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Abstrak :
ABSTRAKNon-alcoholic fatty liver disease (NAFLD) merupakan penyakit degeneratif yang berkaitan dengan kondisi kurang kalori dan diet tinggi lemak. NAFLD menyebabkan disfungsi mitokondria dan menurunkan aktivitas MnSOD. Penelitian ini bertujuan untuk membandingkan respon hepatosit pada pemberian diet tinggi lemak (DTL) pada tikus dengan intake kalori berbeda selama masa pertumbuhan. Penelitian ini menggunakan organ hati Spraque Dawley usia 6 minggu yang telah diberi intake kalori berbeda selama 8 minggu, dilanjutkan dengan diet tinggi lemak selama 20 minggu. Terdiri atas kelompok kurang kalori+diet tinggi lemak (KK+TL), cukup kalori+diet tinggi lemak (CK+TL), tinggi kalori+diet tinggi lemak (TK+DL) dan kontrol (diet standar). Parameter yang diperiksa adalah berat organ, histopatologi (HE dan Masson trichrom) serta aktivitas MnSOD (ELISA). Hasil penelitian ini menunjukkan tidak terdapat perbedaan berat organ dan aktifitas MnSOD pada semua kelompok. Steatosis ditemukan pada kelompok perlakuan dengan prosentase steatosis kelompok KK+TL lebih tinggi dibanding kelompok CK+TL, TK+TL dan kontrol (p<0,05). Kesimpulan: pemberian DTL selama 20 minggu pada tikus dewasa dengan riwayat intake kalori yang berbeda semasa pertumbuhan dapat menyebabkan steatosis, namun belum diikuti dengan gangguan aktivitas MnSOD. Oleh karena itu pemberian diet tinggi lemak pada kasus kurang kalori protein masih perlu dipertimbangkan dan diteliti lebih lanjut terkait faktor keamanan dan manfaatnya pada usia dewasa.

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ABSTRACT Non-alcoholic fatty liver disease (NAFLD) is a degenerative disease associated with less of calorie and high-fat diet (HFD). NAFLD causes mitochondrial dysfunction and decreasing of MnSOD activity. This study aimed to compare the response of hepatocytes to the provision of HFD in rat with different caloric intake during infancy. This study uses the liver of 6 weeks Spraque Dawley rats which have been given a different caloric intake for 8 weeks, followed by HFD for 20 weeks. The groups were divided into less calorie + HFD (KK+TL), enough calories + HFD (CK+TL), high-calorie + HFD (TK+TL), and control. The parameters examined were liver weights, histopathology (HE and Masson Trichrome) and MnSOD activity (ELISA). The result showed no differences in liver weights and MnSOD activity in all groups. Steatosis was found in research groups, with higher percentage in KK+TL compared to CK+TL, TK+TL, and control (p<0,05). We conclude that giving of HFD for 20 weeks in adult rat with a history of different calorie intake during growth may cause steatosis, but there is no MnSOD activity disorder. Therefore, the provision of HFD in the case of less calorie still need to be considered and investigated especially for its safety and efficiency.

