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"Latar belakang. Malnutrisi berkaitan dengan memburuknya kondisi selama di perawatan dan berkaitan dengan keluaran yang buruk. Kehilangan berat badan akan menyebabkan penurunan kekuatan otot yang akan menimbulkan penurunan fungsi. Kekuatan genggam tangan mungkin bermanfaat sebagai indikator status nutrisi khususnya bilamana pengukuran antropometri gagal untuk membedakan nutrisi kurang dengan orang yang berat badan kurang. Sampai saat ini belum ada data mengenai kekuatan genggam tangan dengan status nutrisi pasien yang dirawat di bangsal penyakit dalam di Indonesia. Tujuan Penelitian. Mendapatkan perbedaan rerata kekuatan genggam tangan pasien nutrisi kurang dan nutrisi baik di bangsal penyakit dalam. Metodologi. Studi potong lintang pada pasien di ruang perawatan penyakit dalam. Pemilihan subyek dengan cara konsekutif Pasien dinilai dengan Subjective Global Assessment, pengulcuran indeks massa tubuh dan pemeriksaan kekuatan genggam tangan. Basil. Pada bulan Juli - Nopember 2008 telah didapatkan 140 subyek yang memenuhi kriteria. Subyek terdiri dari 70 laki-Iaki dan 70 perempuan. Sebaran umur pada kelompok laki-laki berkisar 18 - 57 tahun dengan rerata umur 39,4 ± 11,4 tahun dan pada kelompok perempuan berkisar 19 - 59 tahun dengan rerata umur 40,1±12,4 tahun. Untuk menentukan perbedaan rerata digunakan uji t test. Rerata kekuatan genggam tangan kelompok laki-laki nutrisi kurang 19,5 ± 7,7 kg, nutrisi baik 29,5 ± 6,7 kg dan rerata kekuatan genggam tangan kelompok perempuan nutrisi kurang 10,2 ± 3,6 kg dan nutrisi baik 14,2 ± 3,7 kg. Penelitian mendapatkan perbedaan rerata yang bermakna pada subyek nutrisi kurang, baik pada kelompok laki-Iaki ataupun perempuan (kelompok lakilaki t = 5,805, P = 0,00 95% IK 6,6; 13,5, kelompok perempuan t = 4,555, P = 0,00 95% IK 2,2;5,7). Simpulan. Penelitian ini mendapatkan perbedaan kekuatan genggam tangan yang bermakna pada subyek kelompok nutrisi kurang dan nutrisi baik.

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Background. Malnutrition is associated with a deterioration of clinical condition during hospitalization hence a poor outcome. A weight loss will cause a decrease of muscle strength thus the function. Handgrip may be useful as an indicator of the nutritional status, especially when the anthropometric measurement fails to differentiate malnutrition with a less than normal body weight person. Up to now, there has been no data regarding the correlation of handgrip and the nutritional status of patients confined at the internal medicine ward in Indonesia. Objective. To obtain a difference of the mean value of handgrip in patients with malnutrition and a good nutrition at the internal medicine ward. Methodology. This is a cross-sectional study of patients confined at the internal medicine ward. Subjects were consecutively included. Patients were evaluated using Subjective Global Assessment, body mass index calculation and handgrip. Result. From July to November 2008, there were 140 subjects who fulfilled the criteria. 70 were male and 70 were female. The range age for the male group was 18-57 years old with means 39,4 ± 11,-1 years old, and the female group was 19-59 years old with means 40, 1±12,4 years old. A t test was used to determine the difference of m~ value. Means handgrip in male subject with malnutrition was 19,5 ± 7,7 kg and good nutrition was 29,5 ± 6,7 kg. Means handgrip in female subject with malnutrition was 10,2 ± 3,6 kg and good nutrition was 14,2 ± 3,7 kg. This study showed a significant difference of mean value in subjects with malnutrition, both male and female groups (male t = 5,805, P = 0,00 95% CI 6,6;13,5, female group t = 4,555, P = 0,00 95% CI 2,2;5,7). Conclusion. This study showed a significant difference means handgrip in subjects with malnutrition."

