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"Graves disease is an autoimmune disorder which affect thyroid gland. Graves disease is the most common cause of hyperthyroidism and thyrotoxicosis. Understanding of disease pathophysiology, diagnostic and treatment strategies, and prevention of disease relapse are important for all clinicians especially internal medicine specialist to give optimal and comprehensive management for Graves disease patients. This article highlights clinical points to treat Graves disease patients from reviews and latest guidelines from American Thyroid Association (ATA), European Thyroid Association (ETA), and Japan Thyroid Association/ Japan Endocrine Society."

"Background: Each kidney injury may develop into chronic kidney disease (CKD) and end stage renal disease (ESRD) that associates with high mortality and socio-economic burden. There is limited data about clinical characteristics of children having CKD in developing countries, espesially in Indonesia.Objective: To describe clinical profiles and characteristics of kidney diseases in adolescents aged 15-18 years.Methods: This study was a cross-sectional study which used data from National Basic Health Survey (Riskesdas) 2013. There were 2 data groups. The first data group included questionnaires about history of kidney stone disease, hypertension, chronic renal failure, antihypertension administration, and blood pressure measurement. The second data group included subsamples of the first group which had laboratory test results, i.e. hemoglobin and serum creatinine levels. All of the data were classified by nutritional status, estimated glomerulofiltration rate (eGFR), blood pressure classification, and hemoglobin level.Results: Among 52,454 adolescents in the first data group, 20,537 (39%) had kidney diseases with female predominance and good nutritional status. Other findings found were history of kidney stone disease (0.2%), chronic renal failure (0.1%), history of hypertension (0.6%), antihypertensive agents consumption (0.1%). Prehypertension and hypertension were found in 51% and 48.3% of adolescents, respectively. Adolescents with decreased eGFR were accounted for 1.4%.Conclusion: The proportion of prehypertension and hypertension in adolescents aged 15-18 years in Indonesia is high. Hence, routine blood pressure measurement is important for early detection and prevention of kidney disease progression."

"Placental morphology and cellular arrangement can be altered in maternal diseases. Rheumatic heart disease (RHD) is a chronic heart condition that can lead to death in pregnant women. The aim of this study is to determine the histological changes of the placenta in pregnant women suffering from RHD. Methods: Placentae were collected from 10 healthy pregnant women, and 31 pregnant women with heart conditions (26 with RHD and 5 with NRHD) who had been admitted to the Baghdad Teaching Hospital. Placental tissues were fixed in10% formal-saline and were processed for light microscopy. Measurements including the placental weight and diameter of the chorionic villi capillaries were recorded. Results: The results indicate that there are many histological changes in pregnant women with RHD such as hyalinisation, fibrosis of the chorionic villi, proliferation of trophoblastic cells, and thickening of its membrane. Additionally, expectant mothers with RHD experience a reduction in capillary diameter and thickening of the capillary walls, and decreased size and weight of their placenta when compared with the control. Conclusions: Heart diseases, especially RHD, are associated with developmental damage of the placenta in pregnant women by injuring the endothelial cells of the placentas capillaries."

"Cardiovascular disease causes 8.6 million deaths of women every year, which is the major cause of death by one-third of all deaths of women in the world.Half of all deaths of women older than 50 years old is caused by cardiovascular and stroke diseases. This study aimed to analyze risk factors related to coronaryheart disease among women aged older than 45 years at Dody Sarjoto Makassar Air Force Hospital 2016. The total of sample was 76 consisting of 64cases of coronary heart disease and 12 non-coronary heart disease. Determination of sample used purposive sampling. Primary data were obtained throughinterview to respondents using questionnaire and direct interview. Data were analyzed by using contingency correlation coefficient (Exp (B)) test to identifysignificant relation between dependent and independent variables. Results found were hypertension (Exp (B) = 0.309), obesity (Exp (B) = 0.140), diabetesmellitus (Exp (B) = 0.164) and dyslipidemia (Exp (B) = 0.185), as proven having relation with coronary heart disease among women aged older than 45 years,and the factor which had the most significant relation was dyslipidemia.Penyakit kardiovaskuler menyebabkan 8.6 juta kematian pada perempuan setiap tahun, yang merupakan penyebab kematian terbanyak, yaitu sepertiga dariseluruh kematian perempuan di seluruh dunia. Setengah dari seluruh kematian perempuan berusia di atas 50 tahun disebabkan oleh penyakit jantung danstroke. Penelitian ini bertujuan untuk menganalisis faktor yang berhubungan dengan penyakit jantung koroner pada perempuan usia > 45 tahun di RumahSakit TNI AU Dody Sarjoto Makassar. Besar sampel sebanyak 76 sampel yang terdiri dari 64 kasus penyakit jantung koroner dan 12 kasus non penyakit jantungkoroner. Penentuan sampel menggunakan metode purposive sampling. Data primer diperoleh melalui wawancara terhadap responden dengan menggunakankuesioner dan wawancara langsung. Data dianalisis menggunakan uji koefisien korelasi kontingensi (Exp (B)) terhadap variabel independen dandependen. Adapun hasil yang ditemukan adalah obesitas (Exp (B) = 0.140), diabetes mellitus (Exp (B) = 0.164), dan dislipidemia (Exp (B) = 0.185) terbuktimemiliki hubungan dengan kejadian penyakit jantung koroner pada perempuan usia > 45 tahun dan faktor yang memiliki hubungan paling besar adalah dislipidemia."

