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"Pabrik sepatu merupakan suatu industri pengolahan yang pekerjanya hampir seluruhnya wanita dimana pekerja di bagian stitching athletic bekerja dengan kepala menunduk menghadap mesin kerja. Pada saat kepala maju kedepan diperlukan kekuatan untuk keseimbangan kepala dan bila ini berlangsung lama akan timbul kelelahan otot yang berakibat nyeri. Oleh karena itu dilakukan penelitian ini dengan tujuan mengetahui prevalensi serta faktor-faktor yang berhubungan dengan nyeri tengkuk.Disain penelitian adalah penelitian potong lintang dengan jumlah sample 251 yang diambil secara random sampling. Data penelitian didapat dari data medical check up, anamnesis, pemeriksaan fisik, pemeriksaan nyeri tekan pada daerah sub occipital, tes kompresi menurut Lhermittet, dan pengukuran-pengukuran antara lain pengukuran sudut fleksi leher menggunakan flexible curve, antopometri, tinggi meja dan penerangan.Hasil penelitian:Didapatkan prevalensi nyeri tengkuk sebesar 55.4%. Faktor-faktor yang berhubungan dengan nyeri tengkuk adalah umur (p = 0.006) dan fleksi leher (p = 0.000). Faktor yang paling berperan adalah fleksi leher (p = 0.000. OR - 4.58).Kesimpulan:Dari penelitian ini secara statistik terbukti bahwa fleksi leher berhubungan dengan timbulnya nyeri tengkuk dimana pada fleksi ≥ 20° mempunyai risiko 4.58 kali lebih besar dari pada fleksi < 20°. Perlu adanya penyuluhan atau pelatihan bagi pekerja tentang cara kerja yang ergonomis dan gerakan-gerakan senam ringan untuk mengurangi keluhan nyeri tengkuk. Oleh karena itu untuk mencegah dan mengurangi prevalensi nyeri tengkuk perlu pemahaman dan kerjasama yang baik dari manajemen, pekerja, perawat dan dokter perusahaan serta instansi terkait.Relation between Neck Flexion and Neck Pain in Woman Workers of Stitching Athletic Division, Shoe Factory in Tangerang

The shoe factory is a manufactory industry where most workers are women. The workers from stitching athletic division usually work with bowing forward. If the head is bent forward muscle strength is needed to maintain the position. In long period this condition leads to muscle fatigue including neck pain. Based on above situation, the research is carried out to assess the prevalence and factors influencing neck pain.

Design research is cross sectional study with amount of 251 samples and randomly selected. The research data are compiled from medical check-up, anamnesis, physical examination, pain pressure examination on sub occipital area , compression test according Lhermitte and other measurements, such as : angle measurement of neck flexion using flexible curve, anthropometry, high' of table and lighting.

Result:

Prevalence of neck pain 55.4%. The neck pain is associated with age (p = 0.006) and neck flexion (p=0.000). The neck flexion is a main factor to deal with the neck pain.

Conclusion:

The research shows that neck pain is statistically associated with neck flexion where neck flexion > 20° has 4.58 greater risks than neck flexion ≤ 20°. Training and counseling on ergonomics of work ethic and light relaxation are needed by the workers in order to reduce neck pain. Awareness and collaboration among management, workers, nurses, company doctors and integrated sector is essential aspect to prevent and minimize prevalence of neck pain of employees."