"Dukungan nutrisi bertujuan memperbaiki status gizi dan prognosis pasien bedah dengan status gizi malnutrisi Pasien yang menjalani pembedahan traktus gastrointestinal GI merupakan kelompok pasien berisiko tinggi mengalami malnutrisi Dilaporkan bahwa terdapat hubungan positif antara malnutrisi dengan morbiditas dan mortalitas pasca bedah lama perawatan RS re admisi RS kebutuhan pembedahan sekunder dan diagnosis atau terapi Serial kasus ini terdiri dari empat kasus dukungan nutrisi perioperatif pada pasien malnutrisi dengan berbagai indikasi pembedahan GI dan komorbid yang berbeda Pasien pada serial kasus ini berusia antara 45 hingga 70 tahun Seluruh pasien menjalani pembedahan mayor abdominal atas indikasi kanker GI Status gizi pasien adalah malnutrisi ringan hingga sedang Terapi nutrisi diberikan berdasarkan kebutuhan dan kondisi klinis pasien Kebutuhan energi basal dihitung menggunakan persamaan Harris Benedict Pemberian energi dimulai dari kebutuhan energi basal dan ditingkatkan bertahap hingga mencapai kebutuhan energi total Lama perawatan RS pada pasien ini antara 19 hingga 43 hari Monitoring yang dilakukan meliputi toleransi asupan kapasitas fungsional imbang cairan data antropometri dan laboratorium serta dilakukan edukasi dan konseling nutrisi setiap hari Secara umum pasien mengalami peningkatan kondisi umum status gizi toleransi asupan Periode perioperatif mempengaruhi toleransi pasien terhadap asupan makanan dan status GI Terapi nutrisi pada pasien bedah harus dilakukan secara individual sebagai bagian integral tata laksana pembedahan Dukungan nutrisi harus dilakukan pada periode pra intra dan pasca bedah untuk menyediakan nutrien yang adekuat agar dapat mengatasi perubahan metabolik pada pasien Dukungan nutrisi yang baik pada pasien bedah terutama dengan malnutrisi dapat memperbaiki prognosis pasca bedah dan akan meningkatkan kualitas hidup pasien.

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The aim of nutritional support is to improve nutritional status and clinical outcome in severely malnourished patients Patients who undergone gastrointestinal surgery constitute as important risk group for malnutrition It has been reported that there is a positive correlation between malnutrition and postoperative morbidity and mortality prolonged hospital stays re admissions secondary operation requirement and diagnosis treatment This case series consisted of four cases of periopertive nutrition support in malnutrition patients with different surgical indication and comorbidities The patients in this case series aged between 45 to 70 years old All patients undergoing major abdominal surgery for gastrointestinal cancer Patients have nutritional status ranged from mild nutrition to moderate malnutrition Nutritional therapy was given according to patients needs and clinical condition The basal energy requirement was calculated using the Harris Benedict equation The intake was given begin with basal energy expenditure and gradually increased to the total energy expenditure Monitoring includes food intake tolerance functional capacity fluid balance anthropometric and laboratory data The nutrition education and counseling was conducted everyday In general all the patients show improvement during monitoring The perioperative periode influenced patients tolerance to food intake and gastrointestinal status Nutrition therapy in surgical patient should be done individually as part of integrated therapy in surgical treatment The nutritional support was done in pre intra and post surgery to provide adekuat nutrient to blunt metabolic changes in this patients Each period of perioperative nutrition support have different function and procedure Good nutritional support in surgical patients specially with malnutrition will improved outcome of the surgery and eventually improved quality of life."

"ABSTRAKMeningkatnya prevalensi kekurangan gizi dan kelebihan berat badan di Indonesia timur menimbulkan dugaan bahwa keterbatasan akses pangan, baik dari sisi akses ke pasar maupun akses secara ekonomi berpengaruh terhadap beban ganda malnutrisi. Studi ini bertujuan untuk menganalisis pengaruh akses pangan terhadap kekurangan gizi pada balita dan kelebihan berat badan individu dewasa serta kemungkinan terjadinya beban ganda malnutrisi dalam satu rumah tangga di Indonesia timur. Dengan menggunakan data IFLS East tahun 2012 dan metode estimasi OLS serta probit with sample selection, hasil studi menunjukkan bahwa keterbatasan akses pangan secara geografis dapat menyebabkan ketidakterjangkauan pangan yang berakibat pada meningkatnya kekurangan gizi, baik pada anak balita maupun individu dewasa.Sedangkan dari sisi akses pangan secara ekonomi, hasil studi menemukan bahwa keterbatasan akses pangan dari sisi pendapatan maupun harga pangan pokok tidak hanya meningkatkan kemungkinan kekurangan gizi pada anak balita, tetapi juga dapat beban ganda malnutrisi dalam satu rumah tangga. Hasil studi ini mengimplikasikan bahwa diperlukan kebijakan stabilisasi harga pangan, terutama pangan pokok untuk mengatasi malnutrisi, termasuk menurunkan kemungkinan beban ganda malnutrisi dalam satu rumah tangga di Indonesia timur. Namun, untuk daerah yang cenderung mengalami kekurangan gizi, diperlukan pula perbaikan akses pasar untuk dapat meningkatkan status gizi masyarakat di daerah tersebut.

