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"Malnutrisi dan Tuberkulosis (TB) memiliki hubungan bidireksional, dimana saling berinteraksi satu sama lain. Pada kondisi infeksi kronis, terjadi ketidakseimbangan antara pemecahan protein dan sintesis protein yang ditandai dengan menurunnya massa bebas lemak. Malnutrisi juga menyebabkan atrofi timus sehingga terjadi penurunan proliferasi limfosit. Kondisi malnutrisi pada pasien TB akan menurunkan kualitas hidup. Kualitas hidup yang baik akan meningkatkan keberhasilan pengobatan, menurunkan mortalitas dan morbiditas. Short Form-36 (SF-36) merupakan kuesioner untuk menilai kualitas hidup yang dapat menilai 2 komponen yaitu komponen fisik (PCS) dan mental (MCS).  Penelitian potong lintang ini bertujuan untuk menilai hubungan asupan protein, massa bebas lemak dan hitung limfosit total dengan kualitas hidup pada pasien TB paru fase intensif di 12 puskesmas yang dipilih secara random di Kota Pekanbaru, Riau. Pengambilan sampel dilakukan secara consecutive sampling, dan didapatkan 72 subjek yang memenuhi kriteria penelitian. Hasil penelitian didapatkan nilai tengah usia adalah 33 tahun dengan usia terendah 18 tahun dan tertinggi 59 tahun. Sebanyak 56,9% subjek adalah laki-laki, sebagian besar berpendidikan menengah dengan pendapatan kurang, perokok aktif dan dengan status gizi kurang (underweight). Sebanyak 59,7% subjek memiliki asupan protein yang kurang, 86,1% dengan massa bebas lemak yang rendah, dan 88,9% subjek memiliki hitung limfosit yang normal. Sebagian besar subjek memiliki kualitas hidup PCS dan MCS yang baik. Hasil penelitian menunjukkan terdapat korelasi dengan kekuatan lemah yang bermakna secara statistik antara massa bebas lemak dengan PCS (r = 0,239, p = 0,044), sedangkan asupan protein dan hitung limfosit total tidak ditemukan adanya korelasi baik terhadap PCS maupun MCS.

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Introduction: Malnutrition and Tuberculosis (TB) have bidirectional relationship, which interact between each other. In chronic infection, there is an imbalance between protein degradation and protein synthesis which marked with the loss of fat free mass (FFM). Malnutrition can cause the atrophy of thymus gland resulted in the reduction of lymphocyte production. Malnutrition in TB patients will reduce quality of life. On the other hand, a good quality of life will increase treatment success rate and decrease the risk of morbidity and mortality. Short Form-36 (SF-36) is a questionnaire used to assess quality of life consists of two different components, physical component score (PCS) and mental component score (MCS).

Methods: This cross-sectional study aimed to assess correlation between protein intake, fat free mass, and total lymphocyte count with quality of life among intensive phase lung tuberculosis patients. Data collected from May to July 2019 in 12 primary health centers chosen randomly in Pekanbaru, Riau Province. Samples selected using consecutive sampling method and 72 subjects fulfilled all research criteria. Interview was used to collect basic characteristic data, dietary intake data, and quality of life score. Anthropometric measurement (body weight, body height, and fat free mass) and laboratory examination (total lymphocyte count) were done. Spearman, Pearson, Mann-Whitney, and Kruskall Wallis test were used in this study.

Results: Research showed median age subjects was 33 years old (18-59 years old). Most of the subjects were male (56.9%), had middle level of education, had low income, were active smoker with underweight nutritional status. Around 59.7% subjects had low protein intake, 86.1% subjects had low fat free mass, and 88.9% subjects had normal lymphocyte count. Most of the subjects had good physical and mental component score of quality of life assessment.

Conclusion: There was a statistically significant weak correlation between fat free mass with PCS (r = 0.239, p = 0.044). However, there was no correlation found between protein intake or total lymphocyte count with PCS or MCS."

