Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar Belakang. Mikroangiopati diabetik DM seperti nefropati, retinopati, dan neuropati merupakan komplikasi umum diabetes melitus tipe 2 T2DM . Paru merupakan salah satu organ target dari komplikasi mikrovaskular dan penurunan kapasitas difusi paru pada mikroangiopati DM masih sedikit diketahui.Metode. Penelitian ini bersifat potong lintang pada subjek T2DM yang menjalani pemeriksaan kapasitas difusi paru terhadap karbon monoksida DLCO, albumin urin, funduskopi dan elektromiografi EMG di poliklinik rawat jalan DM terpadu. Kriteria eksklusi yaitu penyakit paru akut atau kronis.Hasil. Sebanyak 52 subjek L/P:20/32 usia 58 10,4 tahun sebagian besar menunjukkan HbA1c>6,5 41/52 78 , tidak pernah merokok 41/52 78,8 . rerata terdiagnosis DM 10,5 6,9 tahun, sebanyak 33 63,5 le;10 tahun dan 19 36,5 subjek >10 tahun. Subjek dengan neuropati lebih banyak ditemukan yaitu sebesar 41/52 26,3 diikuti nefropati 29/52 18,6 dan retinopati 9/52 5,8 dengan rerata DLCO sebesar 16,01 4,12 ml/menit/mmHg . Penurunan kapasitas difusi pada Mikroangiopati DM ditemukan sebanyak 14/52 25 subjek, didapatkan nilai p pada nefropati sebesar p=0,27, retinopati p=0,36 dan neuropati p=0,49.Kesimpulan. Gangguan kapasitas difusi paru pada mikroangiopati DM mengalami penurunan namun tidak mempunyai hubungan yang yang bermkana, hal ini menunjukkan gangguan faal difusi paru pada mikroangiopati DM.

---

Background. Diabetic microangiopathy such as nephropathy, retinopathy and neuropathy is a common complications of type 2 diabetes mellitus T2DM . The lung is one of the target organs in the development of vascular complications in diabetic patients and little is known about the impairment of pulmonary diffusing capacity due to the diabetic microangiopathy.Method. The subjects were T2DM patients underwent carbon monoxide lung diffusion capacity DLCO test, urine test, funduscopy and electromyography EMG examination with consecutively from diabetic outpatient clinic. The exclusion criterias were acute or chronic pulmonary diseases. Results. A total of 52 subjects m/f: 20/32 ages 58 10.4 years mostly showed HbA1c> 6.5 41/52 78 , never smoked 41/52 78.8 . diagnosed DM rates of 10.5 6.9 years, 33 63.5 le;10 years and 19 36.5 subjects> 10 years. Subjects with more neuropathy were 41/52 26.3 followed by nephropathy 29/52 18.6 and retinopathy 9/52 5.8 with DLCO average of 16.01 4.12 ml / min / mmHg . The decrease in diffusion capacity in Microangiopathy DM was found in 14/52 25 subjects, obtained p value on nephropathy of p=0.27, retinopathy p=0.36 and neuropathy p=0.49 respectively.Conclusion. This study demonstrated that diffusion capacity is impairment in diabetic microangiopathy patients. Pulmonary diffusion capacity has no association with diabetic microangiopathy but there is a decreased pulmonary diffusion physiology."

