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Abstrak :
Sekitar 15-20% pasien poliklinik dan unit gawat darurat datang dengan masalah sawar kulit seperti pemfigus, toxic epidermal necrolysis (TEN), dan eritroderma. Masalah nutrisi terjadi pada penyakit sawar kulit melalui beberapa hal, yaitu kondisi hipermetabolisme sedang sampai berat, masalah pemenuhan nutrisi, kehilangan protein dari lesi kulit, dan efek samping metabolik akibat terapi steroid dosis tinggi jangka panjang. Empat pasien serial kasus dengan diagnosis pemfigus, TEN, dan eritroderma dengan masing-masing kondisi penyerta seperti gangguan hati, obesitas, DM tipe lain dan sepsis. Terapi medik gizi diberikan berdasarkan kondisi klinis, toleransi asupan, dan hasil laboratorium pasien. Target pemberian nutrisi dihitung menggunakan Harris Benedict dengan tambahan faktor stress 1,3-1,5. Diberikan nutrisi dengan komposisi seimbang, terdiri atas protein 1,32 g/kg BB ideal/hari, lemak 2530%, dan karbohidrat 4565%. Mikronutrien yang diberikan berupa vitamin B kompleks 3x1, asam folat 1x1 mg, vitamin A 12.000 IU, vitamin C 500-1000 mg, dan seng 2x20 mg. dari monitoring dan evaluasi dilaporkan bahwa pemberian mikronutrien pada penyakit sawar kulit dapat meningkatkan penyembuhan luka dan menurunkan risiko metabolik. Dari empat pasien serial kasus ini, didapatkan satu kasus mortalitas yaitu pada pasien dengan penyulit sepsis. Ketiga pasien kasus lainnya mengalami perbaikan kondisi klinis, penyembuhan luka baik, tidak ada infeksi dan komplikasi selama perawatan, kontrol glikemik baik, perbaikan kapasitas fungsional, dan lama rawat pasien lebih singkat. Ketiga pasien dipulangkan untuk rawat jalan. Terapi medik gizi yang optimal dapat memerbaiki luaran klinis serta menurunkan angka morbiditas dan mortalitas pasien pemfigus, TEN, eritroderma tanpa penyulit metabolik ......One in five to six patients at the polyclinic and emergency department present with skin barrier problems such as pemphigus, toxic epidermal necrolysis (TEN), and erythroderma. Nutritional problems occur in skin barrier disease through several things, namely moderate to severe hypermetabolic conditions, problems with nutritional compliance, loss of protein from skin lesions, and metabolic side effects due to long-term high dose steroid therapy. Three case series patients with pemphigus, TEN with hepatic complications, and erythroderma with obese nutritional status I and one case of pemphigus complicating sepsis and other types of DM. Nutritional medical therapy is given based on the clinical condition, intake tolerance, and laboratory results of the patient. The target of nutrition intake is calculated using Harris Benedict with a stress factor of 1.3-1.5, with a balanced composition, consisting of protein 1.3-2 g / kg ideal body weight / day, 25-30% fat, and 45-65% carbihydrates. The micronutrients were given in the form of 3x1 vitamin B complex, 1x1 mg folic acid, 12,000 IU vitamin A, 500-1000 mg vitamin C, and 2x20 mg zinc. Administration of micronutrients in skin barrier disease can improve wound healing and reduce metabolic risk. In four case series patients, there was one case mortality in a patient with complicated sepsis. The others had improved clinical conditions, good wound healing, no infection and complications during treatment, good glycemic control, improved functional capacity, and shorter patient length of stay. The three patients were discharged for outpatient care. Optimal nutritional medical therapy can improve clinical outcomes and reduce morbidity and mortality in patients with pemphigus, TEN, erythroderma without metabolic complications

Abstrak :
Penelitian ini bertujuan untuk mengetahui pengaruh dari optimized food-based recommendation FBR dan biskuit fortifikasi terhadap performa kognitif siswa sekolah dasar. Cluster randomized controlled trial selama enam bulan pada anak sekolah usia 7-9 tahun n=252 dilaksanakan di 12 sekolah di Kota Nyaundon yang terdiri dari 3 kelompok; kombimasi optimized FBR dan biskuit fortifikasi, optimized FBR, dan kontrol. Performa kognitif, antropometri, dan indicator biokimia diukur sebagai outcome. Pada kedua kelompok intervensi optimized FBR dengan biscuit fortifikasi dan optimized FBR terdapat pengaruh yang significant terhadap performa kognitif, weight-for-age z-scores dan kadar besi serum. Akan tetapi kombinasi optimized FBR dengan biscuit fortifikasi menghasilkan skor performa kognitif yang lebih tinggi dibandingkan optimized FBR saja dengan skor yang lebih tinggi secara signifikan pada daya ingat 1.1 0.1: p-vale

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The study aimed to determine the effect of optimized food-based recommendation FBR and fortified biscuits on cognitive performance of primary school children. A six-month cluster randomized controlled trial among 7-9 years old school children n=252 were conducted at 12 schools in Nyaungdon Township with three intervention groups; optimized FBR with fortified biscuits, optimized FBR, and control. The cognitive performances, anthropometry and biochemical indicators were assessed as outcomes. Analysis of covariance and multiple linear regression analysis were done. Both intervention optimized FBR with fortified biscuits and optimized FBR groups had significant effect on the cognitive performances, weight-for-age z-scores and serum iron status. But combined optimized FBR with fortified biscuits improved cognitive performances higher scores than optimized FBR alone with significantly higher in memory 1.1 0.1: p-vale.