"Homeostasis protein berperan penting dalam memperlambat proses malnutrisi dan dalam mempertahankan massa bebas lemak pasien kanker. Kehilangan signifikan massa bebas lemak terutama massa otot skelet akan mengurangi mobilitas fisik, kapasitas fungsional, dan skor kualitas hidup pasien kanker. Penelitian ini merupakan studi potong lintang yang bertujuan untuk mengetahui korelasi antara asupan protein dengan massa bebas lemak dan kapasitas fungsional pada pasien kanker paru di poli onkologi RS Persahabatan Jakarta. Didapatkan 52 subjek laki-laki dengan rerata usia 55,63 6,77 tahun. Jenis dan stadium kanker yang terbanyak ditemukan adalah adenokarsinoma 63,5, stadium IV 65,4. Status nutrisi kurang berdasarkan IMT ditemui pada 21,2 subjek, dan berdasarkan kadar albumin serum didapatkan 30,8 subjek dengan hipoalbuminemia. Lebih dari 50 subjek dengan asupan energi dan protein dibawah rekomendasi asupan untuk pasien kanker. Pada pemeriksaan komposisi tubuh didapatkan rerata massa bebas lemak 47,20 6,28 kg, dengan 48,1 indeks massa bebas lemak rendah, massa otot rerata 44,74 5,98 kg dengan 40,4 massa otot tergolong kurang. Nilai kapasitas fungsional skala Karnofsky.

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The homeostasis of protein plays an important role in decreasing the process of malnutrition and in maintaining fat free mass in cancer patients. The significant loss of fat free mass, especially skeletal muscle mass could decrease physical activity, functional capacity, and quality of life of cancer patients. This was a cross sectional study aimed to investigate the correlation of protein intake, fat free mass and functional capacity in lung cancer patients in the Oncology Unit of Persahabatan Hospital Jakarta. Obtained 52 male subjects with a mean age of 55,63 6,77 years old. The most cancers type were adenocarcinoma 63,5 and most of subjects were at stage IV 65,4 . Nutritional status of the subjects 21,2 were in undernutrition based on body mass index parameter, and 30,8 of the subjects were in hypoalbuminemia. More than 50 of the subjects had low energy and protein intake. The mean of fat free mass was at 47,20 6,28 kg, that 48,1 of fat free mass index were in low categorized, and 40,4 of muscle mass were also in small categorized, that the mean was at 44,74 5,98 kg. Functional capacity Karnofsky scale of the subjects 26,9 showed less than 70. The data showed that the subjects had nutrition problems. This study showed positive and significant correlations between protein intake with fat free mass index r 0,379, p "

"Stroke iskemik merupakan penyebab utama disabilitas jangka panjang dengan beban ekonomi serta angka kematian yang tinggi di Indonesia. Malnutrisi pada pasien stroke iskemik berhubungan dengan masa rawat inap lebih lama, luaran fungsional lebih buruk, dan mortalitas yang lebih tinggi. Malnutrisi ditandai oleh adanya penurunan massa otot yang dapat dinilai dengan pemeriksaan indeks massa bebas lemak (fat free mass index, FFMI) menggunakan bioelectrical impedance analysis (BIA). Inflamasi sebagai salah satu penyebab malnutrisi pada pasien stroke iskemik dapat ditandai oleh peningkatan rasio neutrofil terhadap limfosit (neutrophil-to-lymphocyte ratio, NLR). Penelitian ini merupakan studi potong lintang untuk melihat korelasi antara FFMI dan NLR pada 47 subjek dengan stroke iskemik akut berusia >18 tahun hingga 65 tahun yang dirawat di RSUPN Dr. Cipto Mangunkusumo (RSCM) dan RS Universitas Indonesia (RSUI) selama bulan November–Desember 2023. Hasil penelitian menunjukkan rerata usia subjek adalah 57±7,1 tahun dan sebagian besar subjek adalah laki-laki (61,7%). Hipertensi merupakan faktor risiko tertinggi yang ditemukan pada subjek penelitian (83%). Sebagian besar subjek memiliki status gizi berat badan normal (31,9%) dan obesitas (31,9%), sedangkan subjek dengan malnutrisi sebesar 8,5%. Rerata nilai FFMI pada subjek penelitian adalah 18±2,2 kg/m² dan diperoleh 12,8% subjek dengan kategori FFMI rendah. Rerata nilai NLR adalah 3,7±1,3 dan diperoleh 36,2% subjek dengan kategori NLR tinggi. Nilai FFMI dan NLR pada subjek penelitian memiliki korelasi negatif signifikan dengan nilai korelasi r=-0,38, p<0,01.