"ABSTRAK Latar belakang : Prevalens diabetes melitus (DM) terus meningkat di negaraberkembang yang merupakan negara endemis tuberkulosis (TB). Diabetes melitusmeningkatkan risiko infeksi, hambatan konversi sputum dan kegagalanpengobatan TB. Penelitian ini bertujuan menganalisis faktor-faktor yangmempengaruhi konversi sputum Basil Tahan Asam (BTA) mikroskopik padaakhir bulan kedua pengobatan TB pada pasien TB paru kasus baru dengan DM.Metode : Penelitian kohort retrospektif ini dilaksanakan di RSUP Perahabatanterhadap pasien-pasien TB paru BTA positif kasus baru dengan DM yang berobatpada periode Juli 2012 sampai Juni 2015. Hubungan faktor risiko dengan konversisputum BTA mikroskopik dianalisis dengan analisis bivariat dan multivariat.Hasil penelitian: Proporsi kegagalan konversi sputum BTA mikroskopik padapasien TB paru kasus baru dengan DM adalah 43,04%, sedangkan pada pasientanpa DM 22,75% (p<0,001, KI95% 0,11-0,30) dan risiko relatif (RR) kegagalankonversi 1,89 kali lebih tinggi pada kelompok DM. Faktor risiko yang meningkatbermakna pada pasien gagal konversi adalah kadar kepositifan sputum BTAsebelum terapi (p=0,021), HbA1c (p=0,014), GDP (p=0,047), GD 2jam PP(p=0,030) dan kavitas pada foto toraks (p=0,033) sedangkan albumin serum lebihrendah bermakna (p=0,013). Analisis multivariat mendapatkan faktor risikoterkuat untuk kegagalan konversi sputum adalah kadar albumin serum yangrendah (p=0,046, aOR 0,464, KI95% 0,218-0,986), tingkat kepositifan sputumBTA mikroskopik sebelum terapi yang tinggi (p=0,009, aOR 2,313, KI95%1,230-4,349) dan kadar HbA1c yang tinggi (p=0,018, aOR 1,298, KI 95% 1,047-1,610).Kesimpulan: Tingkat kepositifan sputum BTA sebelum terapi yang tinggi, statuskontrol DM yang tidak baik, kavitas pada foto toraks dan kadar albumin serumyang rendah meningkatkan risiko kegagalan konversi sputum BTA pada pasienTB dengan DM.ABSTRACT Background: The link of DM and TB is more prominent in developing countrieswhere TB is endemic and the burden of DM is increasing. Diabetes mellitusincreases the risk of TB infection, delayed sputum smear conversion and TBtreatment failure. This study would like to evaluate factors associated withdelayed sputum smear conversion in the end of two months of TB treatment innew cases TB with DM patients in Persahabatan Hospital.Methods: This retrospective cohort study was conducted in PersahabatanHospital, included all new cases TB with DM patients in the period from July2012 - June 2015. All the risk factors performed bivariate and multivariateanalysis in association with sputum smear conversion in the end of two months ofTB treatment.Results: The proportion of sputum smear conversion failure is higher in TB-DMthan non-DM patients (43,04 vs 22,75%) (p<0,001, CI95% 0,11-0,30) with therelative risk (RR) for sputum conversion failure 1,89 higher in TB-DM patients.Bivariate analysis resulted in significant higher of initial sputum smear level(p=0,021), HbA1c (p=0,014), FBG (p=0,047), post prandial Blood Glucose(p=0,030) and cavity at chest x-ray (p=0,033) and significant lower of serumalbumin (p=0,013) in non-conversion patients. Multivariate analysis resulted inrisk factors strongly associated with sputum conversion failure are low albuminlevel (p=0,046, CI95% 0,218-0,986), high initial sputum smear level (p=0,009,CI95% 1,230-4,349) and high HbA1c level (p=0,018, CI 95% 1,047-1,610).Conclusions: Higher initial sputum smear level, uncontrolled diabetic status,cavity at chest x-ray and lower albumin level associated with sputum smearconversion failure in TB-DM patients.;Background: The link of DM and TB is more prominent in developing countrieswhere TB is endemic and the burden of DM is increasing. Diabetes mellitusincreases the risk of TB infection, delayed sputum smear conversion and TBtreatment failure. This study would like to evaluate factors associated withdelayed sputum smear conversion in the end of two months of TB treatment innew cases TB with DM patients in Persahabatan Hospital.Methods: This retrospective cohort study was conducted in PersahabatanHospital, included all new cases TB with DM patients in the period from July2012 - June 2015. All the risk factors performed bivariate and multivariateanalysis in association with sputum smear conversion in the end of two months ofTB treatment.Results: The