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Abstrak :

Penelitian ini bertujuan untuk menentukan titik potong lingkar lengan atas pada posisi berbaring. Penelitian ini menggunakan desain cross-sectional. Data diambil dari rekam medis pasien poliklinik radioterapi RSUPN Dr. Cipto Mangunkusumo (n=207) dan dilakukan pengukuran antropometri pada pasien. Titik potong lingkar lengan atas diperoleh dari kurva ROC dan indeks Youden tertinggi. Dari penelitian ini didapatkan perbedaan rata-rata antara lingkar lengan atas pada posisi berdiri dan terlentang adalah 0,13 ± 0,33 cm (p<0,001). Lingkar lengan atas dari keseluruhan subjek memiliki korelasi yang kuat dan signifikan dengan indeks massa tubuh (r=0,932; p<0,001). Nilai AUC lingkar lengan atas untuk mendeteksi malnutrisi adalah 0,97 (95% CI 0,947-0,992; p<0,001). Lingkar lengan atas <23,4 cm menunjukkan sensitivitas 94,7% dan spesifisitas 95,6% untuk pria, dan sensitivitas 95% dan spesifisitas 89% untuk wanita. Sebagai kesimpulan, lingkar lengan atas <23,4 cm dapat digunakan sebagai salah satu alternatif pengukuran untuk mendeteksi malnutrisi, terutama bila indeks massa tubuh tidak dapat diukur.

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This study aims to establish a cut-off point for mid-upper arm circumference in the supine position. This is a cross-sectional study. Data were taken from patients at the radiotherapy clinic of Dr. Cipto Mangunkusumo General Hospital (n=207) by medical records, and anthropometric measurements were performed. The cut-off point of the mid-upper arm circumference was obtained from the ROC curve and the highest Youden’s index. This study found that the mean difference between mid-upper arm circumference in the standing and supine positions is 0.13±0.33 cm (p<0.001). The mid-upper arm circumference from all subjects strongly and significantly correlates to body mass index (r=0.932; p<0.001). The area under the curve of the mid-upper arm circumference for detecting malnutrition was 0.97 (95% CI 0.947–0.992; p<0.001). The mid-upper arm circumference of <23.4 cm presents a sensitivity of 94.7% and a specificity of 95.6% for men, and a sensitivity of 95% and a specificity of 89% for women. In conclusion, the mid-upper arm circumference of <23.4 cm can be used as an alternative measurement to detect malnutrition, particularly when body mass index cannot be measured.
 

Abstrak :
Isu malnutrisi menjadi isu penting kesehatan di banyak negara, terutama negara berkembang. Di antara beberapa kasus malnutrisi, stunting menjadi kasus dengan prevalensi tertinggi untuk kelompok kasus kurang gizi. Stunting berdampak terhadap banyak hal, salah satunya pendidikan, baik di jangka pendek maupun jangka panjang. Studi ini membahas dampak balita stunting tahun 2000 terhadap durasi lama sekolah pada pendidikan dasar di Indonesia. Menggunakan data cross section dengan sumber data IFLS tahun 2000 hingga 2014, analisis ini dilakukan dengan metode Regresi Linear Multivariable. Hasil penelitian menunjukkan bahwa stunting tidak signifikan mempengaruhi durasi lama sekolah. Variabel lain seperti jumlah saudara kandung dan status bekerja berpengaruh positif dan signifikan serta pendidikan ayah dan tempat tinggal berpengaruh negatif dan signifikan terhadap durasi lama sekolah. ......Malnutrition issues is an important health issue in many countries, especially in developing countries. Among the few malnutrition cases, stunting becomes the case with the highest prevalence for undernutrition case groups. Stunting affects many things, one of them is education, both in the short and long term. This study analyses the impact of stunting children in 2000 on the duration of schooling of basic education in Indonesia. Using cross-section data with IFLS data sources from 2000 to 2014, this analysis was conducted with a Multivariable Linear regression method. The results showed that stunting did not significantly affect the duration of schooling of basic education. Other variables such as the number of siblings and working status have positive and significant effects. Also, father's education and residence have negative and significant impact on the duration of schooling.