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Ischemic stroke is a leading cause of long-term disability with a high economic burden and mortality rate in Indonesia. Malnutrition in ischemic stroke patients is associated with longer hospitalization, worse functional outcomes, and higher mortality. Malnutrition is characterized by a decrease in muscle mass that can be assessed by examining the fat free mass index (FFMI) using bioelectrical impedance analysis (BIA). Inflammation as one of the causes of malnutrition in ischemic stroke patients can be characterized by an increase in the neutrophil-to-lymphocyte ratio (NLR). This study is a cross-sectional study to see the correlation between FFMI and NLR in 47 subjects with acute ischemic stroke aged >18 years to 65 years who were admitted to Dr. Cipto Mangunkusumo Hospital (RSCM) and University of Indonesia Hospital (RSUI) during November-December 2023. The results showed that the mean age of the subjects was 57±7.1 years and most of the subjects were male (61.7%). Hypertension was the highest risk factor found in the study subjects (83%). Most subjects had a nutritional status of normal weight (31.9%) and obesity (31.9%), while subjects with malnutrition amounted to 8.5%. The mean FFMI value in the study subjects was 18±2.2 kg/m2 and 12.8% of subjects with low FFMI category were obtained. The mean value of NLR was 3.7 ± 1.3 and 36.2% of subjects with high NLR category were obtained. The FFMI and NLR values in the study subjects had a significant negative correlation with a correlation value of r = 0.38, p <0.01."

"Glutamin merupakan asam amino yang berperan penting dalam menjaga homeostasis dari fungsi sel tertentu, di antaranya adalah proliferasi sel limfosit. Penurunan kadar glutamin plasma terjadi pada hewan coba dengan kanker, yang berdampak pada peningkatan kerentanan terhadap infeksi. Beberapa penelitian melaporkan bahwa suplementasi glutamin dapat mencegah terjadinya mukositis oral akibat radiasi, sehingga dapat meningkatkan kualitas hidup pasien kanker kepala leher dengan radioterapi. Penelitian dengan desain potong lintang ini dilakukan di Departemen Radioterapi RSUPN dr. Cipto Mangunkusumo, Jakarta, yang bertujuan untuk mengetahui korelasi antara kadar glutamin plasma terhadap total lymphocyte count TLC dan kualitas hidup pada pasien kanker kepala leher dengan radioterapi. Dari total 52 subjek yang mengikuti penelitian ini, didapatkan median usia 50,50 18-62 tahun dan 63,46 adalah subjek laki-laki. Nasofaring merupakan lokasi kanker tersering. Sekitar 70 subjek berada pada stadium IV dan mendapatkan kombinasi radioterapi dan kemoterapi. Status gizi sebagian besar subjek masih tergolong normal. Hasil penelitian ini menunjukkan bahwa tidak ada korelasi antara kadar glutamin plasma terhadap TLC dan kualitas hidup pada pasien kanker kepala leher dengan radioterapi. Meskipun demikian, beberapa data dalam penelitian ini dapat memberikan gambaran mengenai adanya masalah nutrisi yang dialami pasien kanker kepala leher dengan radioterapi. Data tersebut antara lain lebih dari 60 subjek memiliki asupan kalori dan protein harian yang kurang, kemudian didapatkan juga kadar glutamin plasma semua subjek yang sangat rendah, dengan rerata 7,77 3,32 ?mol/l. Beberapa faktor yang diduga menjadi penyebab terjadinya hal tersebut adalah proses penyakit kanker, lokasi pertumbuhan kanker, efek samping terapi, serta kebutuhan yang sangat tinggi akan glutamin untuk fungsi fisiologis tubuh.

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Glutamin is an amino acid that plays an important role in maintaining the homeostasis of many cells, including the proliferation of lymphocytes. A decrease in plasma glutamine level was observed in rats with cancer, which could increase the susceptibility to infection. Several studies showed that glutamine supplementation could prevent oral mucositis induced by radiation, so this could increase the quality of life of head and neck cancer patients receiving radiotherapy. This cross sectional study conducted at Radiotherapy Department, RSUPN dr. Cipto Mangunkusumo, Jakarta, aimed to investigate the correlations of plasma glutamin level with total lymphocyte count TLC and quality of life in head and neck cancer patients receiving radiotherapy. A total of 52 subjects participated in this study, with median age 50,50 18 62 years old and 63,46 subjects were male. Nasopharynx was the most common site affected. About 70 subjects were at stage IV cancer and receiving a combination of radiotherapy and chemotherapy. Most of the subjects had a normal nutritional status according to body mass index BMI.

