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Abstrak :
This book aims to present the first comprehensive synthesis of the context and impact of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) and to offer insights on successful and sustainable interventions and policies that work for at-risk populations. It includes 12 chapters divided into 3 parts. Part I focuses on the state of the problem and state of knowledge on the epidemiology and burden of the major NCDs. Three chapters review the epidemiology and burden of cardiovascular diseases and diabetes (Chapter 1), cancers (Chapter 2) and neurodegenerative diseases such as dementia and Parkinson's disease (Chapter 4). Two chapters focus on the co-morbid and multi-morbid interactions between the major NCDs and infectious diseases like HIV, tuberculosis and malaria (Chapter 3) and mental health disorders (Chapter 5). Part II focuses on best practices and innovation in research and intervention. Four chapters discuss key issues on this theme including health systems strengthening (Chapter 6), population surveillance (Chapter 7), community-based interventions (Chapter 8) and self-help approaches to NCD care (Chapter 9). Part III focuses on policy development and implementation. Three chapters offer a comprehensive analysis of existing policies relevant to NCD prevention and control. They focus on policies that work, as well as discussing the lessons that can be learned from infectious disease control (Chapter 10), NCD control in high-income countries (Chapter 11) and the current policy issues and activities arising from the 2011 UN High Level Meeting on NCDs and leading to a post-2015 global health agenda (Chapter 12).

Abstrak :

Abstrak :
Pendahuluan: Fatigue merupakan gejala yang paling mengganggu bagi pasien sirosis, dan menurunkan kualitas hidup pasien, sehingga perlu dilakukan penelitian tentang faktor yang paling berpengaruh terhadap fatigue pada pasien sirosis.

Metode: Desain penelitian cross sectional, jumlah sampel 70 orang, teknik pengambilan sampel: consecutive sampling. Data dikumpulkan menggunakan lima kuesioner: karakteristik responden, FSS, MOSsss, self efficacy for managing chronic disease 6 item scale, hasil laboratorium Hb dan skor child pugh. Analisis data dengan chi square dan regresi logistik.

Hasil: Terdapat tiga faktor yang paling berpengaruh terhadap fatigue pada pasien sirosis, diantaranya: anemia: OR = 6,556 (95%CI = 1,683 ; 25,535), dukungan sosial: OR = 5,914 (95%CI = 1,582 ; 22,113) dan self efficacy: OR = 4,559 (95%CI = 1,395 ; 14,901). Ketiga faktor tersebut dapat dijadikan acuan, dalam melakukan intervensi keperawatan yang tepat, untuk mengatasi fatigue pada pasien sirosis.

Rekomendasi: Perawat perlu memiliki format pengkajian deteksi dini fatigue yang valid, dan pemberian edukasi terkait faktor risiko fatigue.

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Introduction: Fatigue is the most disturbing symptom for patients with cirrhosis, and decreases patients quality of life, so it is necessary to do research on the factors that most influence fatigue in patients with cirrhosis.

Method: Cross sectional study design, total sample 70 respondent, sampling technique: consecutive sampling. Data were collected using five questionnaires: respondent characteristics, FSS, MOSsss, self efficacy for managing chronic disease 6 items, laboratory Hb results and child pugh score. Data analysis with chi square and logistic regression.

Results: There were three factors that most influenced fatigue in cirrhotic patients, including: anemia: OR = 6.556 (95% CI = 1.683; 25,535), social support: OR = 5,914 (95% CI = 1,582; 22,113) and self efficacy: OR = 4,559 (95% CI = 1,395; 14,901). These three factors can be used as references, in carrying out appropriate nursing interventions, to overcome fatigue in patients with cirrhosis.

Recommendation: Nurses need to have a valid fatigue early detection assessment format, and education regarding risk factors for fatigue.