proportion of sputum smear conversion failure is higher in TB-DMthan non-DM patients (43,04 vs 22,75%) (p<0,001, CI95% 0,11-0,30) with therelative risk (RR) for sputum conversion failure 1,89 higher in TB-DM patients.Bivariate analysis resulted in significant higher of initial sputum smear level(p=0,021), HbA1c (p=0,014), FBG (p=0,047), post prandial Blood Glucose(p=0,030) and cavity at chest x-ray (p=0,033) and significant lower of serumalbumin (p=0,013) in non-conversion patients. Multivariate analysis resulted inrisk factors strongly associated with sputum conversion failure are low albuminlevel (p=0,046, CI95% 0,218-0,986), high initial sputum smear level (p=0,009,CI95% 1,230-4,349) and high HbA1c level (p=0,018, CI 95% 1,047-1,610).Conclusions: Higher initial sputum smear level, uncontrolled diabetic status,cavity at chest x-ray and lower albumin level associated with sputum smearconversion failure in TB-DM patients.;Background: The link of DM and TB is more prominent in developing countrieswhere TB is endemic and the burden of DM is increasing. Diabetes mellitusincreases the risk of TB infection, delayed sputum smear conversion and TBtreatment failure. This study would like to evaluate factors associated withdelayed sputum smear conversion in the end of two months of TB treatment innew cases TB with DM patients in Persahabatan Hospital.Methods: This retrospective cohort study was conducted in PersahabatanHospital, included all new cases TB with DM patients in the period from July2012 - June 2015. All the risk factors performed bivariate and multivariateanalysis in association with sputum smear conversion in the end of two months ofTB treatment.Results: The proportion of sputum smear conversion failure is higher in TB-DMthan non-DM patients (43,04 vs 22,75%) (p<0,001, CI95% 0,11-0,30) with therelative risk (RR) for sputum conversion failure 1,89 higher in TB-DM patients.Bivariate analysis resulted in significant higher of initial sputum smear level(p=0,021), HbA1c (p=0,014), FBG (p=0,047), post prandial Blood Glucose(p=0,030) and cavity at chest x-ray (p=0,033) and significant lower of serumalbumin (p=0,013) in non-conversion patients. Multivariate analysis resulted inrisk factors strongly associated with sputum conversion failure are low albuminlevel (p=0,046, CI95% 0,218-0,986), high initial sputum smear level (p=0,009,CI95% 1,230-4,349) and high HbA1c level (p=0,018, CI 95% 1,047-1,610).Conclusions: Higher initial sputum smear level, uncontrolled diabetic status,cavity at chest x-ray and lower albumin level associated with sputum smearconversion failure in TB-DM patients.;Background: The link of DM and TB is more prominent in developing countrieswhere TB is endemic and the burden of DM is increasing. Diabetes mellitusincreases the risk of TB infection, delayed sputum smear conversion and TBtreatment failure. This study would like to evaluate factors associated withdelayed sputum smear conversion in the end of two months of TB treatment innew cases TB with DM patients in Persahabatan Hospital.Methods: This retrospective cohort study was conducted in PersahabatanHospital, included all new cases TB with DM patients in the period from July2012 - June 2015. All the risk factors performed bivariate and multivariateanalysis in association with sputum smear conversion in the end of two months ofTB treatment.Results: The proportion of sputum smear conversion failure is higher in TB-DMthan non-DM patients (43,04 vs 22,75%) (p<0,001, CI95% 0,11-0,30) with therelative risk (RR) for sputum conversion failure 1,89 higher in TB-DM patients.Bivariate analysis resulted in significant higher of initial sputum smear level(p=0,021), HbA1c (p=0,014), FBG (p=0,047), post prandial Blood Glucose(p=0,030) and cavity at chest x-ray (p=0,033) and significant lower of serumalbumin (p=0,013) in non-conversion patients. Multivariate analysis resulted inrisk factors strongly associated with sputum conversion failure are low albuminlevel (p=0,046, CI95% 0,218-0,986), high initial sputum smear level (p=0,009,CI95% 1,230-4,349) and high HbA1c level (p=0,018, CI 95% 1,047-1,610).Conclusions: Higher initial sputum smear level, uncontrolled diabetic status,cavity at chest x-ray and lower albumin level associated with sputum smearconversion failure in TB-DM patients."