The results of this study showed no correlations of plasma glutamine level with TLC and quality of life in head and neck cancer patients receiving radiotherapy. However, data from this study revealed nutritional problems that happened in head and neck cancer patients receiving radiotherapy. These data include more than 60 of subjects had below normal limit daily calorie and protein intakes, and the plasma glutamine level of all subjects was very low, with mean 7,77 3,32 mol l. Several factors predicted to be the cause of these problems are the process of the disease, cancer growth location, side effects of therapy, as well as a high need of glutamine for physiological functions of the body. "

"Latar Belakang: Hitung limfosit total berhubungan dengan prognosis serta harapan hidup pasien kanker kepala leher. Regulasi limfosit dipengaruhi berbagai hal termasuk nutrisi. Salah satu zat gizi yang berperan dalam proliferasi limfosit adalah asam amino rantai cabang. Penelitian ini bertujuan untuk melihat korelasi antara asupan asam amino rantai cabang dengan hitung limfosit total pada pasien kanker kepala dan leher.Metode: Studi potong lintang ini dilakukan pada subjek dewasa dengan kanker kepala leher yang belum menjalani terapi di poliklinik radioterapi dan hematologi onkologi medik RSCM. Asupan asam amino rantai cabang dinilai dengan 3 x 24-h food recall dan FFQ semi kuantitatif. Hitung limfosit total diukur dengan differential blood cell counter.Hasil: Sebanyak 85 subjek penelitian dengan rerata usia 53 tahun, dengan sebagian besar laki-laki, terdiagnosis kanker nasofaring dengan jenis karsinoma sel skuamosa dan stadium IV. Rerata subjek memiliki status gizi normal, dengan rerata asupan energi 29,99 ± 0,95 kkal/kgBB dan protein 1,39 ± 0,05 g/kgBB dengan penilaian FFQ semi kuantitatif. Rerata asupan AARC pada subjek sebesar 10,92 ± 0,48 gram dengan FFQ semi kuantitatif. Sebagian besar subyek memiliki hitung limfosit total pada rentang normal. Terdapat sebanyak 17.6% subyek dengan hitung limfosit total yang rendah. Terdapat korelasi lemah antara asupan asam amino rantai cabang dengan hitung limfosit total (r=0,230, p=0,029).Kesimpulan: Terdapat korelasi bermakna yang lemah antara asupan AARC dengan hitung limfosit total pada subjek kanker kepala leher yang belum menjalani kemoradioterapi.

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Background: Total lymphocyte count is related with prognosis and survival rate of head and neck cancer patients. Lymphocyte regulation is affected by multiple factors, including nutrition. One of the nutrients that plays role in lymphocyte proliferation is branched-chain amino acids. This study aims to investigate the correlation between branched-chain amino acid and total lymphocyte count in head and cancer patients.

Method: This cross-sectional study was conducted on adults with head and neck cancer who had not undergone therapy at the radiotherapy and medical hematology oncology clinic at RSCM. Branched-chain amino acid intake was assessed using 3x24-h food recall and semi quantitative FFQ. Total lymphocyte count was measured with differential blood cell counter.

Results: Eighty-five subjects with a mean age of 53 years, mostly are male, diagnosed with nasopharyngeal cancer, with histopathology appearance of squamous cell carcinoma, and stage IV cancer. The average subject had normal nutritional status, with an average intake of 29.99 ± 0.95 kcal/kgBW of energy and 1.39 ± 0.05 g/kgBW of protein with a semi quantitative FFQ assessment. The average branched-chain amino acid intake in subjects was 10,92 ± 0,48 gram with semi quantitative FFQ. There were 17.6% subjects with low total lymphocyte count. There was a low correlation between intake of branched-chain amino acids and total lymphocyte count (r=0,230, p=0,029).

Conclusion: There was a significant low correlation between branched-chain amino acids intake with total lymphocyte count in head and neck cancer subjects who had not undergone chemoradiotherapy."

"Penyakit tuberkulosis paru dapat menimbulkan penurunan terhadap aspek kualitas hidup pasien TB Paru. Beberapa faktor yang mempengaruhi kondisi tersebut adanya depresi dan stigma negatif terhadap penyakit. Tujuan penelitian ini untuk mengetahui hubungan depresi dan stigma dengan kualitas hidup pasien tuberkulosis paru yang menjalani pengobatan OAT. Penelitian ini merupakan penelitian kuantitatif dengan menggunakan desain cross sectional dan teknik yang digunakan adalah concecutive sampling. Populasi target dalam penelitian ini adalah pasien tuberkulosis paru yang menjalani pengobatan OAT di poli paru RSUP Persahabatan yang berjumlah 96 responden. Data dianalisis dengan uji analisa univariat dan bivariat, hasil uji bivariat menggunakan pearson menunjukan hasil p = 0,000 p < 0,05. Berdasarkan hasil tersebut menunjukan adanya hubungan antara depresi dan kualitas hidup serta stigma dan kualitas hidup pasien tuberkulosis paru. Diharapkan hasil penelitian ini dapat menunjukan perlunya deteksi dini depresi dan stigma dilakukan oleh perawat pada saat merawat pasien TB paru.

