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"Full fledged use of construction & demolition (C&D) waste in the construction industry is inevitable. Concrete technologists across the world are engaged to scale its properties and potential uses since last 65 years. The general consensus for the mechanical property is to some extent is acceptable however the workability and durability properties are still under a scanner and needs to be improved. The present paper reports the optimistic results of series of experimental work carried out using high range replacement of normal aggregates (NA) with recycled aggregates (RA) (50-80%) from C&D waste for producing sustainable and durable concrete (water cement ratio 0.4) using C&D waste. Multiple strategies were used in research to enhance workability and durability properties of concrete produced by using C&D waste. Firstly the RA was used as an internal curing (IC) agent to enhance the micro structure and Interfacial Transition Zone (ITZ) of concrete. Secondly by apparently lowering the water cement ratio by using additional low-lime fly ash similar to class F of ASTM C 618 mainly to improve workability, packing of concrete, later age strength and durability. The results show that water diffusion in concrete with RA being used as an IC agent was delayed leading to decrease in shrinkage and micro cracks development; also increase the hydration, compressive strength and improvement of durability indexes such carbonation depth and electrical resistivity is seen. The Scanning Electron Microscope (SEM) result illustrated the considerable improvement in the microstructure. By adopting these strategies which are economical & sustainable, mixtures show additional benefits that should permit their broader application."

"Tantangan utama unit laboratorium klinik di rumah sakit saat ini adalah melakukan efisiensi biaya terutama biaya sumber daya manusia. Di sisi lain pasien dan dokter menginginkan hasil pemeriksaan laboratorium yang lebih cepat dan akurat. Penelitian ini bertujuan untuk mengetahui jumlah kebutuhan ahli teknologi laboratorium medik berdasarkan beban kerja di Unit Laboratorium Klinik Rumah Sakit Santa Maria Pekanbaru. Metode penelitian yang digunakan adalah operational research dengan analisis kuantitatif dan kualitatif. Analisis beban kerja dilakukan terhadap seluruh tenaga ahli teknologi laboratorium medik yang berjumlah 15 orang dengan metode kombinasi work sampling dan daily log. Perhitungan kebutuhan tenaga dilakukan dengan 3 metode yaitu Metode Ilyas, Metode WISN, dan Metode Full Time Equivalent. Hasil penelitian adalah dibutuhkan 18 orang tenaga ahli teknologi laboratorium medik menurut Metode Ilyas, 21 orang menurut Metode WISN, dan 17 orang menurut Metode Full Time Equivalent. Disarankan kepada Rumah Sakit Santa Maria Pekanbaru agar menambah 3 orang tenaga ahli teknologi laboratorium medik.

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The main challenge of the clinical laboratory unit in hospitals today is to carry out cost efficiency, especially the cost of human resources. On the other hand, patients and doctors want the results of laboratory tests that are faster and more accurate. This study aims to determine the number of medical laboratory technology experts needs based on workload at the Clinical Laboratory Unit of the Santa Maria Pekanbaru Hospital. The research method used is operational research with quantitative and qualitative analysis. Workload analysis was carried out on all 15 medical laboratory technology experts with a combination of work sampling and daily log methods. Calculation of workforce needs is carried out with 3 methods, namely the Ilyas Method, the WISN Method, and the Full Time Equivalent Method. The results of research were the needs of 18 medical laboratory technology experts according Ilyas Method, 21 person according WISN Method, and 17 person according Full Time Equivalent Method. It was recommended to the Santa Maria Pekanbaru Hospital to add 3 medical laboratory technology experts. "

