun pengetahuan ibu (p value = 0,004) berhubungan terbalik dengan kejadian underweight. Pendidikan ibu merupakan faktor dominan kejadian underweight pada anak usia 6-23 bulan di Kecamatan Babakan Madang tahun 2019 (OR= 3,259, 95% CI ; 1,132-9,382). Peneliti menyarankan Kepada Dinas Kesehatan Kabupaten Bogor untuk memberikan sosialisasi dan edukasi kepada masyarakat, khususnya ibu yang memiliki anak usia 6-23 bulan tentang gizi bayi dan balita, gejala dan dampak dari kekurangan gizi, pentingnya perilaku hidup bersih dan sehat, beserta faktor-faktor lainnya yang dapat menyebabkan kekurangan gizi pada anak.

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Malnutrition can affect to physical and intellectual growth as well as considered a major cause of children morbidity and mortality. This study aims to determine the dominant factors associated with the underweight cases in children aged 6-23 months in Babakan Madang District, Bogor Regency. The research design was cross-sectional. This study used secondary data obtained from the PITTA B umbrella study in 2019. The results showed that 17.3% of children aged 6-23 months in Babakan Madang District were underweight and 6.1% of them were severelyly underweight. Among 214 children, there were 63.6% children aged 12-23 months, 50.5% were male, 7% experienced LBW, 75.7% raised by mothers with low education, 47.7% had mothers with poor knowledge, 68.7% did not receive exclusive breastfeeding, 25.2% had diarrhea, 46.7% had an energy deficit, and 46.7% had a protein deficit. The results of the chi-square analysis showed that none of the variables associated with the underweight problem. However, the logistic regression test results showed that the children age (p value = 0.014), mothers’ educational background (p value = 0.029) were significantly associated with underweight. Meanwhile, maternal knowledge (p value = 0.004) was inversely related to underweight. Maternal education is the dominant factor in children underweight problem aged 6-23 months in Babakan Madang District in 2019 (OR = 3.259,95% CI; 1,132-9,382). The researcher suggested the Bogor District Health Office to provide socialization and education to the community, especially mothers who have children aged 6-23 months in regard to nutrition for infants and toddlers, symptoms and impacts of malnutrition, the importance of clean and healthy living habits, and other factors which can cause malnutrition in children."

"Penyakit kolestasis pada bayi dan anak memberikan dampak negatif bagi status nutrisi, pertumbuhan serta perkembangan sehingga berdampak pada mortalitas. Sistem imunitas pada bayi dan anak yang lemah meningkatkan morbiditas dan berdampak pada status nutrisi sehingga meningkatkan angka mortalitas pada anak kolestasis. Penelitian ini dilakukan dengan menggunakan data rekam medis pasien bayi dan anak kolestasis yang dirawat inap serta rawat jalan di Rumah Sakit Cipto Mangunkusumo tahun 2010-2015. Dengan menggunakan desain cohort retrospektif, penelitian ini bertujuan untuk mengetahui hubungan status nutrisi dan morbiditas pada anak dengan kolestasis di Rumah Sakit Cipto Mangunkusumo. Hasil penelitian pengukuran status nutrisi berdasarkan lingkar lengan atas per umur (n=37) didapatkan, status gizi normal 10(27%), gizi kurang 10(27%), dan gizi buruk 17(46%). Dengan pengukuran indeks lingkar lengan atas per umur (LLA/U), hubungan morbiditas common cold memiliki hubungan yang bermakna p<0,05. Namun morbiditas terhadap status nutrisi berdasarkan tinggi badan per umur (TB/U) p>0,05.

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Cholestasis disease in infants and children adversely affects nutritional status, growth and development which impact on mortality. The weak immune system in infants and children can increase morbidity and nutritional status thus increasing the mortality rate in children with cholestasis.

This research was conducted using data from medical records patients of infants and children with cholestatic who are hospitalized and given outpatient treatment at Rumah Sakit Cipto Mangunkusumo 2010-2015.

By using a retrospective cohort design, this research aims to determine the relationship of nutritional status and morbidity in children with cholestasis in Rumah Sakit Cipto Mangunkusumo.

Research results measuring of nutritional status with the index mid upper arm circumference for age (n=37), normal nutritional status 10(27%), under nutrition 10(27%) and severe nutrition 17(46%). With the index mid upper arm circumference for age (MUAC/A), morbidity relationship common cold against nutritional status has a significant relationship p<0.05. However, the morbidity of the nutritional status based high for age (H/A) p> 0.05."