Abstrak :
Latar belakang : Meningkatnya faktor-faktor penyebab dan kasus penyakit degeneratif dan kardiovaskular dari hasil pemeriksaan kesehatan berkala selama 3 tahun (2009-2011) dan kurangnya respon pekerja terhadap program promosi kesehatan yang dilakukan sebelumnya di suatu perusahaan kimia di Cilegon mendorong dilakukannya suatu program wellness melibatkan keluarga selama 6 bulan yang diharapkan dapat menurunkan dan mengendalikan gula darah puasa, kolesterol total dan tekanan darah pada pekerja dengan obesitas sentral.Metode Penelitian : Desain penelitian yang digunakan adalah cross sectional (potong lintang) komparatif dengan menggunakan data sekunder untuk membandingkan nilai beberapa parameter sindroma metabolik yaitu gula darah puasa, tekanan darah serta kolesterol total pada sebelum dan sesudah program wellness melibatkan keluarga selama 6 bulan terhadap pekerja dengan obesitas sentral.Hasil penelitian : Empat puluh pekerja dengan obesitas sentral mengikuti program wellness melibatkan keluarga selama 6 bulan. Terdapat perubahan signifikan gula darah puasa dan kolesterol total antara sebelum dan sesudah mengikuti program. Hal tersebut sudah dapat ditunjukkan setelah satu bulan mengikuti program.Sementara tekanan darah tetap berkisar normal.Kesimpulan : Ada perubahan bermakna gula darah puasa dan kolesterol total sebelum dan sesudah program wellness melibatkan keluarga selama 6 bulan terhadap pekerja dengan obesitas sentral. Kata Kunci : Obesitas Sentral, gula darah puasa, kolesterol total, tekanan darah ,Program Wellness melibatkan keluarga, 6 bulan. ......Background : Numbers of degenerative and cardiovascular causal factors and cases from 3 years periodic medical examination (2009-2011) increased and workers showed lack of interest to site health promotion programs which have been done previously at a chemical manufacture in Cilegon. This leads to initiate a 6 month wellness program plus family interactions with the intention to decrease and control fasting blood sugar level, total cholesterol and blood pressure to workers with central obesity.Methods : The research design is a comparative cross sectional to determine whether the changes of several metabolic syndrome parameter values prior to and after 6 months wellness program plus family interactions to workers with central obesity. It used secondary data.Result : Forty workers with central obesity participated in the six months wellness program plus family interactions. There were significant changes of fasting blood sugar and total cholesterol, even after one month participation in the program. However, blood pressure did not significantly changed.Conclusion : There were changes on fasting blood sugar and total cholesterol significantly by partcipatin on pre and post 6 months wellness program plus family interactions to workers with central Key Word : Central obesity, fasting blood sugar, total cholesterol, blood pressure , wellness program with family interactions and 6 months

Abstrak :
Penyakit pada Lanjut usia umumnya penyakit degeneratif, yang penanganannya membutuhkan waktu lama dan biaya tinggi, ini menjadi beban yang berat bagi pemerintah. Puskesmas Santun Lansia merupakan puskesmas yang memberikan pelayanan kesehatan kepada penduduk Lansia yang meliputi promotif, kuratif, preventif, rehabilitatif. Pemeliharaan kesehatan lanjut usia seharusnya lebih mengutamakan promotif dan preventif yang berkualitas. Penelitian ini bertujuan untuk mengevaluasi bagaimana Pelaksanaan Kegiatan Promotif dalam Program Santun Lansia di Puskesmas Kecamatan Cilincing pada tahun 2019 dan apa saja faktor pendukung dan penghambat dalam pelaksanaan kegiatan ini. Penelitian ini merupakan penelitian evaluasi formatif terhadap Pelaksanaan Kegiatan Promotif dalam Program Santun Lansia di Puskesmas Kecamatan Cilincing. Penelitian ini menggunakan pendekatan penelitian kualitatif dengan teknik purposive dan snowball sampling. Informan penelitian ini terdiri dari staf program di Puskesmas, Kader Lansia dan pendamping Lansia. Pengumpulan data dilakukan melalui penelusuran dokumen dan literatur, observasi, dan wawancara mendalam. Hasil