Abstrak :
Penyakit Ginjal Kronik merupakan salah satu penyakit tidak menular yang prevalensinya terus meningkat dari tahun ke tahun. Penurunan fungsi ginjal menjadi penyakit ginjal kronik tahap akhir mengakibatkan pasien harus menjalani terapi penganti ginjal semur hidup. Terapi yang paling banyak digunakan saat ini adalah hemodialisis. Meskipun alat hemodialisis telah banyak dan canggih, namun ketahanan hidup pasien PGK masih rendah. Salah satu penyebab rendahnya ketahanan hidup pasien PGK yang menjalani hemodialisis adalah komorbiditas atau penyakit penyerta. Komorbiditas yang saat ini paling umum pada pasien PGK yang menjalani hemodialisis adalah diabetes mellitus. Desain penelitian ini menggunakan desain kohort restrospektif. Probabilitas ketahanan hidup 3 bulan, 6 bulan, 9 bulan dan 1 tahun pasien PGK yang menjalani hemodialisis dengan komorbiditas diabetes mellitus lebih rendah dibandingkan pasien dengan komorbiditas bukan diabetes mellitus. Probabilitas ketahanan hidup 3 bulan, 6 bulan, 9 bulan, 1 tahun dan pasien PGK yang menjalani hemodialisis dengan komorbiditas diabetes mellitus adalah dalah 69%, 55% 34%, dan 34% sedangkan komorbiditas bukan diabetes mellitus adalah 76%, 61%, 53% dan 51%. Secara bivariat, pasien PGK yang menjalani hemodialisis dengan komorbiditas diabetes mellitus memiliki risiko untuk meninggal 1.75 kali lebih cepat dibandingkan dengan pasien komorbiditas bukan diabetes mellitus. Sementara itu dari analisis multivariat didapatkan variabel konfonder yang mempengaruhi rendahnya ketahanan hidup pasien PGK yang menjalani hemodialisis pada pasien dengan komorbiditas diabetes mellitus adalah akses vaskular.

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Chronic kidney disease (CKD) is one of the no-communicable diseases which increase every years. The decline of kidney function will progress to End Stage Renal Disease (ESRD). The ESRD patients has to undurgo dialysis therapy during their lives. the most dialysis therapy is hemodialysis. Although the machine of hemodialysis are quiet a a lot and sophisticate, the survival of CKD patients is still low. One of the causes of low survival PGK patient on maintenance hemodialysis is the comorbid or present disease. Nowadays the most common comorbid for CKD patient with hemodialysis is diabetes mellitus. Research design is using Kohort Retrospective. The probability of survival of 3 months,6 months, 9 months and 1 year CKD patients on maintenance hemodialysis with comorbid diabetes mellitus is lower than patients without comorbidities of diabetes mellitus. The probability ofsurvival of 3 months, 6 months, 9 months, 1 year and CKD patients on maintenance with comorbid diabetes mellitus are 69%, 55% 34%, and 34% while one not comorbid diabetes mellitus are 76%, 61%, 53 % and 51%. In bivariate analysis,CKD patients on maintenance hemodialis with comorbid diabetes mellitus have a risk of dying 1.75 times faster than patients without comorbiddiabetes mellitus. Meanwhile obtained from multivariate analysis confonder variables that affect the low survival of CKD patients on maintenance in patients with comorbid diabetes mellitus is a vascular access.

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ABSTRACT
Latar Belakang. Sebagai klinisi, dokter diharapkan mampu menegakkan diagnosis etiologi keluhan BKB dengan cepat, tepat, hemat biaya dan tidak hanya bersifat simptomatik belaka. Sayangnya, hingga kini masih sedikit penelitian mengenai etiologi BKB pada anak, padahal setiap pusat pelayanan kesehatan memiliki data etiologi BKB yang berbeda-beda. Perbedaan etiologi ini disebabkan oleh perbedaan definisi yang dianut, batasan usia anak, serta karakteristik dan tingkat pusat pelayanan kesehatan yang menjadi tempat penelitian.

Tujuan. Penelitian ini bertujuan untuk mengetahui prevalens keluhan utama BKB pada pasien anak dengan keluhan batuk, tiga etiologi tersering, waktu yang dibutuhkan untuk menegakkan diagnosis etiologi BKB, profil klinis dan pemeriksaan penunjang pada pasien di unit rawat jalan Departemen IKA-RSCM dari bulan Juli 2007 sampai dengan Juli 2013.

Metode. Metode penelitian ini adalah deskriptif retrospektif dengan melakukan penelusuran dan analisis data rekam medis pasien berusia 1-18 tahun (12-216 bulan) dengan keluhan utama batuk (ICD 10-R05.0).