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ABSTRACT

The increasing of overweight and underweight prevalence in Indonesia represent that Indonesia face double burden of malnutrition. In the Eastern of Indonesia, as high as the prevalence of underweight, the prevalence of overweight are also higher than national prevalence. From these fact, we have an opinion that lack of food access, either geographically or economically, lead adult gain overweight, but in other side, child tend to being underweight. Using IFLS East data 2012, this study aim to analyze the impact of food access to child undernutrition, adult overweight, and household double burden of malnutrition in Eastern Indonesia.

Estimate with ordinary least square and probit with sample selection, this study find out that lack of food accessibility lead children and adult being underweight. In other side, food affordability, higher food price lead to double burden malnutrition. These result imply that stabilizing food price would be one of key to attacking double burden of malnutrition in the Eastern of Indonesia. These study also imply that the policies are needed to tackling malnutrition in the Eastern of Indonesia should be different between province, for province with high prevalence of underweight also need to provide better access to market."

"ABSTRAK Latar Belakang : Malnutrisi merupakan faktor independen yang berhubungan dengan morbiditas, mortalitas dan tingginya biaya pengobatan sirosis hati. Kekuatan Genggam Tangan (KGT) merupakan suatu metode yang sering digunakan untuk mendeteksi malnutrisi dan menilai prognosis pasien. Hubungan KGT dengan Skor Child Pugh (CP) dan massa otot masih dalam kontroversi. Indonesia sampai saat ini belum memiliki data tersebutMetode : Studi potong lintang pada pasien sirosis hati di poliklinik hepatobilier RSCM dari Februari-Juni 2015. Status nutrisi dinilai berdasarkan KGT. Massa otot diukur menggunakan bioimpedans. Analisis statistik menggunakan uji korelasi spearmanHasil : Terdapat 115 pasien yang kontrol di poliklinik hepatobilier RSCM, 112 pasien memenuhi kriteria penelitian, terdiri dari 79 laki-laki dan 33 perempuan. Usia pasien rata-rata 54,15±10,55 tahun, median skor CP 6(5-13) dengan median KGT 26(11-50) kgF, rata-rata massa otot 44,43±8,12 kg. Median asupan energi 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalensi malnutrisi berdasarkan KGT ditemukan sebanyak 33%. Kekuatan genggam tangan tidak berkorelasi dengan skor CP (p 0,046, r=-0,19) namun berkorelasi dengan massa otot (p <0,001, r= 0,70) Simpulan Terdapat 33% kasus malnutrisi berdasarkan KGT pada pasien sirosis rawat jalan. KGT tidak berkorelasi dengan skor Child Pugh namun berkorelasi dengan massa otot pasien sirosis hati.ABSTRACT Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test. Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis.;Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test. Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis.;Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test. Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis."