penelitian menunjukkan bahwa proses pelaksanaan terhadap kegiatan promotif dalam Program Santun Lansia di Puskesmas kecamatan Cilincing pada tahun 2019 telah berjalan sesuai rencana yang tertuang dalam model logika Rancangan Usulan Kegiatan pada tahun 2019 Puskesmas Santun Lansia kecamatan Cilincing dan diharapkan kegiatan promotif dalam program Santun Lansia ini tetap dipertahankan keberadaanya di masa mendatang, karena Lansia sebagai sasaran langsung (direct beneficiaries) sangat merasakan manfaatnya setelah mengikuti kegiatan ini. Kegiatan ini memiliki faktor-faktor pendukung yaitu; 1) Lokasi Puskesmas yang berdekatan dengan rumah para kader; 2) Jumlah Kader Lansia yang cukup; 3) Pengetahuan dan pemahaman para Kader dan Lansia terhadap kesehatan yang memadai; 4) Pelayanan Kesehatan Santun Lansia di Poli Lansia Puskesmas kecamatan Cilincing yang sudah berjalan sesuai rencana; 5) Koordinasi lintas sektor antara kecamatan, kelurahan, RW dan Kader serta Puskesmas yang terbina dengan baik. Sedangkan faktor-faktor penghambatnya yaitu; 1) Belum ada anggaran untuk transportasi para Petugas Puskesmas dan Kader untuk mengunjungi rumah para Lansia; 2) Ruangan Poli Lansia yang kurang luas; 3) Pencatatan laporan kegiatan Lansia yang masih secara manual; 4) Keterbatasan komunikasi dan mobilitas Lansia untuk datang ke Kegiatan Promotif Santun Lansia; 5) Perlunya reward agar Lansia mau hadir ke Kegiatan Promotif; 6) Keterbatasan anggaran yang menunjang kegiatan promotif Lansia.

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The disease in the elderly is generally a degenerative disease, which takes a long time to handle and costs a lot of money. This becomes a heavy burden for the government. The Puskesmas Santun Lansia is a public health center that provides health services to the elderly, including promotive, curative, preventive, rehabilitative. Health care for the elderly should give priority to quality promotion and prevention. This study aims to evaluate how the process of implementing the Promotional Activities in the Santun Lansia Program at the Cilincing District Health Center in 2019 and what are the supporting and inhibiting factors in the implementation of this activity. This research is a formative evaluation research on the implementation process of Promotional Activities in the Santun Lansia program at the Cilincing District Health Center which is still running until the end of 2019. This study uses a qualitative research approach with purposive techniques and snowball sampling. The informants of this study consisted of program staff at the Puskesmas, elderly cadres and elderly assistants. The data was collected through document and literature search, observation, and in-depth interviews. The results of this study indicate that the implementation process of the promotional activities in the Santun Lansia Program at the Cilincing Subdistrict Health Center in 2019 has been going according to the plan set out in the logic model of the Proposed Activity Design in 2019 Puskesmas Santun Lansia, Cilincing district and it is hoped that promotional activities in this Santun Lansia program their existence will be maintained in the future, because the elderly as direct beneficiaries really feel the benefits after participating in this activity. The supporting factors; 1) Location of the Puskesmas near to the houses of the cadres; 2) Sufficient number of Elderly cadres; 3) Knowledge and understanding of cadres, the Elderly towards adequate health; 4) Health Services for the Elderly in Puskesmas Cilincing, which has gone according to plan; 5) Cross-sector well coordination between sub-districts, and cadres and Puskesmas. The inhibiting factors; 1) No budget for transportation of Puskesmas officers and cadres to visit the homes of the Elderly; 2) The Poli Room at Puskesmas is less spacious; 3) Manual recording of Elderly reports; 4) Limited communication and mobility for the Elderly to come to Promotional Activities; 5) The need for rewards, that the Elderly want to attend the Promotional Activities; 6) Limited budget to support promotional activities for the Elderly.

