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Abstrak :
Background: optimal hydration represents adequate total daily fluid intake to compensate for daily water losses, ensure adequate urine output to reduce the risk of urolithiasis and renal function decline, and also avoid the production of arginine vasopressin (AVP). Twenty four hour urine osmolality has been used to assess hydration status, but it is challenging because of the possibility of spilling urine and limitation of daily activities. This study is aimed to determine the performance of the afternoon urine osmolality to assess the optimal hydration status compared with 24 hour urine osmolality. Methods: a cross sectional study was conducted on healthy employees aged 18-59 years at Universitas Indonesia Medical Faculty/Cipto Mangunkusumo Hospital, with consecutive sampling method. The ROC curve was analyzed to obtain the optimal cut off point and the accuracy of the afternoon urine osmolality in assessing the optimal hydration status. Results: between August-September 2016 there were 120 subjects (73.8% female, median age 32 years) who met the study criteria with a median 24 hour urine osmolality 463.5 (95% CI, 136-1427) mOsm/kg H2O and median afternoon urine osmolality 513 (95% CI, 73-1267). We found moderate correlation (r=0.59; p<0.001) between afternoon urine osmolality and a 24 hour urine osmolality. Using ROC curve, the AUC value was 0.792 (95% CI, 0.708-0.875) with the cut off 528 mOsm/kg H2O. To assess the optimal hydration status, the afternoon urine osmolality had the sensitivity of 0.7 (95% CI, 0.585-0.795) and the specificity of 0.76 (95% CI, 0.626-0.857), Likelihood Ratio (LR) (+) 2.917 (95% CI, 1.74-4.889) and LR (-) 0.395 (95% CI, 0.267-0.583). Conclusion: afternoon urine osmolality can be used as a diagnostic tool to assess the optimal hydration status in healthy population with cut off 528 mOsm/kg H2O, sensitivity of 0.7, and specificity of 0.76.

Abstrak :
Tengkes (stunting) merupakan salah satu permasalahan gizi kurang pada balita yang ada di Indonesia. Pengelolaan sampah yang belum maksimal di TPA dapat menimbulkan pencemaran sanitasi lingkungan yang menjadi faktor penyebab tidak langsung tengkes (stunting) dan perilaku hidup bersih yang kurang. TPA Cipeucang menjadi satu-satunya TPA untuk wilayah Tangerang Selatan dengan 2 kelurahan yang berada dekat dengan TPA mengalami kenaikan kasus tengkes (stunting) pada tahun 2021-2022. Penelitian ini bertujuan untuk mengetahui hubungan sanitasi dasar rumah sehat dan personal higiene rumah tangga dengan kejadian tengkes tengkes (stunting) pada balita di pemukiman sekitar TPA Cipeucang Kota Tangerang Selatan. Jenis penelitian ini adalah analitik observasional melalui pendekatan cross sectional. Populasi penelitian adalah seluruh balita yang ada di pemukiman sekitar TPA meliputi 2 Kelurahan dengan 4 RT dan 2 RW. Sampel penelitian berjumlah 86 dengan menggunakan teknik total dan purposive sampling. Penelitian dilaksanakan bulan April hingga Juni 2023. Analisis data menggunakan univariat, bivariat (uji Chi Square) dan multivariat (uji regresi logistik). Hasil penelitian menunjukan bahwa ada hubungan antara sarana air minum dengan tengkes (stunting) (p=0,05, POR=1,89) dan menjadi faktor dominan penyebab tengkes (stunting) (p=0,054). Sedangkan sarana air bersih (p=0,374, POR=1,44), sarana jamban (p=0,613, POR=1,22), sarana pembuangan air limbah (p=1,000, POR=1,54), kebersihan kulit (p=1,000, POR=1,24) serta kebersihan kuku dan tangan (p=0,625, POR=1,22) tidak berhubungan dengan tengkes (stunting) namun berpotensi menjadi risiko tengkes (stunting). Sarana pengelolaan sampah padat rumah tangga (p=0,310) tidak ada hubungan dengan tengkes (stunting) dan bukan merupakan faktor risiko. Kesimpulan dalam penelitian ini adalah sarana sanitasi dasar air minum memiliki hubungan yang bermakna dengan kejadian tengkes (stunting) dan menjadi faktor dominan yang mempengaruhi kejadian tengkes (stunting) pada balita di pemukiman sekitar TPA Cipeucang Kota Tangerang Selatan Tahun 2023. ......Stunting is one of malnutrition problems towards toddlers in Indonesia. Environmental sanitation has an important role against stunting. Waste management that has not been maximized at landfill can cause environmental sanitation pollution and lack of healthy hygiene behavior. Cipeucang Landfill is the only landfill for South Tangerang City with 2 sub-districts that are close to the landfill and have an increase stunting case in 2021-2022. This study aims to determine the relationship between basic healthy home sanitation and household personal hygiene with stunting case towards toddlers in settlements around Cipeucang Landfill, Tangerang Selatan City. This type of research is observational analytic through a cross sectional approach. The study population was all toddlers in settlements around Cipeucang Landfill with 2 Sub-Districts (4 RTs and 2 RWs). The research sample was 86 using a total and purposive sampling technique. The research was conducted from April to June 2023. Data analysis used univariate, bivariate (Chi Square test) and multivariate (logistic regression test). The results showed that there was relation between drinking water facilities and stunting (p=0.05, POR=1.89) and became a dominant factor causing stunting (p=0.054). While clean water facilities (p=0.374, POR=1.44), latrines (p=0.613, POR=1.22), waste water disposal facilities (p=1.000, POR=1.54), skin hygiene (p=1.000, POR=1.24) and hand and nail hygiene (p=0.625, POR=1.22) were not related to stunting but were potentially a risk of stunting. Household solid waste management facilities (p=0.310) have no relation with stunting and is not a risk factor. The conclusion in this study is basic sanitation facility for drinking water has a significant relationship with stunting case and is the dominant factor influencing stunting case towards toddlers in the settlements around TPA Cipeucang, South Tangerang City, 2023.