"Ulkus diabetik merupakan komplikasi dari diabetes melitus, lama sembuh dan terjadi berulang sehingga mempengaruhi kualitas hidup penderita. Penelitian ini bertujuan mengidentifikasi hubungan antara tingkat depresi dengan kualitas hidup pasien ulkus diabetes. Desain penelitian ini adalah deskriptif korelasi dengan pendekatan cross-sectional. Pemilihan sampel dengan cara purposive sampling yang melibatkan 30 responden. Hasilnya menunjukkan adanya hubungan yang signifikan antara nilai depresi dengan kualitas hidup dengan p-value 0,000. Hasil penelitian ini diharapkan merekomendasikan program pencegahan dan penanganan depresi pada pasien dengan ulkus diabetik.

---

Diabetic ulcers is complications of diabetes mellitus, delayed healing and repeated that affect the quality of life patients. The purpose of this study was to identify the relationship between depression and quality of life patients with diabetic ulcer. The design of this study is a descriptive correlation cross-sectional approach. The selection of samples were done in purposive sampling method and involved 30 respondents. The result are a significant correlation value depression with quality of life with p-value 0,000. The results of this study are expected to recommendation a program of prevention and treatment of depression patients with diabetic ulcers."

"ABSTRAKLatar belakang : Jumlah pasien diabetes melitus (DM) di dunia diperkirakan meningkat menjadi 366 juta pada tahun 2030 dengan peningkatan tercepat pada negara berpendapatan rendah dan menengah. Orang dengan TB laten memiliki kemungkinan jangka panjang menjadi TB aktif. Hubungan antara TB dan DM sudah lama diketahui. Orang dengan DM memiliki risiko lebih tinggi berkembangnya TB laten menjadi TB aktif. Tujuan: mengetahui prevalens TB paru dan faktor yang mempengaruhi munculnya TB paru pada pasien DM tipe 2 di RSUP Persahabatan. Metode : Penelitian ini merupakan penelitian potong lintang di Poli Endokrin RSUP Persahabatan. Subjek penelitian yaitu pasien DM tipe 2 yang berobat di Poli Endokrin RSUP Persahabatan. Data yang diperoleh dilakukan analisis bivariat dan multivariat antara variabel bebas dan terikat Hasil: Jumlah subjek penelitian yaitu 174 subjek yang terdiri dari jenis kelamin laki-laki sebanyak 71(40,8%) dan perempuan 103(59,2%). Prevalens TB paru pada pasien DM tipe 2 yaitu 49 orang (28,2%) yang terdiri dari TB paru BTA (+) yaitu 37 subjek (21,3%) dan TB paru BTA (-) sebanyak 12 subjek (6,9%). Faktor yang memiliki hubungan dengan terjadinya TB paru pada pasien DM yaitu riwayat kontak erat dengan penderita TB (aOR 3,2; [95% IK 0,538-3,164 ]), IMT rendah (aOR 15,92 [95% IK 4,760-56,160), lama DM kurang dari 1 tahun (aOR 23,136 [95% IK 4,654-11]) dan kadar HbA1C >8 (aOR 17,475 [95% IK 3,428-89,094]). Kesimpulan: Prevalens TB paru pada pasien DM tipe 2 pada di RSUP Persahabatan adalah 28,2%. Terdapat hubungan bermakna secara statistik antara kontak dengan penderita TB, lama menderita DM dan kadar HbA1c dengan terjadinya TB paru pada pasien DM tipe 2.

---

ABSTRACTBackground : Diabetes mellitus (DM) patients in the world is estimated rise to 366 million by 2030, with the fastest increase in low and middle income countries. Approximately one-third of the world population is estimated suffer from latent tuberculosis (TB). People with latent TB have a long -term possibility of becoming active TB. The relationship between TB and diabetes has been known. People with DM have a higher risk of developing latent TB into active TB . Objective : To determine the prevalence of TB and the factors that affect the develping TB in patients with DM at Persahabatan Hospital Methods: This study was a cross sectional study. Subject was 174 patients with DM type 2 taken by consecutive sampling. Datas were performed bivariate and multivariate analyzes between independent and dependent variables Results : 174 subjects consisted of male 40.8 % and women 59.2 %. Prevalence of pulmonary TB in patients with type 2 DM are 49 people ( 28.2 % ). Factors that correlation with the development of pulmonary TB in DM patients were patients with a history of close contact with TB patients (aOR 3,2; [95% CI 0,538-3,164 ]), underweight BMI (aOR 15,92 [95% CI 4,760-56,160), duration of diabetes of less than 1 year (aOR 23,136 [95% CI 4,654-11]) and HbA1c levels > 8 (aOR 17,475 [95% CI 3,428-89,094]). Conclusion : Prevalence TB in patients with type 2 DM at Persahabatan Hospital was 28.2 %. There were correlation between contact with TB patient, duration suffering from DM and HbA1c levels with development of pulmonary TB in patients with type 2 DM."