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Treatment pulmonary tuberculosis disease may lead to a decrease in the quality of life of patients with pulmonary tuberculosis. Several factors that affect the existence of depression and negative stigma against the disease.The study aimed to identify relation of depression and stigma and quality of life of patients with tuberculosis who were undergoing anti tuberculosis regimen.

This quantitative study used cross sectional approach and used consecutive sampling technic. Target population of this study was patients with tuberculosis who have undertaking anti tuberculosis medication in polyclinic of pulmonary of RSUP Persahabatan with total sample of 96 respondents."

"Latar Belakang: Penurunan massa bebas lemak dan status fungsional akan mempengaruhi prognosis pada pasien kanker kepala leher. Pembentukan massa bebas lemak dipengaruhi berbagai hal termasuk nutrisi. Salah satu zat gizi yang berperan dalam adalah asam amino rantai cabang. Karnofsky Performance Scales (KPS) adalah salah satu parameter status fungsional yang dinilai secara rutin untuk pasien kanker Penelitian ini bertujuan untuk melihat korelasi antara asupan asam amino rantai cabang dengan massa bebas lemak dan status fungsional pada pasien kanker kepala dan leher.Metode: Studi potong lintang ini dilakukan pada subjek dewasa dengan kanker kepala leher secara consecutive sampling method di poliklinik radioterapi RSCM. Wawancara dilakukan untuk mengumpulkan data karakteristik dasar, data asupan zat gizi dan penilaian status fungsional. Pengukuran komposisi tubuh massa bebas lemak dengan alat bioimpedance analysis single Frequency. Pengukuran status fungsional dengan KPS.Hasil: Sebanyak 77 subjek penelitian dengan rerata usia 52 tahun, dengan sebagian besar berjenis kelamin laki-laki, 61 % berpendidikan menengah dan sebagian besar bekerja. Lokasi kanker terbanyak pada nasofaring dengan jenis karsinoma sel skuamosa dan stadium IV. Rerata subjek memiliki status gizi normal. Penilaian 3 x24-h Food Recall didapatkan dengan rerata asupan energi 27,44 kkal/kgBB dan protein 1,33 g/kgBB. Penilaian rerata asupan AARC dengan FFQ semi kuantitatif pada subjek penelitian didapatkan sebesar 10,99 gram. Pada penelitian ini didapatkan rerata nilai massa bebas lemak 42,10 kg dengan sebanyak 46 % subjek penelitian laki- laki memiliki index massa bebas lemak < 17 kg/m2 sedangkan pada subjek penelitian wanita terdapat 16 % dengan index massa bebas lemak <15 kg/m2 Status fungsional dengan menggunakan KPS subjek penelitian dengan median 90 dengan nilai minimum 40. Sekitar 11,6% subjek penelitian yang memiliki nilai KPS kurang dari sama dengan 70. Terdapat korelasi lemah antara asupan asam amino rantai cabang dengan massa bebas lemak (r=0,238, p=0,037).Tidak terdapat korelasi antara asupan AARC dengan status fungsional (r=0.147; p>0.05)Kesimpulan: Terdapat korelasi bermakna yang lemah antara asupan AARC dengan massa bebas lemak dan tidak terdapat korelasi antara asupan AARC dengan status fungsional pada subjek kanker kepala leher

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Background: Decreased fat-free mass and functional status will affect the prognosis in head and neck cancer patients. The formation of fat-free mass is influenced by various things including nutrition. One of the nutrients that play a role in is branched chain amino acids. Karnofsky Performance Scales (KPS) is a functional status parameter that is routinely assessed for cancer patients.

Methods: This cross-sectional study was conducted on adult subjects with head and neck cancer by consecutive sampling method at the radiotherapy polyclinic RSCM. Interviews were conducted to collect data on basic characteristics, data on nutrient intake and assessment of functional status. Measurement of body composition fat-free mass using a single Frequency bioimpedance analysis tool. Functional status measurement using the KPS.