"ABSTRAK Latar Belakang: Malnutrisi berdampak besar pada pasien kanker sehingga harusdievaluasi dengan Patient-Generated Subjective Global Assessment (PG-SGA),namun memakan waktu dan membutuhkan tenaga kesehatan terlatih. Pengukurankekuatan genggam tangan (KGT) memiliki keuntungan lebih singkat dan mudahdibandingkan PG-SGA, tetapi belum ada data titik potong dan akurasi diagnostikKGT pada pasien kanker di Indonesia. Tujuan: Mendapatkan titik potong dan akurasi diagnostik KGT sebagai penapismalnutrisi pasien kanker rawat jalan di RSCM.Metode: Penelitian potong lintang ini dilakukan pada pasien 18-59 tahun dipoliklinik onkologi RSCM selama 4 Mei-1 Oktober 2015. Titik potong KGTdianalisis menggunakan kurva ROC. Akurasi diagnostik KGT dinilai denganmenghitung sensitivitas, spesifisitas, NDP, NDN, RKP, dan RKN.Hasil: Proporsi pasien dengan status nutrisi baik, malnutrisi sedang, danmalnutrisi berat adalah17,4%, 64,2%, dan 18,4%. Titik potong optimal KGT pasien kanker lelaki dan perempuan berturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgfdengan sensitivitas 92,2% dan 73,9%, spesifisitas 54,6% dan 60,9%, NDP 92,2% dan 88,3%, NDN 54,6% dan 36,8%, RKP 2 dan 1,9, serta RKN 0,1 dan 0,4. Simpulan: Titik potong optimal KGT pasien kanker lelaki dan perempuanberturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgf. Akurasi diagnostik KGT pasienkanker lelaki dan perempuan sebagai penapis malnutrisi berturut-turut dinilai baik dan sedang.ABSTRACT Background: Malnutrition has a huge impact on cancer patients and therefore ithas to be evaluated using PG-SGA, but there are limitations such as the timeconsumingnature and the need of trained health personnels. Measurement ofHGS is faster and easier, but there is no sufficient information regarding its cutoffpointand diagnosticaccuracyfor cancerpatientsin Indonesia.Aim:defining cut-off point and diagnostic accuracy of HGS as a malnutritionscreening modality for outpatient cancer population at RSCM.Method: A cross-sectional study was conducted at RSCM oncology outpatientclinic from May 4th-October 1st, 2015. Subjects were 18-59 years old. Cut-offpoint and diagnostic accuracy of HGS were analyzed to generate sensitivity,specificity, PPV, NPV, LR+, and LR- .Result: The proportion of well nourished, moderately malnourished, and severelymalnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimalHGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgfrespectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV92.2% and 88.3%, NPV 54.6% and 36.8%, LR+ 2 and 1.9, and LR- 0.1 and 0.4. Conclusion: The optimal HGS cut-off point in male and female cancer patientswere ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as amalnutrition screening modality in male and female cancer patients were good and moderately good.;Background: Malnutrition has a huge impact on cancer patients and therefore ithas to be evaluated using PG-SGA, but there are limitations such as the timeconsumingnature and the need of trained health personnels. Measurement ofHGS is faster and easier, but there is no sufficient information regarding its cutoffpointand diagnosticaccuracyfor cancerpatientsin Indonesia.Aim:defining cut-off point and diagnostic accuracy of HGS as a malnutritionscreening modality for outpatient cancer population at RSCM.Method: A cross-sectional study was conducted at RSCM oncology outpatientclinic from May 4th-October 1st, 2015. Subjects were 18-59 years old. Cut-offpoint and diagnostic accuracy of HGS were analyzed to generate sensitivity,specificity, PPV, NPV, LR+, and LR- .Result: The proportion of well nourished, moderately malnourished, and severelymalnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimalHGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgfrespectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV92.2% and 88.3%, NPV 54.6% and 36.8%, LR+ 2 and 1.9, and LR- 0.1 and 0.4. Conclusion: The optimal HGS cut-off point in male and female cancer patientswere ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as amalnutrition screening modality in male and female cancer patients were good and moderately good."

"protein-energy malnutrition is common in patients with liver cirrhosis , especially in advanced and severe stage. Liver cirrchosis patients with malnutrition have increasing risk to get post-operative complication and mortality...."