Abstrak :
Rumah sakit adalah institusi pelayanan kesehatan yang menyelenggarakan pelayanan kesehatan perorangan secara paripurna yaitu promotif, preventif, kuratif, dan rehabilitatif, yang menyediakan pelayanan rawat inap, rawat jalan, dan gawat darurat. Rumah sakit harus mampu meningkatkan pelayanannya agar lebih bermutu dan terjangkau demi terwujudnya derajat kesehatan yang setinggi-tingginya. Oleh sebab itu rumah sakit diharapkan memiliki karakter mutu pelayanan prima sesuai dengan harapan pasien, serta memberikan pelayanan medis yang bermutu. RSAL Dr. Mintohardjo adalah salah satu rumah sakit milik pemerintah yang melayani pasien swasta maupun pasien JKN. Untuk meningkatkan kualitas pelayanannya, pada bulan Agustus 2017 RSAL Dr. Mintohadjo berinisiasi mengembangkan poli rawat jalan sore yang dibuka pada pukul 15.00 – 19.00 WIB. Tujuan penelitian ini adalah untuk mengetahui efektivitas implementasi program rawat jalan sore di RSAL Dr. Mintohardjo. Penelitian ini menggunakan metode kualitatif dengan pendekatan studi kasus di poli rawat jalan sore RSAL Dr. Mintohardjo pada bulan Juli – September 2018. Hasil penelitian menunjukkan bahwa implementasi program rawat jalan sore di RSAL Dr. Mintohardjo belum efektif. Beberapa kendala yang dihadapi adalah komitmen dari dokter pelaksana program yang masih kurang, promosi mengenai program dan komunikasi antar organisasi yang belum maksimal, jumlah dokter & perawat yang terbatas, serta belum dibentuknya struktur organisasi khusus yang mengatur pelaksanaan poli sore. Dibutuhkan suatu strategi yang dapat berjalan simultan, salah satu caranya adalah dengan melakukan promosi besar-besaran dan melakukan kerja sama dengan klien lain seperti asuransi swasta yang dilakukan bersamaan dengan pembenahan kualitas pelayanan poli sore di RSAL Dr. Mintohardjo. ......The hospital is a health service institution that organizes individual health services in a comprehensive manner that is promotive, preventive, curative, and rehabilitative, which provides inpatient, outpatient, and emergency services. Hospitals must be able to improve their services to be more qualified and affordable for the sake of achieving the highest degree of health. Therefore hospitals are expected to have the character of excellent service quality in accordance with patient expectations, as well as providing quality medical services. RSAL Dr. Mintohardjo is one of the government-owned hospitals that serve private patients and JKN patients. To improve the quality of service, in August 2017 RSAL Dr. Mintohadjo took the initiative to develop an afternoon outpatient poly that was opened at 15.00 - 19.00 WIB. The purpose of this study was to determine the effectiveness of the implementation of the afternoon outpatient program at RSAL Dr. Mintohardjo. This study used a qualitative method with a case study approach at the afternoon outpatient clinic RSAL Dr. Mintohardjo in July - September 2018. The results of the study showed that the implementation of the afternoon outpatient program at RSAL Dr. Mintohardjo has not been effective. Some of the obstacles faced were commitments from program administrators who were still lacking, promotion of programs and communication between organizations that were not optimal, the number of doctors & nurses was limited, and the formation of a special organizational structure that regulated the implementation of the afternoon poly. A strategy that can run simultaneously is needed, one of the ways is by conducting large-scale promotions and collaborating with other clients such as private insurance which are carried out simultaneously with improving the quality of afternoon poly services at RSAL Dr. Mintohardjo.