Results: A total of 77 study subjects with an average age of 52 years, with most of them being male, 61% having secondary education and most of them working. Most cancer locations in the nasopharynx with the type of squamous cell carcinoma and stage IV. On average, the subjects had normal nutritional status. The 3 x24-h Food Recall assessment was obtained with an average energy intake of 27.44 kcal/kgBW and protein 1.33 g/kgBW. The assessment of the average BCAA intake with semi-quantitative FFQ on research subjects was 10.99 grams. In this study, the average fat-free mass value was 42.10 kg with as many as 46% of male research subjects having a fat-free mass index <17 kg/m2 while in female research subjects there were 16% with a fat-free mass index <15 kg/m2. Functional status using KPS of research subjects with a median of 90 with a minimum value of 40. Approximately 11.6% of study subjects had a KPS value of less than 70. There was a weak correlation between intake of branched-chain amino acids and fat-free mass (r=0.238, p=0.037. There was no correlation between BCAA intake and functional status (r=0.147; p>0.05)

Conclusion: There is a weak significant correlation between BCAA intake and fat-free mass and there is no correlation between BCAA intake and functional status in head and neck cancer subjects

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"Latar Belakang: Katabolisme pascalaparotomi menyebabkan imbang nitrogen negatif dan diduga tidak dapat dicegah dengan pemberian nutrisi. Nutrisi parenteral dapat meningkatkan faktor anabolisme. Belum diketahui apakah proporsi asupan energi dan protein dari jalur parenteral terhadap asupan total berkorelasi dengan imbang nitrogen pasien pascalaparotomi elektif.Metode: Studi potong lintang dilakukan di Rumah Sakit Cipto Mangunkusumo (RSCM) pada pasien pascalaparotomi elektif yang memperoleh supplemental parenteral nutrition (SPN) antara 3 hari pertama pascalaparotomi. Pemeriksaan nitrogen urea urin (NUU) dilakukan terhadap pasien dengan asupan ≥ 12 kkal/kg BB pada hari ketiga pascalaparotomi. Pasien dengan gangguan ginjal dan hati tidak disertakan dalam penelitian.Hasil: Rerata imbang nitrogen hari ketiga pascalaparotomi sebesar -2,8 ± 3,8 g/hari, dengan median asupan energi 19 (12–34) g/kg BB dan protein 0,9 (0,4–1,9) g/kg BB. Proporsi asupan energi dari jalur parenteral sebesar 0,51 ± 0,26 dan protein 0,59 ± 0,28. Tidak ditemukan korelasi signifikan pada proporsi asupan energi dan protein dari jalur parenteral terhadap asupan total dengan imbang nitrogen. Korelasi signifikan ditemukan pada variabel total asupan energi (r = 0,697, p <0,001) dan protein (r = 0,808, p <0,001) dengan imbang nitrogen.Kesimpulan: Pemberian SPN dini penting dalam mencapai total asupan energi dan protein untuk mengimbangi kehilangan nitrogen hari ketiga pascalaparotomi elektif di RSCM meskipun korelasi proporsi asupan nutrisi dengan imbang nitrogen belum tampak pada penelitian ini.

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Background: Post-laparotomy catabolism causes a negative nitrogen balance and is unlikely prevented by nutritional intervention. Parenteral nutrition can increase anabolic factor. It is not known whether the proportion of energy and protein intake from parenteral nutrition to total intake correlates with nitrogen balance in elective post-laparotomy patients.

Methods: A cross-sectional study was conducted at Cipto Mangunkusumo Hospital in elective post-laparotomy patients who received supplemental parenteral nutrition (SPN) within first 3 days after laparotomy. Urine urea nitrogen (UUN) examination was performed on patients with intake ≥ 12 kcal/kg BW on the third day after laparotomy. Patients with renal and hepatic impairment were excluded. Results: The mean nitrogen balance on the third day post-laparotomy was -2.8 ± 3.8 g/day, with median energy intake of 19 (12–34) g/kg BW and protein 0.9 (0.4– 1.9) g/kg BW. The proportion of energy intake from the parenteral route was 0.51 ± 0.26 and protein was 0.59 ± 0.28. No significant correlation was found in the proportion of energy and protein intake from the parenteral nutrition to total intake with nitrogen balance. Significant correlations were found for total energy intake (r= 0.697, p <0.001) and protein (r= 0.808, p <0.001) with nitrogen balance. Conclusion: Early administration of SPN is important in achieving total energy and protein intake to compensate nitrogen loss on the third day after elective laparotomy although the association between the proportion of nutrition intake and nitrogen balance has not been observed in this study."