"Gizi ganda (dual form of malnutrition/DFM) merupakan fenomena kesehatan yang tidak hanya terjadi di tingkat nasional tetapi sudah sampai pada tingkat keluarga. Kondisi ini cukup unik, mengingat anggota keluarga tinggal dalam kondisi yang sama. DFM menjadi tantangan dan masalah kesehatan baru, kedua masalah gizi salah sama penting dan memberikan beban lebih besar pada rumahtangga. Tujuan penelitian adalah mengetahui prevalensi dan determinan DFM di Indonesia dengan menggunakan data Riskesdas 2010. Analisis multilevel modelling digunakan untuk mengidentifikasi determinan DFM di level rumahtangga, wilayah desa/kota dan propinsi. Definisi Dual form of Malnutrition yang digunakan adalah anggota rumahtangga mempunyai status gizi yang berbeda; dipilih pasangan balita kurang gizi (<-2 z-score) dan ibu gizi lebih (IMT>25 kg/m2). Kriteria inklusi adalah rumahtangga dengan pasangan ibu kandung dan balita, usia ibu >18-40 tahun, dan usia balita >=2-5 tahun, sedangkan kriteria eksklusi adalah ibu hamil dan anak masih menyusu. Determinan variabel yang digunakan adalah jumlah anggota rumahtangga, komposisi rumahtangga, sosial ekonomi, Intra Household Food Distribution/IHFD, usia dan jenis kelamin anak, pekerjaan, usia dan pendidikan ibu, wilayah desa-kota, dan kondisi fiskal, akses ke pelayanan kesehatan, kondisi kesehatan propinsi, tingkat kemiskinan, petugas gizi, angka melek huruf yang merupakan proksi indikator kondisi nutrition and epidemiologic transition. Hasil penapisan diperoleh 1899 rumahtangga yang memenuhi syarat. Hasil penelitian menunjukkan prevalensi DFM adalah 29.8% (95%CI 26.5-31.2). ibu berusia diatas 30 tahun OR=1.68;95%CI (0.31-0.72), ibu berpendidikan kurang dari SMA OR=1.63;95%CI(1.23- 1.71), balita mendapatkan alokasi karbohidrat lebih sedikit OR=1.28;95%CI(1.02-1.60), rendahnya distribusi lemak pada anak di level rumahtangga OR=1.24;95%CI(1.02-1.51), dan kondisi kesehatan di masyarakat (IPKM) di level propinsi OR=1.43;95%CI(1.06-1.93). Wilayah desa/kota tidak berhubungan dengan kejadian DFM. Resiko kejadian DFM antara rumahtangga berisiko dengan rumahtangga kurang berisiko adalah 1.33. Level kontekstual propinsi tidak terlalu berpengaruh terhadap perbedaan kejadian DFM di rumahtangga MOR 1.28 (perubahan MOR 3.75%), IOR 0.89-2.29). Penelitian ini menunjukkan bahwa rumahtangga khususnya ibu mempunyai peran yang sangat penting dalam upaya preventif kejadian DFM.

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Dual form of malnutrition/DFM is a health phenomenon that is not only happening at the national level but has reached the lowest level of the family. This condition is quite unique, given the family members living and share the same conditions. DFM is a health challenge and new health problem, of which problem has equal/same important and provide a greater burden to households.

The research objective was to determine the prevalence and determinants of DFM in Indonesia using data Riskesdas 2010. Multilevel modeling analysis used to identify the determinants of DFM in household, urban/rural area and province level. Dual form of malnutrition defined as member of household has an opposite nutritional status; the study used pair of malnourished child (<-2 z-score) and overweight mother (BMI> 25 kg/m2). Inclusion criteria were households with pair child and mother, maternal age> 18-40 years, and child’s age >=2-5years, whereas exclusion criteria were pregnant women and breastfed children. Determinants variable used were the number of household members, household composition, household socio-economic, Intra Household Food Distribution/IHFD, age and gender of children, occupation, age and maternal education, rural and urban areas, and fiscal conditions, access to health care, provincial health condition, poverty level, nutrition workers, literacy rate which are considered as a proxy indicator of nutrition and epidemiologic transition.

The screening result obtained 1899 households are eligible. Results showed the prevalence of DFM was 29.8% (95% CI 26.5-31.2). Mothers aged over 30 years OR =1.68; 95% CI (0.31- 0.72), lower mother’s education (less than senior high school) OR = 1.63, 95% CI (1.23- 1.71), child received lower carbohydrate allocation over the family OR = 1.28, 95% CI (1.02- 1.60), child received lower fat distribution over the family OR = 1.24;95% CI (1.02-1.51), and health conditions in the community (IPKM score) at the provincial level OR = 1.43;95% CI (1.06-1.93. Urban/rural was not associated with DFM. The risk of DFM between households at risk with less risk households is 1.33. Contextual level of provinces do not much affect to the incidence of DFM among households MOR 1.28 (small change of MOR 3.75%) and IOR 0.89-2.29). This study showed that household and particularly mother has a very important role in to prevent DFM events."

"Penelitian ini bertujuan mengetahui efektifitas PERGIZI dilihat dari komponen input, proses, output dan outcome. Penelitian kualitatif dengan rancangan RAP (Rapid Assesment Procedure), dilakukan minggu keempat bulan Mei 2013 dengan informan kepala seksi gizi, petugas gizi, kader, bidan di desa, ibu balita dan tokoh masyarakat. Hasil penelitian menunjukkan PERGIZI efektif untuk menanggulangi gizi buruk di Puskesmas Sepatan. dengan indikator meningkatnya status gizi sebesar 69,1%, hanya komponen input yakni dana yang disebagian besar pos gizi masih kurang, sedangkan dari komponen proses dan output telah dapat mencapai tujuan yang ditetapkan. Agar mengoptimalkan penanggulangan gizi buruk di wilayah Puskesmas Kabupaten Tangerang dengan PERGIZI.