Abstrak :
Waktu latihan mempengaruhi peningkatan kadar antigen t-PA (ant t-PA). Waktu latihan sore meningkatkan kadar ant t-PA lebih tinggi dibanding waktu latihan pagi pada intensitas latihan yang sama. Penelitian ini bertujuan untuk melihat pengaruh waktu latihan aerobik intensitas 60-70% laju jantung maksimal (LJM, 220-umur) selama 15 menit terhadap peningkatan kadar dnt t-PA. Subyek terdiri dari 16 laki-laki sehat, tidak terlatih berumur 25-35 tahun yang menjalani uji sepeda pagi (06.30-08.30 wib) dan sore (15.00-17.00) pada selang waktu 2 hari. Uji Wilcoxon sign ranked menunjukkan peningkatan kadar ant t-PA yang bermakna setelah latihan pagi dan sore sebesar 43,5% (P=0,03) dan 35% (P=0,03). Uji Wilcoxon U menunjukkan tidak terdapat perbedaan bermakna antara peningkatan kadar ant t-PA setelah latihan pagi dan sore. Dari hasil tersebut dapat disimpulkan bahwa waktu latihan pagi atau sore tidak berpengaruh terhadap peningkatan kadar ant t-PA pada intensitas latihan sedang.

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Increased t-PA antigen (t-PA ant) level during exercise is affected by diurnal variation. Exercise in the afternoon increases t-PA ant higher than exercise in the morning. Purpose of this study was to examine the effect of time of day aerobic exercise on t-PA ant level. Subjects were 16 sedentary, healthy untrained male, performed 2 session ergo cycle at 60-70 maximal heart rate (MHR, 220-age) both Morning (06.30-08.30) and afternoon (15.00-17.00) by 2 days separated. Wilcoxon sign ranked test show t-PA ant increased significantly after exercise in the morning (43.5%, P=0,03) and afternoon (38%, P=0,03) but not significant different between morning and afternoon (P=0,97). It was concluded that time of day exercise did not affect t-PA ant level in moderate aerobic exercise intensity.

Abstrak :
ABSTRAK
Latar Belakang: Hidrasi optimal merupakan hidrasi yang mencukupi untuk menggantikan kehilangan cairan, menjamin produksi urin cukup untuk mengurangi risiko urolitiasis dan penurunan fungsi ginjal, serta mencegah keluarnya arginin vasopresin AVP . Osmolalitas urin 24 jam diketahui dapat mengukur status hidrasi seseorang, namun dirasakan memberatkan karena kemungkinan urin tercecer dan membatasi aktivitas kerja. Oleh karena itu, dibutuhkan metode yang lebih sederhana untuk menggantikan pemeriksaan tersebut. Penelitian sebelumnya menunjukkan osmolalitas urin sore memiliki nilai terdekat dengan osmolalitas urin 24 jam. Namun, belum ada penelitian yang mengukur kemampuan urin sore hari sebagai penentu status hidrasi optimal. Tujuan: Mengetahui peranan pemeriksaan osmolalitas urin sore hari untuk menilai status hidrasi optimal dibandingkan dengan osmolalitas urin 24 jam. Metode: Studi diagnostik dengan desain studi potong lintang terhadap subjek sehat berusia 18-59 tahun dengan menganalisa kurva ROC untuk mendapatkan titik potong dan akurasi osmolalitas urin sore hari dalam menilai status hidrasi optimal. Hasil: Antara bulan Agustus-September 2016 terkumpul 120 subjek 73,8 perempuan, median usia 32 tahun yang memenuhi kriteria penelitian dengan median osmolalitas urin 24 jam 463,5 95 IK, 136-1427 mOsm/kg H2O dan median osmolalitas urin sore hari 513 95 IK, 73-1267 mOsm/kg H2O. Pada analisis didapatkan korelasi sedang r= 0,59; p

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ABSTRACT
Background: Optimal hydration representing adequate total daily fluid intake to compensate for daily water losses, ensure urinary output to reduce the risk of urolithiasis and renal function decline, and also avoid production of arginine vasopressin AVP . Twenty four hour urine osmolality has known to assess hydration status, but it is challenging because of the possibility of spilling urine and limiting time for daily activities. So that, we need easier method to determine optimal hydration status to replace 24 hour urine osmolality. Previous studies showed afternoon urine osmolality have an association with 24 hour urine osmolality. However, no studies measure the performance of afternoon urine osmolality to assess optimal hydration status. Objective: To determine the performance of afternoon urine osmolality to assess the optimal hydration status compared with 24 hour urine osmolality. Methods: Diagnostic study with cross sectional study design was conducted to healthy subjects aged 18 59 years by analyzing the ROC curve to obtain the optimal cutt off point and accuracy of afternoon urine osmolality in assessing the optimal hydration status. Results: Between August September 2016 there were 120 subjects 73.8 female, median age 32 years who met the study criteria with a median 24 hour urine osmolality 463.5 95 CI, 136 1427 mOsm kg H2O and median afternoon urine osmolality 513 95 CI, 73 1267 mOsm kg H2O. From the analysis, we found the correlation was moderate r 0.59 p