"Prevalensi obesitas di Indonesia menunjukkan peningkatan yang bermakna dari tahun ke tahun, termasuk di dalamnya prevalensi obesitas sentral yang dapat diukur melalui lingkar pinggang. Penelitian ini merupakan penelitian dengan desain potong lintang yang bertujuan untuk melihat korelasi antara asupan energi total, asupan lemak, dan lingkar pinggang dengan kadar HbA1c pada obesitas. Penelitian dilakukan di kantor Balai Kota DKI Jakarta dari akhir bulan November sampai Desember 2013. Pengambilan subyek dilakukan dengan cara consecutive sampling, didapatkan 47 subyek yang memenuhi kriteria penelitian. Karakteristik subyek yang diambil adalah usia, jenis kelamin dan indeks massa tubuh (IMT). Variabel data yang diteliti adalah asupan energi total, asupan lemak, lingkar pinggang, dan kadar HbA1c. Hasil penelitian didapatkan subyek terbanyak berusia antara 36-50 tahun (93,6%), sebagian besar berjenis kelamin perempuan sebanyak 27 subyek (57,4%), dan sebanyak 35 subyek (74,5%) termasuk kategori obes I, karena sebagian besar subyek berada pada rentang usia 36 sampai 50 tahun, maka selanjutnya analisis data dan pembahasan dilakukan pada 44 subyek dengan rentang usia tersebut. Asupan energi total 32 subyek (72,7%) dibawah AKG (˂ 70% AKG). Median (min-maks) asupan energi total adalah sebesar 1225,8(766,0-4680) kkal. Sebagian besar subyek penelitian mengonsumsi lemak lebih dari persentase KET yang dianjurkan yaitu sebanyak 42 orang subyek (95,5%). Seluruh subyek laki-laki dan sebagian besar subyek perempuan (84%) memiliki LP lebih. Rerata kadar HbA1c pada subyek laki-laki adalah 6,3±0,2% dan perempuan 6,3±0,3%, dan hampir sebagian besar (68,2%) memiliki kadar HbA1c berisiko tinggi. Terdapat korelasi negatif tidak bermakna antara asupan energi total dengan kadar HbA1c pada subyek laki-laki (r=-0,15, p=0,536) dan korelasi positif tidak bermakna pada subyek perempuan (r=0,28, p=0,898). Korelasi negatif tidak bermakna dijumpai antara asupan lemak dengan kadar HbA1c pada seluruh subyek (r=-0,06, p=0,687). Korelasi positif tidak bermakna antara lingkar pinggang dengan kadar HbA1c terdapat pada seluruh subyek (r=0,18, p=0,236).

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The prevalence of obesity in Indonesia is increasing and also the prevalence of central obesity which can be measured by waist circumference. The aim of this cross sectional study was to find the correlation between total energy intake, fat intake, and waist circumference with HbA1c levels in obes subject. Data collection was conducted during November to December 2013 in the institution of Balaikota DKI Jakarta. The subjects was obtained by consecutive sampling, and 47 subjects who meet study criteria were enrolled in this study. The data collection were characteristics of the subjects including age, gender and body mass index (BMI), as well as total energy intake, fat intake, waist circumference, and HbA1c levels.

The results showed the highest age between 36-50 years (93.6%), majority of the subjects were female (57.4%), and catagorized as obese I (74.5%). Because most of the subjects were in the range of age 36 to 50 years, the data analysis and discussion conducted on 44 subjects. Most of the subject had total energy intake under RDI requirements, i.e., 13 people (68.4 %) of male and 19 subjects (76%) of female subjects. Most of the subjects (42 subjects, 95.5%) had fat intake over recommended percentage of total energy requirement. All of the male and most of female subjects (84%) have waist circumference greater than the normal criteria. Mean of HbA1c levels were 6.3±0.2%, for male subjects and almost the same levels for female subjects, while 68.2% of the subjects were categorized as high risk. The were no significant negative correlation between total energy intake and HbA1c levels in male subjects (r =-0.15, p=0,536) and no significant in female subjects (r=0.28, p=0.898). There were no significant negative correlation between fat intake and HbA1c levels in all subjects (r=-0.06, p=0.687), while non significant positive correlation between waist circumference and HbA1c levels were found in all subjects (r=0.18, p=0.236)."