"AbstrakDeclining environmental quality is one of population caused by household consumption behavior. Some of the highest contaminant contributions are domestic waste, waste, and company waste. Waste contamination will lead to dead fish, decreased water quality and disease transmission. Community approach can be done to solve the waste problem, especially at the household level. This study uses quantitative methods to analyze the effect of intervention and waste management training on changes in household waste management knowledge and practices. This type of research uses quasi experiment with one group of pre and post test design. The results showed that there was an increase of knowledge about waste management after being given intervention by the researcher because the p value ≤ 0,05. The results also show that there is an increasing practice on waste management after being given intervention by researchers because the p value ≤ 0.05. Based on the research results, it can be concluded that the provision of intervention is effective for improving knowledge and practice in the household waste management."

"Bervariasinya penerapan SIMPUS IHIS dan e-Health di Kabupaten Bantul membuat laporan SP2TP sebagai keluran dari SIMPUS menjadi terhambat. Dalam penerapan SIMPUS IHIS dan e-Health di Kabupaten Bantul terdapat hambatanhambatan yang perlu diperhatikan dan ditangani dengan baik agar tidak semakin kompleks. Evaluasi SIMPUS di Kabupaten Bantul dengan menggunakan metode HOT-fit digunakan untuk mengetahui sejauh mana penerapan dan kendala dalam implementasi. Metode penelitian dengan menggunakan pendekatan penelitian campuran yaitu penelitian kualitatif dan penelitian kuantitatif. Pengumpulan data dilakukan dengan wawancara mendalam, kuesioner, observasi pada Puskesmas dan dokumentasi tertulis kegiatan penerapan SIMPUS IHIS dan e-Health. Hasil penelitian menunjukkan SIMPUS IHIS dan e-Health sudah digunakan seluruh Puskesmas di Kabupaten Bantul. Faktor organisasi memberikan pengaruh terhadap berjalannya sistem, komitmen Kepala Puskesmas tidak dijabarkan dalam bentuk operasional teknis seperti pembentukan tim SIK dan tidak dibuatnya SOP dalam penerapan SIMPUS IHIS dan e-Health.

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The variations in the application of SIMPUS IHIS and e-Health in Bantul detain SP2TP reports as the output of SIMPUS. There are obstacles in the application of SIMPUS IHIS and e-Health in Bantul that need to be considered and dealt with in order not to become more complex. The evaluation of SIMPUS in Bantul using HOT-fit method is used to determine the effectiveness of implementation and the constraints in implementation. The research uses both qualitative research and quantitative research. Data was collected through in-depth interviews, questionnaires, observation and written documentations on the SIMPUS IHIS and e-Health application. The results shows that SIMPUS IHIS and e-Health have been used in all Puskesmas in Bantul. Organizational factors impact the run of the system, head of the health center's commitment is not described in technical operations such as forming SIK team and SIMPUS IHIS and e-Health SOP is not determined."

"ABSTRAKBy 2015, 68% of deaths in Indonesia are due to non-communicable diseases (NCD) and are forecast to increase to 74% by 2030. Riskesdas data of 2013 show that 69.6% of cases of diabetes mellitus and 63.2% of cases of hypertension have not been diagnosed. The government has been trying to proactively make efforts to prevent NCD through the implementation of Posbindu (Integrated Health Post) NCD, but visit Posbindu NCD in the work area of Pasir Mulya Puskesmas, Bogor City is very diverse. The purpose of this study is to analyze the factors of management, communication, partnership, and innovation in the implementation of Posbindu NCD and determinants of the implementation of Posbindu NCD. We conducted in-depth interviews, focus group discussions, document review and observation at two Posbindu NCD with the highest number of visits and the lowest in Gunung Batu Village, Bogor City in 2017. We interviewed 15 informants, consisting of cadres, in charge of NCD Puskesmas, in charge of Puskesmas Pembantu and supervisor of Posbindu NCD. This research found 4 factors, namely management (human resources, fund, and facilities), innovation, communication and partnership that influence the result of Posbindu implementation. Therefore, to run effectively the Posbindu NCD program, then 4 of those factors need to be optimized.ABSTRAKPada tahun 2015 sebanyak 68% kematian di Indonesia disebabkan penyakit tidak menular (PTM) dan diproyeksi meningkat menjadi 74% tahun 2030. Data Riskesdas tahun 2013 menunjukkan bahwa 69,6% kasus diabetes melitus dan 63,2% kasus hipertensi belum terdiagnosis. Pemerintah proaktif melakukan upaya pencegahan PTM melaluipelaksanaan Posbindu PTM. Data kunjungan Posbindu PTM di wilayah kerja Puskesmas Pasir Mulya, Kota Bogor menunjukkan jumlah yang sangat beragam. Tujuan penelitian adalah menganalisis faktor manajemen, komunikasi, kemitraan, dan inovasi dalam pelaksanaan Posbindu PTM dan faktor penentu pelaksanaan Posbindu PTM. Disainpenelitian adalah studi kualitatif dengan metode wawancara mendalam, focus group discussion (FGD), telaah dokumen, dan observasi di dua Posbindu PTM dengan jumlah kunjungan tertinggi dan terendah di Kelurahan Gunung Batu, Kota Bogor tahun 2017. Informan penelitian sebanyak 15 orang yang terdiri dari kader, penanggung jawab program PTM Puskesmas, penanggung jawab Puskesmas Pembantu dan pembina Posbindu PTM. Penelitian menemukan terdapat perbedaan manajemen (SDM, dana, dan sarana), inovasi, komunikasi dan kemitraan antara Posbindu RW 1 dan RW 7 yang memengaruhi hasil pelaksanaan Posbindu PTM. Keempat faktor tersebut pada Posbindu dengan kunjungan terbanyak berjalan lebih optimal dibandingkan dengan Posbindu dengan kunjungan terendah. Agar program PosbinduPTM dapat berjalan efektif maka perlu optimalisasi faktor manajemen, inovasi, komunikasi dan kemitraan."