Abstrak :
Ruang Iingkup dan cara penelitian: Beberapa penelitian membuktikan bahwa buah dan sayur berperan panting dalam mencegah berbagai penyakit degeneratif dan penuaan dini. Di dalam bahan slam pangan ini banyak terkandung senyawa fitokimia yang berperan sebagai somber antioksidan. Beberapa antioksidan terdapat di dalam bahan alam pangan, seperti vitamin C, vitamin E, karotenoid dan polifenol. Telah banyak dilaporkan bahwa kontribusi senyawa fenol terhadap aktivitas antioksidan lebih besar dibandingkan vitamin C, E dan karotenoid. Setiap bahan slam pangan memiliki jenis dan aktivitas antioksidan yang berbeda. Penelitian ini bertujuan menentukan aktivitas antioksidan dan kandungan fenol total yang terkandung dalam ekstrak bahan alam pangan, yaitu jahe, mengkudu, pisang, tomat, bawang merah, bawang putih dan minyak buah merah (MBM), serta menganalisis kontribusi senyawa fenol terhadap aktivitas antioksidan total ekstrak tersebut. Aktivitas antioksidan total ditentukan dengan metode penghambatan radikal bebas sintetik 1,1-difenil-2-pikrilhidrazil (DPPH'), sedangkan kandungan fend total diukur dengan metode Singleton dan Rossi menggunakan pereaksi Folln Ciocalteu. Analisis kontribusi senyawa fenol terhadap aktivitas antioksidan total ekstrak dilakukan dengan metode statistik analisis regresi. Pengujian diawali dengan mencelupkan bahan ke dalam alkohol mendidih kemudian bahan tersebut dilumatkan, ekstraksi dilakukan dengan aseton 80% atau metanol 70%, sedangkan MBM diekstraksi dengan campuran air dan heksan. Larutan ekstrak kerudian dikeringkan dan residu dilarutkan dengan metanol 50% seterusnya dilakukan pengukuran kandungan fenol total dan aktivitas antioksidan total. Kandungan fenol total dinyatakan sebagai mg ekivalen asam galat/l00 g bahan segar, sedangkan aktivitas antioksidan total dinyatakan sebagai pmo! ekivalen - TROLOX, butil hidroksi toluen (BHT), dan vitamin C/100 g bahan segar. Hasil dan kesimpulan: Kandungan fenol total dan aktivitas antioksidan total untuk semua bahan (kecuali MBM) yang diekstraksi dengan aseton 80% dibandingkan dengan metanol 70% tidak menunjukkan perbedaan yang bermakna. Jahe mempunyai kandungan fenol total yang paling tinggi, diikuti mengkudu, bawang merah, bawang putih, pisang, tomat dengan pembanding asam galat. Sedangkan kandungan fenol total MBM hampir tidak terdeteksi. Antioksidan sintetik TROLOX mempunyai kekuatan antioksidan yang lebih besar dibandingkan vitamin C dan BHT dalam menangkal radikal bebas DPPH. Jahe mempunyai aktivitas antioksidan yang paling tinggi, diikuti mengkudu, pisang, bawang merah, bawang putih dan MBM bail( dengan pembanding TROLOX, BHT maupun vitamin C. Berdasarkan hasil analisis regresi dinyatakan korelasi antara kandungan fenol total dan aktivitas antioksidan total cukup kuat dengan koefisien korelasi, R2 = 0.81, terutama untuk jahe, mengkudu, pisang dan MBM. Dad hasii ini dapat disimpulkan bahwa senyawa fenol pada bahan alam tersebut memberikan kontribusi kuat terhadap aktivitas antioksidan, karena 81% kapasitas antioksidan dari bahan alam pangan tersebut berasal dari senyawa-senyawa fenol. Sedangkan senyawa fenol pada bawang merah, bawang putih dan tomat memberi kontribusi yang kurang kuat, yang mungkin disebabkan adanya kandungan antioksidan lain di dalam bahan alam tersebut yang lebih dominan seperti: karotenoid, vitamin C dan vitamin E.