"Salah satu komplikasi mikroangiopati dari penyakit DM dan merupakan penyebab kematian terpenting pada penderita DM adalah Nefropati Diabetik. Tujuan penelitian ini adalah untuk mengetahui gambaran kejadian Gangguan Ginjal pada penderita DM serta faktor-faktor yang mempengaruhi kejadian tersebut di RSCM tahun 2012. Penelitian ini dilakukan pada penderita DM yang berobat baik di rawat jalan (Poli DM) maupun rawat inap dengan menggunakan desain cross sectional. Sampel penelitian terdiri dari 255 pasien DM yang terpilih seara random sampling. Hasil penelitian menunjukan bahwa sebanyak 34,9% sampel mengalami Gangguan Ginjal. Hasil dari analisis chi square menunjukan bahwa terdapat hubungan antara jenis kelamin dan lama menderita DM dengan kejadian Gangguan Ginjal.

---

One of the microangiopathic complications and the most important cause of death in people with diabetes is Diabetic Nephropathy. The purpose of this study was to describe the incidence of renal disorders in patients with diabetes and the factors that influence the event at the RSCM in 2012. The study was conducted in patients with DM were treated well in the outpatient (Poly DM) and hospitalizations using cross-sectional design. The research sample consisted of 255 patients who elected seara DM random sampling. The results showed that as many as 34.9% of the sample had Kidney Disorders. Results of chi-square analysis showed that there is a relationship between sex and the incidence of long- suffering DM Kidney Disorders."

"Latar Belakang Diabetes melitus dapat menyebabkan gangguan sistem saraf otonom (SSO) yang disebut sebagai neuropati otonom diabetik. SSO mengendalikan banyak sistem organ dan salah satu gangguannya dapat bermanifestasi sebagai disfungsi ereksi (DE). Prevalensi DE dan neuropati otonom diabetik di dunia masih beragam dan hubungan keduanya masih memiliki hasil yang bervariasi. Dengan deteksi dini neuropati otonom diabetik diharapakan dapat turut mendeteksi DE dan mencegah progresifitas DE menjadi lebih berat. Terdapat pilihan skrining untuk mendeteksi neuropati otonom salah satunya dengan Survey of Autonomic Symptom (SAS) dan pemeriksaan variabilitas detak jantung (HRV)Tujuan Mengetahui proporsi dan hubungan antara neuropati otonom dengan disfungsi ereksi pada DMT2 yang dinilai dengan kuesioner SAS dan pemeriksaan HRVMetode Penelitian ini menggunakan studi potong lintang dari 86 pasien DMT2 di Poliklinik Metabolik Endokrin RSUPN dr. Cipto Mangunkusumo sejak Agustus 2021 hingga November 2021. Pasien dilakukan wawancara dengan kuesioner SAS, IIEF-5, dan Pemeriksaan HRV. Dilakukan analisis multivariat untuk menilai hubungan variabel bebas dan terikat setelah dikontrol dengan variabel-variabel perancu yang berhubungan.Hasil Pada penelitian ini didapatkan proporsi pasien DE pada DMT2 sebanyak 59,3%. Proporsi pasien neuropati otonom yang dinilai dengan HRV sebanyak 94,3% dan neuropati otonom yang dinilai dengan kuesioner SAS sebanyak 41,9%. Terdapat hubungan secara statistik bermakna setelah dilakukan analisis multivariat antara neuropati otonom diabetik yang dinilai dengan kuesioner SAS dengan DE (adjusted OR 18,1 [IK95% 3,90-84.33]). Pemeriksaan HRV dalam penelitian ini tidak menunjukan hubungan yang signifikan secara statistik dengan DE.Kesimpulan Proporsi pasien dengan neuropati otonom diabetik yang dinilai dengan kuesioner SAS didapatkan sebesar lebih dari 40% dan yang dinilai dengan HRV lebih dari 90%. Terdapat hubungan yang secara statistik bermakna antara neuropati otonom diabetik yang dinilai dengan kuesioner SAS dengan DE.

---

Background Diabetes mellitus (DM) affecting the autonomic nervous system known as diabetic autonomic neuropathy (DAN), which controls many organ systems and can manifest as erectile dysfunction (ED). The range of ED and DAN prevalence has been found to vary widely depending on the baseline comorbidities in the population of the subject studied. Autonomic neuropathy is still rarely studied and its relationship with erectile dysfunction needs to be explored whether the two variables are related. By early detection of autonomic neuropathy, it is hoped that can help detect ED and prevent the progression more severe. There are screening options to see autonomic neuropathy: survey of Autonomic Symptoms (SAS) questionnaire and Heart rate variability (HRV) test.