Hasil. Prevalens BKB dari seluruh subjek dengan keluhan batuk adalah 437 subjek (87,6%), dengan median usia 54 bulan (12-220 bulan). Etiologi spesifik tersering adalah United airway diseases (46,9%), asma (31,7%) dan TB paru (15,4%). Riwayat penyakit dahulu dan keluarga dengan atopi, alergi dan asma membantu penegakan diagnosis. Dari 28 subjek yang tidak mendapat imunisasi BCG, 15 (53,6%) subjek didiagnosis TB paru dan 1 subjek TB milier. Sebanyak 362 (82,9%) subjek yang didiagnosis etiologi batuk pascainfeksi virus, rinitis alergi, asma dan TB paru telah mendapat terapi antibiotik sebelumnya. Median waktu yang dibutuhkan untuk menegakkan diagnosis etiologi BKB adalah 2,5 hari/pasien (0-8 hari/pasien) untuk diagnosis BKB nonspesifik batuk pasca infeksi virus dan diagnosis etiologi spesifik yaitu rinitis alergi adalah 3,7 hari/pasien (0-21hari/pasien), rinosinusitis 4,8 hari/pasien (2-21 hari/pasien), asma 2,5 hari/pasien (0-53 hari/pasien) dan TB paru 6,2 hari/pasien (3-60 hari/pasien). Pemeriksaan penunjang yang banyak dilakukan untuk penegakan diagnosis meliputi uji tuberkulin (84,7%), foto toraks (72,5%), spirometri (14%), dan foto polos sinus paranasal (26,8%).

Simpulan. Prevalens BKB mencapai 87,6% dengan etiologi tersering adalah penyakit saluran respiratorik atas, asma dan TB paru. Kata kunci. Batuk kronik berulang (BKB) pada anak,

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ABSTRACT
Background. As clinician, a physician should be able to diagnose the etiology of chronic cough in children, therefore the therapy could be done promptly, precisely, cost-effectively, and not merely symptomatic. Unfortunately, publication on the etiology of chronic cough in children is limited up to now, and every health care centers may have different etiologic data. This differences might be caused by the gaps of chronic cough definition, the child's age restrictions, as well as the characteristics and the level of health care services.

Objective. To determine the prevalence of chronic cough in pediatric patients with chief complaints of cough, the three most common etiology, the duration of time to establish the etiology, clinical profiles and supportive investigation in outpatient pediatric unit at CMH from July 2007 to July 2013.

Method. A descriptive retrospective analysis was conducted from medical records of patients aged 1-18 years (12-216 months) with a chief complaint of cough (ICD-10 R05.0)

Result. Chronic cough prevalence of all subjects with complaints of cough was 87.6% (437 subjects), with a median age of 54 months (12-220 months). The most common specific etiology is upper respiratory tract disease (44.7%), asthma (31.7%%) and pulmonary tuberculosis (15.4%). Past medical history and family with atopy, allergy and asthma aid diagnosis. In 28 subjects who had never received BCG immunization, 15 (53.6%) subjects were diagnosed as pulmonary tuberculosis and 1 subject as miliary TB. Prior antibiotic treatment had been given in 362 (82.9%) subjects that were diagnosed as post viral cough, allergic rhinitis, asthma and pulmonary TB. Median duration of time to diagnose the etiology of nonspesific post viral cough was 2.5 days/patient (0-8 days/patient) and specific etiologic such as allergic rhinitis was 3.7 days/patient (0-21 days/patient), rhinosinusitis in 4.8 days/patient (2-21 days/patient), asthma in 2.5 days/patient (0-53 days/patient) and pulmonary TB in 6.2 days /patient (3 - 60 days/patient). Investigations that commonly done to established the diagnosis were tuberculin test (84.7%), chest Xray (72.5%), spirometer (14%), and plain radiography of paranasal sinuses (26.8%).

Conclusion. The prevalence of chronic cough from all subjects with complaints of cough in the outpatient pediatric unit at CMH is 87.6% with the most common etiologies are upper respiratory tract disease, asthma and pulmonary tuberculosis.