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Several studies have demonstrated that fruits and vegetables play an essential role in preventing degenerative diseases and aging process. Plant foods contain many phytochemicals which have an antioxidant effect, such as vitamin C, vitamin E, carotenoids and polyphenols. There were several reports that the contribution of phenol compounds to antioxidant activity was much greater than those of vitamin C, vitamin E and carotenoids. Plant foods contain many different classes and activity of antioxidant. The aim of this study was to determine the antioxidant activity and total phenols content in several plant food extracts, i.e. ginger, noni, tomato, banana, shallot, garlic and red fruit oil (RFC)), as well as to analyze the contribution of phenol compounds to total antioxidant activity of these extracts. The total antioxidant activity was determined using 1-diphenyl-2 pycrilhydrazyl (DPPH') free radical scavenging method, whereas the total phenols content was measured using Fofin Ciocalteu reagent based on Singleton & Rossi method. The contribution of phenol compounds was statistically analyzed using regression analysis method. The experiment was started by plunging the materials into boiling alcohol then blend and extracted the materials with 80% acetone and 70% methanol respectively, whereas RFO was extracted using H2O : hexane (1:1). Extract solution was evaporated until dryness then dissolved with methanol 50%. The total phenols content were expressed as galic acid equivalent/100 g fresh weight and the total antioxidant activity as TROLOX, Butyl hydroxy toluene (BHT) and vitamin C equivalent/100 g fresh weight. The total phenols content and total antioxidant activity of almost every plant foods (except RFO) extracted using 80% of acetone compared to 70% of methanol statistically showed no significant difference. Ginger extract has the highest total phenols content, followed by noni, shallot, garlic, banana and tomato. Surprisingly, the total phenol content of RFO extract was almost undetected. In scavenging the free radical of DPPH', TROLOX, an synthetic antioxidant, has an antioxidant capacity higher than other synthetic antioxidant, such as Vitamin C and BHT. The total antioxidant activity of ginger was the highest one, followed by noni, banana, shallot, garlic and RFO extracts, using either TROLOX, BHT or Vitamin C as a standard. The result of statistical regression analysis showed the good correlation between total phenols content and total antioxidant activity with a coefficient of R2 = 0.81, especially in ginger, noni, banana and RFO extracts. Therefore, we could conclude that the phenol compounds of these plant food extracts give a strong contribution to antioxidant activity, since 81% of antioxidant capacity of these extracts come from the phenol compounds. However, the contribution of phenol compounds in shallot, garlic or tomato extracts to total antioxidant activity was not dominant due to the presence of other essential natural antioxidants, such as carotenoids, vitamin C and vitamin E.

Abstrak :
Background : Laminoplasty was developed to widen the spinal canal dimensions without permanently removing the dorsal elements of the cervical spine. The retained dorsal elements should aid in the prevention of muscle scarring to the dura and potentially reduce the incidence of postoperative instability. Cervical laminoplasty has been advocated as an alternative procedure to laminectomy for the decompression of the cervical spine. It provides favourable cord decompression and stabilisation of the cervical spine and is a simpler and safer alternative to anterior fusion and laminectomy for myelopathy and myeloradiculopathy, due to degenerative cervical stenosis. Most authors report outcome based on the Japanese Orthopedic Association (JOA) scoring system. Reported results include mean preoperative and postoperative scores for all patients, and a calculated rate of recovery is provided. The mean recovery rate after the Hirabayashi expansive laminoplasty is approximately 60%. To know the outcome, we evaluated 9 patients with degenerative cervical spinal stenosis that had been treated with laminopalsty using JOA score and Oswestry disability index questioner also the correlation between them. Methods : We performed pre and post interventional study on patients with degenerative cervical spinal stenosis with moderate until severe stenosis that had failed non operative treatment from January 2007 -June 2008 at Cipto mangunkusumo Hospital Jakarta. With JOA score as clinicall approach and Oswestri Disability Index (001) questioner by patient approach, we identify the cervical spine function of the patients before and after laminoplasty (1 month, & 6 month post operative) Results: There were significant difference of JOA and 001 score before and after decompression by laminoplasty with p<0.05. The improvement of cervical spine function also significantly increase until 6 months after surgery compare to the 1$ month post operative JOA and 001 score (p=0.028, p=0.035 respectically). There is strong correlation between them (r=0.804). Conclusion : Laminoplasty decompression technique can improve the cervical spine clinically (increase the JOA score) and quality of life (decrease the 001 score) of patient with degenerative cevical spinal stenosis.