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The aims of this study was to determine the effectiveness of the PERGIZI program viewed by its component such as inputs, process, outputs and outcomes. A qualitative research with RAP (Rapid Assessment Procedure) design was conducted at fourth week of May 2013. The data collection methods used an indepth interview and focused group discussion. With the informants 42 persons consisting of section head of nutrition, nutrition workers, cadres, village midwives, mothers of under five children and community leaders. This could be seen from change of nutritional status from the under five children as much as 69,1%. From the input component the mean barrier was funding both component process and output was considered successfull and achieving the predetermined goal. It is recomended to solve existing under five nutritional problem in the district of Tangerang using the PERGIZI approach."

"Latar Belakang: Stroke merupakan penyakit neurologi yang sering dijumpai dengan disabilitas dan mortalitas yang tinggi. Defisiensi vitamin D sering dijumpai pada pasien stroke dan berhubungan dengan meningkatnya risiko stroke serta luaran klinis yang buruk. Terapi medik gizi termasuk pemberian vitamin D diperlukan untuk membantu proses penyembuhan dan memberikan luaran klinis yang baik pada pasien stroke iskemik.Kasus: Serial kasus ini membahas empat pasien stroke iskemik yaitu dua pasien laki-laki dan dua pasien perempuan dengan usia 46-86 tahun. Tiga pasien didiagnosis sebagai malnutrisi berat secara klinis dan satu pasien dengan berat badan berlebih. Empat pasien tersebut memiliki kadar vitamin D yang rendah yaitu tiga pasien dengan defisiensi vitamin D dan satu pasien dengan insufisiensi vitamin D. Pasien mendapatkan tatalaksana nutrisi selama perawatan di rumah sakit dan rawat jalan.Hasil: Durasi perawatan rumah sakit pada empat pasien tersebut antara 22-59 hari. Dua pasien stroke iskemik dengan defisiensi vitamin D mengalami kematian saat perawatan di rumah sakit. Dua pasien yang hidup hingga akhir pemantauan mendapatkan suplementasi vitamin D dan didapatkan perbaikan kadar vitamin D. Pasien tersebut menunjukkan perbaikan klinis berupa perbaikan status gizi dan kapasitas fungsional.Kesimpulan: Tatalaksana medik gizi yang adekuat dan suplementasi vitamin D dapat memperbaiki luaran klinis pasien stroke iskemik.

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Background: Stroke is a neurological disease with high disability and mortality. Vitamin D deficiency is common in stroke patients and is associated with increased risk of stroke and poor clinical outcome. Nutritional medical therapy is needed to help the healing process and provide a good clinical outcome in ischemic stroke patients.

Methods: This case series discusses four ischemic stroke patients, consist of two male patients and two female patients with aged 46-86 years. Three patients were diagnosed as clinically severe malnutrition and one patient was overweight. Four patients had low vitamin D levels, consist of three patients with vitamin D deficiency and one patient with vitamin D insufficiency. The patients received nutritional management during hospitalization and outpatient treatment.

Results: The length of stay of these four patients was 22-59 days. Two ischemic stroke patients with vitamin D deficiency were died during hospitalization. Two patients who lived until the end of monitoring received vitamin D supplementation and had improvement in vitamin D levels. These patients showed clinical improvement in nutritional status and functional capacity.

Conclusions: Adequate nutritional medical management and vitamin D supplementation can improve the clinical outcome of ischemic stroke patients."