"Laju kekambuhan tuberkulosis (TB) di Nusa Tenggara Timur hanya mencapai 71,3% di era Directly Observed Treatment Short-course (DOTS). Pasien pasca TB memiliki risiko kembali terinfeksi TB hingga empat kali lipat di daerah endemik. Sementara itu, kontak serumah pasien juga merupakan kelompok dengan kelompok risiko tinggi sakit TB. Penelitian ini bertujuan untuk mengevaluasi gambaran klinis dan radiologi serta mencari faktor yang berhubungan pada pasien pasca TB dan kontak serumah.Penelitian ini meggunakan desain potong lintang pada pasien pasca TB dan kontak serumah pasien. Pasien diambil berdasarkan catatan Puskesmas tahun 2003-2010 di NTT yang telah dinyatakan sembuh atau selesai pengobatan. Sebanyak 63 pasien pasca TB dan 45 kontak serumah mengikuti penelitian ini. Gejala klinis yang dominan terdapat pada pasien pasca TB yakni batuk produktif kronik (69,8%) sementara pada kontak serumah yakni penurunan berat badan (26,7%) dan sesak napas (24,4%). Sebanyak 54% pasien pasca TB dan 35,6% kontak serumah memiliki lesi aktif radiologi. Gejala batuk berdahak kronik berhubungan bermakna dengan adanya lesi aktif (p=0,001). Pasien pasca TB dalam rentang waktu tiga tahun setelah pengobatan TB secara statistik berhubungan bermakna terhadap kejadian lesi aktif radiologi (p=0,012). Pada penelitian ini juga didapatkan 11 dari 35 subjek (31,4%) memiliki sputum BTA positif, dimana sembilan diantaranya merupakan pasien pasca TB.

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Cure rate TB in East Nusa Tenggara was around 71.3% in the era of DOTS. Post tuberculosis patients had four times increased risk of TB reinfection, especially in high endemic area. Meanwhile, household contacts were prone to TB disease as they had high exposure to TB. This study aimed to evaluate the clinical symptoms and radiologic findings and factors associated with them among post TB patients and household contacts.This was cross sectional study involving post TB patients and household contacts. Patients were recruited based on Primary Heath Center (Puskesmas) registry from 2003-2010 in three districts in East Nusa Tenggara. Sixty-three patients and 45 household contacts were recruited in this study. The most dominant clinical symptom among post TB patients was chronic productive cough (69.8%) whereas among household contacts were weight loss (26.7%) and dyspnea (24.4%). Fifty-four persen post TB patients and 35.6% household contacts had active lesions based on radiological reading. Chronic productive cough was associated with active lesion (p=0.001). Post TB patients in three years period after completion of TB therapy was associated with active lesion (p=0.012). In this study, we examined sputum smear with 11 from 35 subjects (31.4%) had positive sputum smear, with nine of them were post TB patients."

"Latar belakang: Penentuan derajat degenerasi diskus intervertebralis (DDI) dan pemantauan progresivitasnya sangat penting untuk menentukan tatalaksana dan memantau efektivitas terapi. Penilaian T2 map menggunakan Magnetic Resonance Imaging (MRI) dapat mengevaluasi derajat DDI secara kuantitatif namun dengan hasil yang bervariasi, tergantung pada mesin, coil, protokol, dan perangkat lunak MRI yang digunakan.Metode: MRI sekuens T2 – weighted image potongan sagital digunakan untuk menilai dan mengelompokkan derajat DDI lumbal berdasarkan skala Modifikasi Pfirrmann. Derajat DDI lumbal yang termasuk dalam kriteria penelitian adalah derajat 2 – 4. Pasien yang tidak memiliki diskus normal (derajat 1) dieksklusi. MRI sekuens T2 mapping potongan mid – sagital digunakan untuk memperoleh rerata nilai T2 map dengan meletakkan Regio of Interest (ROI) di seluruh penampang diskus normal dan diskus yang berdegenerasi. Rerata nilai T2 map diskus yang berdegenerasi dibandingkan dengan diskus normal pada pasien yang sama, sehingga didapatkan nilai rasio (T2 map index).Hasil: Didapatkan perbedaan signifikan rerata nilai T2 map index pada tiap derajat skala Modifikasi Pfirrmann (p < 0,001), dimana semakin berat derajat DDI lumbal, maka rerata nilai T2 map index semakin rendah (derajat 1: 0,97 ± 0,05 ms; derajat 2: 0,93 ± 0,07 ms; derajat 3: 0,60 ± 0,11 ms; derajat 4: 0,48 ± 0,04 ms).Kesimpulan: Penghitungan nilai T2 map index dapat digunakan untuk mengevaluasi progresivitas DDI lumbal secara kuantitatif dan dapat mengeliminasi variabilitas nilai T2 map.