Objective To determine the proportion and relationship between diabetic autonomic neuropathy and erectile dysfunction in Type 2 DM using SAS questionnaire and HRV examination

Methods Cross-sectional study of 86 type 2 DM patients at the Metabolic Endocrine Polyclinic, dr. Cipto Mangunkusumo from August 2021 to November 2021. Patients were interviewed with the IIEF-5 questionnaire, SAS and HRV examination. Multivariate analysis with logistic regression analysis was performed to assess the relationship between diabetic autonomic neuropathy with ED in the type 2 DM population.

Results In this study, the proportion diabetic autonomic neuropathy in Type 2 DM was 41.9% with SAS questionnaire and 94,3% with HRV, and Proportion of ED was 59.3%. The proportion of autonomic neuropathy who had ED was 91.7% with SAS and 69,7% with HRV. There was a statistically significant relationship between diabetic autonomic neuropathy use SAS and ED (adjusted OR 18.1 [95% CI 3.90-84.33]). HRV examination did not show an association with ED in this study.

Conclusion More than half of the subjects had erectile dysfunction and almost all of the patients with diabetic autonomic neuropathy had erectile dysfunction. There is a statistically significant relationship between diabetic autonomic neuropathy using SAS questionnaire and ED."

"Latar Belakang : Pasien Non-Proliferative Diabetic Retinopathy (NPDR), Proliferative Diabetic Retinopathy (PDR) dengan neuropati kornea akan mengalami terganggunya stabilitas air mata. Penurunan sekresi dan konsituen air mata akan menyebabkan gangguan berupa mata kering. Pada pasien Diabetes dengan retinopati diabetik, gangguan kornea ini berpotensi lebih memperburuk gangguan penglihatan yang terjadi. Tujuan : Menilai stabilitas air mata pada pasien NPDR, PDR dengan neuropati kornea sebelum, sesudah diberikan tetes mata Sodium hyaluronat+Vitamin A,E (HA+Vit A,E) atau Sodium Hyaluronat saja (HA). Metodologi : Penelitian ini merupakan uji eksperimental randomisasi acak terkontrol, dengan dua kelompok utama (NPDR, PDR), kedua kelompok mendapatkan tetes mata HA+Vit A,E atau HA selama 28 hari. Sensitivitas kornea, Skoring Ocular Surface Disease Index (OSDI), Non-Invasive Break Up Time (NIBUT), Schirmer I, jumlah sel goblet konjungtiva dinilai pada 0, 2, 4 minggu. Hasil : 96 subyek berpartisipasi, 65.6% wanita, 34.4% laki-laki (rerata usia 54.4 tahun). Skor OSDI memperlihatkan perbaikan signifikan, nilai terbesar pada kelompok PDR HA+Vit A,E dengan -4.86±5.76 (P= 0.000), NIBUT memperlihatkan perbaikan signifikan, nilai terbesar pada kelompok NPDR HA dengan 4.79±2.63 (P= 0.000), Schirmer I memperlihatkan perbaikan signifikan, hasil terbesar pada kelompok NPDR HA dengan 2.41±2.35 (P= 0.000). Sitologi impressi konjungtiva memperlihatkan perbaikan signifikan, terutama pada kelompok NPDR HA+Vit A,E (66% perbaikan). Seluruh kelompok memperlihatkan perbaikan signifikan, tetapi perbaikan antar kelompok tidak bermakna. Kesimpulan : Parameter seluruh kelompok memperlihatkan perbaikan yang signifikan setelah diberikan tetes mata HA+Vit A,E maupun HA saja, Tetapi jika dibandingkan antar kelompok, tidak terdapat perbedaan perbaikan yang signifikan.

---

Background : Patient with Non-Proliferative Diabetic Retinopathy (NPDR), Proliferative Diabetic Retinopathy (PDR) with corneal neuropathy will experiencing disruption in tear film stability. Decrease in tear film secretion and constituent will cause dry eyes. In Diabetic patients with diabetic retinopathy, this corneal disorder has the potential to further worsen visual impairment.

Purpose : To Assess tear film stability in NPDR, PDR patients with corneal neuropathy before, after treatment with topical Sodium hyaluronat+Vitamin A,E (HA+Vit A,E) or Sodium Hyaluronat only (HA).