Abstrak :
Latar belakang: Penyakit ginjal kronik menyebabkan beberapa perubahan fungsi tubuh dalam memetabolisme nutrisi. Hal ini menyebabkan ditemukannya kasus malnutrisi pada pasien PGK khususnya pada stadium akhir yang menjalani hemodialisis. Ini tentu perlu menjadi perhatian karena nutrisi sangat penting bagi pertumbuhan anak. Oleh karena itu, penelitian ini dilakukan untuk mencari pengaruh hemodialisis dan faktor yang berpengaruh lainnya terhadap status gizi anak. Metode: Penelitian dilakukan dengan desain potong lintang dengan mengambil data sekunder berupa stadium penyakit, durasi penyakit, faktor etiologi primer, komorbiditas dari rekam medis. Data status gizi anak diperoleh dengan mengukur berat badan serta tinggi, lingkar lengan atas lalu dimasukan ke aplikasi WHO Anthro. Data demografi, seperti tingkat pendidikan ayah & ibu, status ekonomi keluarga, usia, dan jenis kelamin diperoleh dengan pengisian Case Report Form (CRF). Terdapat sebanyak 20 responden yang memenuhi kriteria inklusi dan eksklusi dari penelitian ini. Hasil: Rerata penilaian status gizi dilihat dari indeks massa tubuh menurut umur menunjukkan hasil -2 SD < x < 1 SD dengan interpretasi gizi baik dan x <-2 SD (perawakan pendek) dilihat dari tinggi badan menurut umur. Berdasarkan analisis bivariat, tidak ditemukan adanya pengaruh signifikan antara durasi hemodialisis, frekuensi hemodialisis, etiologi, usia, jenis kelamin, dan komorbiditas (p>0.05) pada anak dengan gagal ginjal kronik yang sedang menjalani hemodialisis terhadap status gizinya. Kesimpulan: Status gizi pada anak PGK yang menjalani hemodialisis dinilai berdasarkan indeks massa tubuh dan tinggi badan menurut usia ditemukan hasil rata-rata gizi baik namun berperawakan pendek. Tidak ditemukan pengaruh durasi, frekuensi, etiologi, usia, jenis kelamin, dan komorbiditas pada anak dengan gagal ginjal kronik yang sedang menjalani hemodialisis terhadap status gizinya. ......Introduction: Chronic kidney disease causes several changes in the body's function in metabolizing nutrients. This has led to the discovery of cases of malnutrition in CKD patients, especially in ESRD patients undergoing hemodialysis. This certainly needs to be a concern because nutrition is very important for children's growth. Therefore, this study was conducted to find out the effect of hemodialysis and other influencing factors on the nutritional status of children. Method: The study was conducted with a cross-sectional design by taking secondary data in the form of disease stage, duration of disease, primary etiologic factors, and comorbidities from medical records. Data on the nutritional status of children was obtained by measuring weight and height, and upper arm circumference and then entered into the WHO Anthro application. Demographic data, such as the education level of the father & mother, family economic status, age, and gender were obtained by filling out the Case Report Form (CRF). 20 respondents met the inclusion and exclusion criteria of this study. Result: The average nutritional status assessment seen from the body mass index according to age showed results of -2 SD < x < 1 SD with good nutrition interpretation and x <-2 SD (short stature) in terms of height according to age. Based on bivariate analysis, there was no significant effect between duration of hemodialysis, frequency of hemodialysis, etiology, age, sex, and comorbidities (p>0.05) in children with chronic kidney failure who were undergoing hemodialysis on their nutritional status. Conclusion: The nutritional status of CKD children undergoing hemodialysis was assessed based on body mass index and height according to age. The average results were good nutrition but short stature. There was no effect of duration, frequency, etiology, age, gender, and comorbidities in children with chronic renal failure undergoing hemodialysis on their nutritional status.

Abstrak :
Gizi kurang menjadi salah permasalahan yang terjadi pada usia anak, salah satunya yaitu anak usia sekolah. Kurangnya variasi makan, porsi yang kurang tepat, atau makanan yang tidak sesuai dengan gizi seimbang dapat menyebabkan anak mengalami gizi kurang. Anak dengan masalah gizi kurang berisiko mengalami terhambatnya pertumbuhan dan perkembangan. Salah satu upaya untuk mengurangi masalah gizi kurang yaitu dengan melakukan intervensi penyusunan menu makan. Penelitian ini dilakukan melalui pendekatan asuhan keperawatan keluarga kepada anak sekolah yang memiliki masalah gizi kurang dengan pemberian intervensi penyusunan menu makan berdasarkan isi piringku. Setelah diberikan intervensi terdapat perubahan pada keluarga yaitu variasi makan pada anak lebih bervariasi dan porsi makan yang dihabiskan sesuai dengan kebutuhan tubuh.  Penelitian ini merekomendasikan kepada pelayanan kesehatan dan juga kader untuk melibatkan keluarga dalam penanganan untuk mengatasi masalah gizi kurang. ......Malnutrition is one of the problems that occur in children which is school-age. Lack of variety in eating, less food portions, or foods that are not in accordance with balanced nutrition can cause malnutrition in children. Children with malnutrition are at risk for stunted growth and development. One of the efforts to reduce the problem of malnutrition is to give intervention in the preparation of food menu. This research was conducted through a family nursing care approach to school age who have malnutrition problems by providing an intervention for preparing a meal menu based on the contents ‘isi piringku’. After given the intervention, there has been a changes in the family. Existing changes namely the variety of eating in children was more varied and the portion of food spent according to the needs of the body. This study recommends health services and ‘ibu kader’ to involve families to handle the problem of malnutrition.