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Background: Severity and progression of intervertebral disc degeneration in early stages should be evaluated not only for an adequate treatment planning, but also for monitoring the effectiveness of therapies. Obtaining T2 map value using MR T2 mapping was beneficial for the assessment of disc degeneration albeit different MR machine, coil, software, and protocol used could affect its value.

Methods: Sagittal T2 – weighted image were used to evaluate lumbal disc degeneration by Modified Pfirrmann grading system. Grade 2 – 4 were included, while patients without grade 1 disc (normal disc) were excluded. Using mid – sagittal MR T2 mapping, range of interest (ROI) were placed in whole disc. Mean T2 map value in degenerated disc was compared to mean T2 map value in normal disc with resultant of a ratio (T2 map index).

Results: Mean T2 map index value between each Modified Pfirrmann grading differed significantly (p < 0,001). Higher Modified Pfirrmann grade correlates with lower mean T2 map index value (grade 1: 0,97 ± 0,05 ms; grade 2: 0,93 ± 0,07 ms; grade 3: 0,60 ± 0,11 ms; grade 4: 0,48 ± 0,04 ms).

Conclusion: T2 map index is reliable in evaluating the progressivity of lumbal disc degeneration quantitatively and in eliminating T2 map value variabilities."

"ABSTRAKTuberkulosis (TB) paru masih terus menjadi masalah kesehatan di dunia terutama di negara berkembang. Streptomisin adalah suatu antibiotik golongan aminoglikosida yang harus diberikan secara parenteral pada pasien TB paru kategori dua dan bekerja mencegah pertumbuhan organisme ekstraselular. Kekurangan dari streptomisin adalah efek samping toksik pada saraf kranial kedelapan yang dapat menyebabkan disfungsi vestibular dan/atau hilangnya pendengaran. Ototoksik sudah lama dikenal sebagai efek samping pengobatan kedokteran dan dengan bertambahnya obat-obatan yang lebih poten, daftar obat-obatan ototoksik makin bertambah. Tuli akibat ototoksik yang menetap dapat terjadi berhari-hari, berminggu-minggu atau berbulan-bulan setelah selesai pengobatan. Penggunaan obat ini masih menjadi dilema, karena efek samping streptomisin dapat menyebabkan tuli sensorineural, sedangkan obat ini perlu diberikan pada penderita TB paru kategori dua dalam jangka waktu tertentu. Pada penelitian ini, yang melibatkan 46 sampel, pasien TB paru setelah terapi Streptomisin sulfat yang mengalami penurunan pendengaran >15 dB pada frekuensi 8000 Hz sebanyak 12 sampel (26,1%) dan secara statistik bermakna.

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ABSTRACT

Pulmonary tuberculosis is still a health problem in the world, especially in developing countries. Streptomycin is an aminoglycoside class of antibiotics that must be given parenterally in patients with category two of pulmonary tuberculosis and working to prevent the growth of extracellular organisms. Disadvantages of streptomycin is toxic side effects on the eighth cranial nerve that can cause vestibular dysfunction and / or loss of hearing. Ototoxic has long been known as a side effect of treatment with increasing medical and drugs more potent, ototoxic drugs list growing. Deafness due to ototoxic persistent can occur days, weeks or months after completion of treatment. The use of these drugs is still a dilemma, because the side effects of streptomycin can cause sensorineural hearing loss, whereas these drugs should be given to category two of pulmonary tuberculosis patients within a certain period. In this study, involving 46 samples, pulmonary tuberculosis patients after therapy Streptomycin sulfate experiencing hearing loss > 15 dB at a frequency of 8000 Hz as many as 12 samples (26.1%) and statistically significant."