"Penelitian ini bertujuan untuk mendeskripsikan hubungan antara komunikasi keluarga dan akses kesehatan terhadap akses kesehatan di RW 5, Kelurahan Kalianyar, Tambora, Jakarta Barat. Studi-studi sebelumnya telah menunjukkan korelasi yang positif antara kepadatan penduduk, dinamika komunikasi dalam keluarga, akses kesehatan, dan tingkat morbiditas. Penelitian ini menggunakan metodologi kuantitatif dengan RW 5 sebagai wilayah penelitian. Sampel diacak dari wilayah RT 3, RT 5, dan RT 6 yang berjumlah total sebanyak 100 responden, ditentukan menggunakan rumus Slovin dengan margin of error sebesar 10%. Hasil penelitian menunjukkan bahwa variabel komunikasi keluarga signifikan secara statistik dengan p-value sebesar 0,003, di bawah ambang batas kesalahan 0,1. Selain itu, dua dimensi komunikasi keluarga juga masing-masing memiliki p-value sebesar 0,021 dan 0,011. Sebaliknya, variabel akses kesehatan dan lima dimensinya tidak signifikan secara statistik. Semua kekuatan hubungan bersifat lemah atau hampir tidak ada. Hasil dari variabel komunikasi keluarga mendukung studi sebelumnya sedangkan hasil variabel akses kesehatan berkontradiksi dengan hasil penelitian sebelumnya karena skor yang tidak signifikan secara statistik. Maka dari itu, studi selanjutnya harus lebih berhati-hati dalam menentukan model analisis dan mengevaluasi variabel yang ada. Secara praktis, hasil penelitian ini dapat menjadi basis awal untuk meningkatkan kualitas Pusat Kesehatan Masyarakat (Puskesmas), perkembangan komunikasi keluarga, dan untuk kebijakan kesehatan masyarakat di perkotaan oleh pemerintah.

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This study aims to describe the relationships between family communication and health access on the morbidity level in RW 5, Kalianyar, Tambora, West Jakarta. Previous research has demonstrated a positive correlation between population density, the dynamics of family communication, health access, and morbidity levels. This research employs quantitative methodology, with RW 5 serving as the study area. The sample was randomly selected from RT 3, RT 5, and RT 6, resulting in a total of 100 respondents, determined using Slovin's formula with a margin of error of 10%. The findings indicate that family communication is statistically significant, with a p-value of 0.003, which is less than the 0.1 threshold. Additionally, two dimensions of family communication have p-values of 0.021 and 0.011, respectively. In contrast, the health access variable and its five dimensions are not statistically significant. All directional measures are considered weak or negligible. While the results regarding family communication support previous studies, the findings related to health access contradict earlier research due to the insignificant scores. Consequently, future studies should carefully re-examine the research model and evaluate the variables. For practical purposes, the findings serve as a basis for improving Primary Health Care services, family development, and the government in relation to health policy in the urban areas."

"Latar Belakang: Obstruksi usus strangulata merupakan masalah kegawatdaruratan yang sering ditemui, mencakup 20% dari total pasien di unit gawat darurat. Obstruksi usus strangulata memiliki morbiditas dan mortalitas yang tinggi. Terdapat banyak faktor yang memengaruhi luaran pascaoperasi obstruksi usus strangulata, dan sebgaian besar berhubungan dengan komplikasi respirasi, infeksi daerah operasi, dan acute kidney injury (AKI). Tujuan dari penelitian ini adalah untuk mengetahui faktor-faktor yang memengaruhi morbiditas dan mortalitas pascaoperasi pada pasien dengan obstruksi usus strangulata.Metode: Studi kohort retrospektif dengan menggunakan total sampling dari registrasi Divisi Bedah Digestif dari tahun 2015-2019. Analasis bivariat digunakan dengan menggunakan studi Chi Square, Fisher, Mann Whitney, dan Spearman. Total 133 pasien tercakup di dalam analisis studi.Hasil: Angka mortalitas obstruksi usus strangulata di RS Cipto Mangunkusumo sebesar 7,5%. Angka kejadian acute kidney injury (AKI) pascaoperasi sebesar 30,1%. Terdapat beberapa faktor yang berhubungan dengan luaran morbiditas dan mortalitas, seperti usia pasien, onset strangulata, kondisi sepsis, dan kadar asam laktat serum.Kesimpulan: Faktor-faktor seperti usia pasien, onset strangulata, kondisi sepsis, dan kadar asam laktat serum berpengaruh terhadap morbiditas dan mortalitas pascaoperasi pada pasien dengan obstruksi usus strangulata. Beberapa faktor lain juga berhubungan dengan luaran mortalitas

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Background: Strangulated bowel obstruction is common emergency problem, included 20% of total patients registered to emergency department. Strangulated bowel obstruction is serious medical conditioin with high morbidity and mortality. There are many factors influencing postoperative outcome of strangulated bowel obstruction, and most related to respiratory complications, surgical site infection, and acute kidney injury. The objective of this study is to find out which factors contributing to postoperative morbidity and mortality in patients with strangulated bowel obstruction.Method: A cohort retrospective with total sampling is used from Digestive Surgery Division registry by the year 2015-2019. Bivariate analysis has been done using Chi Square, Fisher, Mann Whitney, and Spearman study. Total of 133 patients were included in the analysisResult: Mortality rate of strangulated bowel obstruction was 7,5% in Cipto Mangunkusumo Hospital. The acute kidney injury morbidity rate was 30,1%. There are some factors related to the postoperative morbidity and mortality outcome, such as age, strangulation onset, sepsis condition, and lactate acid serum level.Conclusion: Factors such as age, strangulation onset, sepsis condition, and lactate acid serum level are contributing to postoperative morbidity and mortality outcome in patients with strangulated bowel obstruction. Some of these factors also related to mortality outcome."