Method : This study was a double blind experimental randomized control trial with two parallel groups (NPDR, PDR), both group receives HA+Vit A,E or HA for 28 days. Corneal sensitivity, Ocular Surface Disease Index (OSDI), Non-Invasive Break Up Time (NIBUT), Schirmer I, conjungtival goblet cells will be assessed on 0, 2, 4 weeks.

Result : 96 subjects participated, 65.6% female, 34.4% male, mean age 54.4 years old. OSDI score shows significant improvement, highest improvement seen on PDR HA+Vit A,E with -4.86±5.76 (P= 0.000), NIBUT hows significant improvement, highest improvement seen on NPDR HA with 4.79±2.63 (P= 0.000), Schirmer I shows significant improvement, highest improvement seen on NPDR HA with 2.41±2.35 (P= 0.000). Conjungtival goblet cells shows significant improvement, highest improvement seen on NPDR HA+Vit A,E (66% improved). All groups shows shows significant improvement, but between groups the improvement was not statistically significant.

Conclusion : Parameters on all groups shows statistically significant improvement after topical HA+Vit A,E or HA. But, if compared between groups, the improvement was not significantly differed."

"Efikasi diri dan kepatuhan merupakan faktor yang penting dalam meningkatkan kualitas hidup pasien DM tipe 2. Penelitian ini bertujuan untuk mengetahui hubungan antara tingkat efikasi diri dan kepatuhan dengan kualitas hidup pasien DM tipe 2 yang menjalani rawat jalan di Rumah Sakit di Jakarta.Desain dalam penelitian ini adalah cross sectional, dengan jumlah sampel 125 pasien DM tipe 2. Alat ukur yang digunakan adalah Diabetes Management Self-Efficacy (DMSES), the Diabetes Activities Questionare (TDAQ), dan Diabetes Quality Of Life (DQOL).Hasil penelitian menunjukkan bahwa efikasi diri (0,0005), dan kepatuhan (0,0005) berhubungan secara signifikan dengan kualitas hidup dengan variabel yang paling dominan adalah kepatuhan.Hasil uji multivariat menunjukkan bahwa variabel efikasi diri, kepatuhan, tingkat pendidikan, dan depresi menentukan kualitas hidup pasien DM. Perlunya dikembangkan pengkajian dan intervensi keperawatan yang berfokus pada efikasi diri dan kepatuhan pasien DM tipe 2.

---

Self-efficacy and adherence are important factor in improving the quality of life of patients with type 2 diabetes. This study aimed to determine the relationship between self-efficacy and adherence to the quality of life of patients with type 2 diabetes mellitus in an outpatient unit of a Hospital in Jakarta.

This study was a cross-sectional, with sample of 125 patients with type 2 diabetes mellitus. The Diabetes Management Self- Efficacy (DMSES), the Diabetes Activities Questionare (TDAQ), and the Diabetes Quality of Life (DQOL) were employed as instruments.

The results showed that selfefficacy (0.0005), and adherence (0.0005) were significantly associated with quality of life and the most dominant variable is adherence.

Multivariate test results indicate that the variable self-efficacy, adherence, education level, and depression determines quality of life of diabetic patients. This study suggestsis the need fornursing assessment and interventions that focus on the self-efficacy and adherence diabetes mellitus patient."