"Status gizi kurang yang dialami pasien selama rawat inap di rumah sakit akan berdampak pada rendahnya penyembuhan pasien dari penyakit yang diderita dan berujung pada hari rawat yang lebih lama, angka kesakitan dan biaya rawat meningkat. Kejadian gizi kurang pasien penyakit dalam masih cukup tinggi, penelitian di Universitas Alabama 46% pasien menderita kurang gizi dan di RSCM berkisar 34.2-51.4% mengalami hal yang sama.Penilitian ini merupakan penelitian primer yang dilakukan di ruang rawat Penyakit Dalam kelas III Rumah Sakit Dr. Cipto Mangunkusumo, dengan tujuan untuk mengetahui hubungan antara asupan makan dengan status gizi pasien rawat inap penyakit dalam RSCM. Dilaksanakan pada bulan April hingga Awal Juni 2006. Responden adalah pasien rawat inap penyakit dalam usia 18-60 tahun yang memenuhi kriteria inklusi dan eksklusi. Desain penelitian dengan analitik potong lintang, terpilih 91 sampel laki-laki dan perempuan secara purposive. Pengolahan dan analisis data menggunakan program FP2 dan SPSS.Penilaian asupan makan yang diterjemahkan kedalam energi dan protein dinilai dengan food recall 2x24 jam. Adapun penilaian status gizi dengan melakukan pengukuran antropometri, albumin serum dan pemeriksaan SGA (subjective global assessment). Penilaian selera makan dengan wawancara, jenis penyakit dan obat didapat dari rekarn medis.Hasil penelitian menunjukkan bahwa sebanyak 47 responden (51.6%) asupan makan kurang dari kebutuhan dan sebanyak 44 responden (48.4%) asupan makan cukup. Penilaian status gizi dengan 3 pengukuran yaitu antropometri (IMT), SGA dan albumin serum ditemukan status gizi kurang masing-masing 45.1%, 53.8%, dan 61.5%.Dengan uji kai kuadrat didapatkan adanya hubungan yang bermakna antara asupan makan dengan status gizi kecuali dengan parameter albumin serum. Analisis multivariat regresi logistik didapatkan hasil, responden dengan asupan makan kurang berisiko mengalami status gizi kurang 3.143 kali dibandingkan responden dengan asupan makan eukup setelah dikontrol variabel jenis kelamin dan selera makan.Didapatkan hubungan yang bermakna antara selera makan dengan status gizi. Data yang didapat tidak dapat membuktikan adanya hubungan antara penyakit, obat, jenis kelamin, dan usia terhadap status gizi.Bertitik tolak dari hasil penelitian yang diperoleh disarankan kepada manajemen rumah sakit untuk mengadakan standar makanan tinggi kalori tinggi protein dan perlu adanya dukungan gizi (nutritional support) bagi pasien rawat inap penyakit dalam, dalam bentuk makanan enteral maupun lainnya. Menyertakan diagnosis status gizi pasien berdasar SGA kedalam diagnosis penyakit. Bagi unit penyelenggara makanan rumah sakit untuk meningkatkan cita rasa masakan.

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Undernourished status of in-patient in hospital will have an impact on the low rate of recovery from the disease one suffers and end up with longer stay in hospital, increase in morbidity and cost. Incidence of undernourished among in-patient of internal medicine ward is high. Study by University of Alabama 46% of patient suffer from undernourished and in RSCM is around 34.2 - 51.4%.

This study is primarily study conducted in Internal Medicine Ward CIass III, RSCM. The aim of the study was to know the relationship between food intake and nutritional status of in-patient of internal medicine ward, RSCM. The study was conducted from April to early June 2006. Respondent was patient of in-patient internal medicine ward aged 18-60 years with certain inclusive and exclusive criteria. The study design was analytic cross-sectional with 91 male and female respondent selected purposively. Data processing and analysis was using FP2 and SPSS.

Calculation of food intake that translated into energy and protein was from food recall 2x24 hours method. Nutritional status was based on anthropometric measurement, albumin serum and examination of Subjective Global Assessment (SGA). Examination of appetite was by interview, type of disease and medicine were noted from medical record.

The results show that 47 respondent (51.6%) had food intake less than daily requirement. Nutritional status using 3 (three) assessments i.e. anthropometric which is Body Mass Index (BMI), SGA and albumin serum was found that 45.1%, 53.8%, and 61.5% respectively under normal.

Statistical test (chi-square) showed a significant relationship between food intake and nutritional status except with albumin serum. Multivariate analysis showed that patient with food intake less than daily requirement had 3.143 times risk of undernourished after controlling sex and appetite.

There was a relationship between appetite and nutritional status. However, there was no relationship between disease, medicine, sex and age with nutritional status.

From these findings it is recommended that hospital management to take some measures on food standard for high calorie and high protein and need nutritional support for in-patient of internal medicine ward in the form of enteral food or others. Additional diagnosis of nutritional status using SGA was needed in the disease diagnosis. For hospital food management unit it is recommended to increase food taste."