"Kuantitas dan kualitas asupan protein belum sepenuhnya diketahui perannya terhadap kualitas hidup. Prognostic Nutritional Index (PNI) juga belum diketahui dapat mencerminkan kualitas hidup dan apakah bisa ditingkatkan dengan asupan protein. Penelitian dengan desain potong lintang ini bertujuan untuk mengetahui korelasi antara asupan protein dengan PNI dan kualitas hidup serta korelasi PNI dengan kualitas hidup pada pasien kanker kepala leher dengan radioterapi di Departemen Radioterapi Rumah Sakit dr. Cipto Mangunkusumo, Jakarta. Sebanyak 61 subjek didapatkan dari consecutive sampling. Rerata usia subjek adalah 46,3 ± 12,4 dan 65,6% subjek berada pada kanker stadium IV dan mendapatkan terapi kemoradiasi. Sebanyak 32,8% subjek yang memiliki status gizi kurang. Median asupan protein adalah 1,42 (0,26-4,11) g/kg/hari. Nilai PNI pada subjek penelitian memiliki median 45,9 (29,4-54,2). Hasil penelitian menunjukkan adanya korelasi bermakna antara kuantitas asupan protein berdasarkan Food Frequency Questionnaire (FFQ) semikuantitatif dan beberapa aspek gejala pada kualitas hidup yaitu pada aspek pain (head and neck) (r=-0,32; p=0,01), swallowing (r=-0,37;p=0,004), social eating (r=-0,29; p=0,02), dry mouth (r=-0,41; p=0,001), sticky saliva (r=-0,32; p=0,01), fatigue (r=-0,28; p=0,03), nausea and vomiting (r=-0,26; p=0,04) dan appetite loss (r=-0,3; p=0,01). Kualitas asupan protein tidak berkorelasi bermakna dengan kualitas hidup. PNI berkorelasi bermakna terhadap 1 aspek fungsional yaitu physical function (r=0,378; p=0,003) dan 2 aspek gejala yaitu opening mouth (r=-0,325; p=0,01) dan dyspnea (r=-0,257; p=0,045). Meskipun tidak signifikan secara statistik, namun PNI memiliki arah korelasi yang positif terhadap aspek fungsional lainnya dan memiliki arah korelasi negatif terhadap aspek gejala lainnya yang berarti semakin tinggi PNI maka aspek fungsional semakin baik dan gejala semakin ringan. Studi ini tidak menemukan adanya korelasi bermakna antara asupan protein, baik kualitas maupun kuantitasnya, terhadap PNI. Hasil ini diduga berkaitan dengan penemuan bahwa sebagian besar penderita masih memiliki pola asupan yang mampu mencukupi kebutuhan kalori dan protein harian. Diperlukan studi prospektif yang menelusuri aspek prognostik kanker kepala leher dari segi kualitas hidup untuk mengetahui apakah PNI dapat memprediksi aspek kualitas hidup dengan lebih rinci.

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Quality and quantity of protein intake has not been well understood that it can affect quality of life. Moreover, Prognostic Nutritional Index (PNI) also has not been well studied upon its usage to reflect quality of life of head and neck cancer patients undergoing radiotherapy. This cross sectional study was aimed to determine the correlation between protein intake and PNI and also the correlation between PNI and quality of life in head and neck cancer patients undergoing radiotherapy at Radiotherapy Department, dr. Cipto Mangunkusumo General Hospital, Jakarta. Total of 61 subjects were recruited with consecutive sampling method with mean age of 46,3 ± 12,4 years old and 65,6% subjects were on stage IV cancer and were getting a combination of chemo and radiotherapy. Only 32,8% subjects were on low nutritional status. Median of total protein intake was 1,42 (0,26-4,11) g/kg/day. Median of PNI was 45,9 (29,4-54,2) among subjects. The result of the study showed a significant correlations between quanitity of protein intake based on semiquantitative Food Frequency Questionnaire (FFQ) with several aspects of quality of life, that were pain (head and neck) (r=-0,32; p=0,01), swallowing (r=-0,37; p=0,004), social eating (r=-0,29; p=0,02), dry mouth (r=-0,41; p=0,001), sticky saliva (r=-0,32; p=0,01), fatigue (r=-0,28; p=0,03), nausea and vomiting (r=-0,26; p=0,04) dan appetite loss (r=-0,3; p=0,01). This aspects were all symptomatics. PNI was significantly correlated with 1 functional aspect, which was Physical function (r=0.378; p=0,003) and 2 symptomp aspects, which were opening mouth (r=-0,325; p=0,01) dan dyspnea (r=-0,257; p=0,045). Although not statistically significant, but there were positive direction of correlation with other functional aspects and negative direction of correlation with other symptomps aspects. This implicates that the higher the PNI, the lower the symptoms and the better the functional status of head and neck cancer patients undergoing radiotherapy. This study did not show a significant correlation between quality and quantity of protein intake with PNI. An adequate intake of calorie and protein in most subjects were found in this study which might explain the result. More studies, preferably prospective one, may be needed to show the usage of PNI to reflect quality of life, especially involving quality of life progresivity."