"Latar belakang: Gangguan fungsi ginjal pada tahap awal sangat jarang diketahui karena belum memunculkan tanda dan gejala. Saat gangguan fungsi ginjal berkembang progresif dan muncul penyakit ginjal terminal hingga hemodialisis akan menyebabkan status kesehatan jemaah haji menjadi risiko tinggi dan dapat menjadi tidak memenuhi syarat istithaah. Perlu dilakukan evaluasi lebih awal dengan mengetahui faktor risiko yang berhubungan dengan gangguan fungsi ginjal seperti obesitas sentral untuk mendapatkan upaya pencegahan dan intervensi yang lebih menguntungkan. Tujuan: Mengetahui prevalensi gangguan fungsi ginjal dan hubungan obesitas sentral dengan gangguan gangguan fungsi ginjal pada jemaah haji penderita DM tipe 2. Metode: Penelitian ini menggunakan desain cross sectional terhadap 2.106 jemaah haji yang menderita DM tipe 2. Subyek diperoleh dari data sekunder Siskohatkes Shar'i Puskeshaji Kemenkes RI tahun 1438 H / 2017 M. Semua subyek dilakukan pemeriksaan kesehatan di puskesmas atau rumah sakit rujukan. Estimasi nilai LFG menggunakan persamaan CKD EPI untuk menentukan fungsi ginjal. Obesitas sentral ditentukan menggunakan indeks lemak visceral. Analisis menggunakan regresi logistik multivariat. Hasil: Nilai rata-rata estimasi LFG 78,63 ml/menit/1,72 m2. Prevalensi gangguan fungsi ginjal pada jemaah haji yang menderita DM tipe 2 sebesar 39,55%. Prevalensi gangguan fungsi ginjal pada Jemaah haji penderita DM tipe 2 dengan obesitas sentral adalah 29,17%. Obesitas sentral berhubungan signifikan secara statistik dengan gangguan fungsi ginjal pada jemaah haji penderita DM tipe 2. Nilai adjusted OR sebesar 1,45 (95% CI 1,19-1,77). Kesimpulan: Prevalensi gangguan fungsi ginjal pada jemaah haji yang menderita DM tipe 2 sebesar 39,55%. Obesitas sentral berhubungan secara signifikan dengan gangguan fungsi ginjal pada jemaah haji yang menderita DM tipe 2.

---

Background: Impaired renal function in the early stages often not raised signs and symptoms. End-stage renal disease with hemodialysis will cause Indonesian pilgrims in high risk health status and does not meet istithaah requirements. Early detection of risk factors such as central obesity might be directed to benefit prevention dan intervention.

Objective: to estimate the prevalence of renal function impairment in type 2 DM and the association of central obesity with renal function impairment among Indonesian pilgrim with type 2 DM based on Siskohatkes shar'i 1438 H / 2017 M.

Methods: This cross sectional studi consisted of 2.106 Indonesian pilgrims with type 2 DM. The data was obtained from Siskohatkes 2017 of Pilgrimage Health Center, Ministry of Health. The variable data analyzed were creatinin serum, anthropometric, age, gender, smoking, family history of end-stage renal disease, blood pressure, HDL, LDL, trigliserida and uric acid. Renal function impairment was defined according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation to estimate Glomerulus Filtration Rate (eGFR). Central obesity was determined using visceral adiposity index (VAI). Multivariable logistic regression was used to analyze the association of central obesity and renal function impairment.

Result: The prevalence of renal function impairment in Indonesia pilgrim with type 2 DM was 39,55%. The mean of eGFR was 78,63 ml/min/1,72 m2. Central obesity was associated with renal function impairment (adjusted OR = 1,45; 95% CI 1,19-1,77).

Conclusion: The prevalence of renal function impairment in Indonesia pilgrim with type 2 DM was 39,55%. Central obesity was associated with renal function impairment."

"Atas rekomendasi dokter spesialis pelayanan Rujuk Balik ke puskesmas dianjurkan bagi pasien di RS yang menderita penyakit kronis termasuk diabetes melitius. Penelitian ini bertujuan untuk melihat faktor-faktor yang berhubungan dengan kesediaan pasien diabetes mellitus tipe 2 peserta JKN di RSU Jagakarsa untuk dirujuk balik ke FKTP.Desain potong lintang dan pendekatan kualitatif melalui wawancara mendalam digunakan dalam studi ini. Hasil penelitian menunjukkan bahwa kepercayaan pasien terhadap dokter layanan primer, persepsi pasien mengenai ketersediaan obat di fasilitas kesehatan primer, jarak tempuh terhadap fasilitas kesehatan primer dan dukungan keluarga dan teman berhubungan dengan kesediaan pasien untuk dirujuk balik. Disarankan untuk mengembangkan SOP rujuk balik di RS dan mengembangkan pojokrujuk balik.

---

Back referral service to primary care is provided for JKN patients including diabetes mellitus type 2 patients as recommended by the internal medicine specialist. This studyaim is to analyse the factors that related to willingness of the patients to be referred to primary care after receiving care at the hospital in Jagakarsa Hospital. This study is using quantitative method with cross sectional design, followed by qualitative method with in depth interview.

The study revealed that trust to the primary health care physician, perception on medicine availability in primary health care facility, accessiibility and support from family and friend affect patient willingness to agree with back referral service. The study suggested to develop standard procedure for back referral and initiate back referral corner in hospital."