Abstrak :
Pasien kanker serviks berisiko tinggi mengalami malnutrisi. Asupan makanan yang tidak adekuat, peningkatan kebutuhan, penurunan aktivitas fisik dan hiperkatabolisme, mendorong terjadinya malnutrisi. Kondisi ini dapat terjadi selama sakit maupun pada saat pengobatan, yang dapat memengaruhi status gizi pasien. Prevalensi malnutrisi pada pasien kanker serviks sebesar 48−66% dan meningkat hingga 82% setelah mendapat terapi. Pasien kanker serviks, 25% mengalami cachexia dan 33−69% mengalami sarkopenia. Penurunan massa otot yang merupakan penyusun utama massa bebas lemak (MBL), secara negatif memengaruhi efektivitas terapi dan kelangsungan hidup pasien. Bioelectrical impedance analysis (BIA) adalah alat tervalidasi untuk mengukur MBL sebagai bagian dari diagnosis malnutrisi, namun tidak selalu tersedia di fasilitas kesehatan. Penelitian menunjukkan bahwa kekuatan genggam tangan (KGT) dapat dijadikan sebagai prediktor MBL. Pengukuran KGT dengan handheld dynamometers (HHD) yang relatif murah, valid, dan andal, masih jarang digunakan. Penelitian ini bertujuan untuk melihat hubungan antara KGT dan MBL pada pasien kanker serviks yang menjalani radioterapi di Poliklinik Radioterapi RSCM. Penelitian menggunakan desain potong lintang pada subjek usia 18−60 tahun. KGT dinilai menggunakan Jamar digital HHD. MBL dinilai menggunakan BIA single frequency Omron® HBF−375. Terdapat 54 subjek dengan median usia 49 tahun, mayoritas stadium III, tidak terdapat metastasis dan komorbid, dan mendapat radioterapi saja. Mayoritas subjek tergolong BB lebih, dengan rerata asupan energi 20,79 ± 6,70 kkal/kgBB/hari, median asupan protein 0,68 (0,05−1,87) g/kgBB/hari, dan rerata asupan lemak 31,22 ± 8,81% dari energi total. Mayoritas asupan energi, protein dan lemak tergolong kurang dibandingkan dengan rekomendasi ESPEN. Rerata KGT 23,54 ± 5,16 kg dan rerata MBL 36,40 ± 6,03 kg. Dilakukan uji korelasi antara KGT dan MBL. Terdapat korelasi positif yang cukup antara KGT dan MBL pada pasien kanker serviks yang menjalani radioterapi (r = 0,346, p = 0,010). KGT berkorelasi positif kuat dengan MBL (r = 0,601, p = 0,001) pada pasien kanker serviks yang hanya menjalani radioterapi (n=28). Pemeriksaan KGT kemungkinan dapat memprediksi MBL, sehingga dapat membantu diagnosis malnutrisi lebih dini dan mencegah luaran buruk pada pasien kanker serviks yang menjalani radioterapi, terutama di fasilitas kesehatan yang tidak tersedia BIA. Penelitian lebih lanjut diperlukan untuk mendapatkan formulasi dalam memprediksi MBL dari KGT. ......Cervical cancer patients are at high risk for malnutrition. Inadequate food intake, increased energy and protein requirements, decreased physical activity and hypercatabolism in cancer patients lead to malnutrition. This condition can occur during illness or during treatment, which can affect the nutritional status of the patient. The prevalence of malnutrition in cervical cancer patients was 48−66% and increased to 82% in patients receiving therapy. Patients with cervical cancer, 25% were cachectic and 33%–69% were sarcopenic. Loss of muscle mass, which are the main constituents of fat free mass (FFM), negatively impact therapeutic efficacy and survival in cervical cancer patients. Bioelectrical impedance analysis (BIA) is a validated tool for measuring FFM, as part of malnutrition, but it is not always available in health facilities. Research shows that hand grip strength (HGS) can be used as a predictor of FFM. HGS measurement with handheld dynamometers (HHD) which is relatively cheap, valid, and reliable, is still rarely used. This study aims to examine the relationship between HGS and FFM in cervical cancer patients undergoing radiotherapy at the Radiotherapy Outpatients Clinic of Dr. Cipto Mangunkusumo Hospital. The study used a cross-sectional design on subjects aged 18−60 years. HGS was assessed using a Jamar digital hand dynamometer. FFM was assessed using the BIA single frequency Omron® HBF−375. A total of 54 study subjects with a median age of 49 years, the majority were in stage III, had no metastases, received radiation therapy only, and had no comorbidities. Most of the subjects were classified as overweight and obes, with a mean of energy intake 20.79 ± 6.70 kcal/kgBW/day, a median of protein intake 0.68 (0.05−1.87) g/kgBW/day, and an average of fat intake 31.22 ± 8.81% of the total energy. The majority of the energy, protein and fat intakes were less than the ESPEN recommendations. The mean HGS in the subjects was 23.54 ± 5.16 kg and the mean FFM was 36.40 ± 6.03 kg. Correlation test was conducted between HGS and FFM. There was a moderately positive correlation between HGS and KGT in cervical cancer patients undergoing radiotherapy (r = 0.346, p = 0.010). HGS was strongly positive correlation with FFM (r = 0.601, p = 0.001) in cervical cancer patients undergoing radiotherapy only (n=28). HGS maybe able to predict FFM for early diagnose of malnutrition and prevent poor outcomes in cervical cancer patients undergoing radiotherapy, especially in health facilities where BIA isn’t available. Further research is needed to get a formulation in predicting FFM from HGS.

Abstrak :
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. ......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.