"Kanker kepala dan leher KKL merupakan penyakit yang berhubungan dengan malnutrisi Massa tumor perubahan metabolik dan efek samping terapi dapat menyebabkan berkurangnya asupan sehingga pasien jatuh pada kondisi malnutrisi Efek samping radiasi dapat berupa mual muntah mukositis xerostomia dan disfagia Tatalaksana nutrisi pada pasien KKL yang menjalani radioterapi bertujuan untuk meningkatkan mempertahankan status gizi mencegah terputusnya terapi meningkatkan kualitas hidup pasien dan meningkatkan angka harapan hidup Tatalaksana nutrisi meliputi pemenuhan kebutuhan makronutrien mikronutrien nutrien spesifik disertai konseling dan edukasi Serial kasus ini membahas tatalaksana nutrisi pada empat kasus KKL stadium IV yang menjalani radioterapi Keempat pasien menjalani skrining metoda malnutrition screening tool MST dengan nilai ge 2 kemudian mendapatkan tatalaksana nutrisi yang sesuai dengan kondisi pasien Kebutuhan basal masing masing pasien dihitung menggunakan rumus Harris Benedict dan kebutuhan total dihitung dengan cara mengalikan kebutuhan basal dengan faktor stres yang sesuai dengan kondisi klinik pasien Kebutuhan protein 1 5 2 5 g kgBB hari dan lemak sebesar 25 30 kebutuhan total sesuai kondisi pasien Pemantauan yang dilakukan mencakup keluhan subjektif klinis dan tanda vital gejala efek samping antropometri dan kapasitas fungsional Berdasarkan hasil pemantauan pada keempat pasien tatalaksana nutrisi yang diberikan dapat meningkatkan jumlah asupan dan meningkatkan berat badan pada pasien 1 2 dan 3 sedangkan pada pasien 4 dapat meminimalkan penurunan berat badan Tatalaksana nutrisi pada keempat pasien juga dapat meningkatkan kapasitas fungsional dan menunjang kelangsungan terapi Sebagai kesimplan tatalaksana nutrisi pada pasien KKL stadium IV yang menjalani radioterapi bersifat individual disesuaikan dengan kondisi metabolik dan efek samping terapi disertai dengan konseling dan edukasi untuk pasien dan keluarga Tatalaksana nutrisi yang baik dapat menunjang kelangsungan terapi pasien sehingga membantu memperpanjang angka harapan hidup pasien

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Head and neck cancer HNC is a malnutrition related disease Tumor mass metabolic alterations and radiation side effects like nausea vomiting mucositis xerostomia and dysphagia can decrease nutrition intake and leads to malnutrition The aim of nutritional management on HNC patients undergoing radiotherapy is to improve and maintain nutritional status prevent therapy interruption improve and increase patient's quality of life and life expectancy The nutritional management contains of macronutrient micronutrient and nutrition specific along with counceling and education This case series discusses the nutritional management in four cases of stage IV HNC undergoing radiotherapy The patients were screened by malnutrition screening tool MST with score ge 2 then given the provision nutritional management Patients'needs were calculated using the Harris Benedict formula by multiplying basal energy requirement with stress factor according to the patient's condition Protein need were 1 5 2 5 g kgBW and fat 25 30 of total energy requirement matched with metabolic conditions Monitoring includes subjective complaints clinical and vital signs symptoms of treatment's side effects antropometry and functional capacity Based on the monitoring results nutritional management of these four patients could increase dietary intake promote weight loss in patients 1 2 and 3 and minimize weight loss in patient 4 The treatment also could improve the patients'functional capacity and support continuation of radiotherapy Nutritional management of stage IV HNC patients undergoing radiotherapy is individualized tailored to the metabolic conditions and treatment's side effects along with counseling and education to patients and families With an adequate nutritional management it can support the continuity of therapy thus improving the patients'life expectancy"

"[ABSTRAKLatar Belakang : Inkontinensia urin sampai saat ini masih menjadi masalah bagimasyarakat dunia. Telah ada tiga penelitian yang membandingkan penurunanleher kandung kemih pada kelompok inkontinensia urin jenis stres dankontinensia. Namun penelitian mengenai perbandingan tersebut belum ada diIndonesia sementara hasil penelitian yang telah ada belum dapat digeneralisirpada populasi di Indonesia. Berdasarkan hal tersebut peneliti ingin mengetahuiapakah terdapat perbedaan rerata penurunan leher kandung kemih kelompokinkontinensia urin jenis stres dan kontinensia di Indonesia dengan perbedaan padatiga buah aspek, yaitu aspek penegakan diagnosis, kelompok pembanding, danpengukuran.Tujuan : Menganalisis perbedaan rerata mobilitas leher kandung kemih padainkontinensia urin jenis stres dan kontinensia.Metode : Penelitian ini merupakan penelitian observasional. Untuk menjawabpertanyaan penelitian utama dan tambahan digunakan desain deskriptif potonglintang. Populasi target dalam penelitian ini adalah semua perempuan yangmengalami inkontinensia urin jenis stres dan kontinensia di Indonesia. Populasiterjangkau penelitian ini adalah semua perempuan yang mengalami inkontinensiaurin jenis stres dan kontinensia masing-masing 37 orang yang berobat ke UnitRawat Jalan Poliklinik Ginekologi RSCM periode Februari 2014 sampai Januari2015.Hasil : Rerata jarak leher kandung kemih ke simfisis pubis saat istirahat, saatvalsava dan mobilitas leher kandung kemih pada inkontinensia urin jenis stresberturut-turut adalah 26,9 ( SB 3,2) mm, 5 ( -29 - 22) mm dan 24,3 (SB 7,9) mm.Rerata jarak leher kandung kemih ke simfisis pubis saat istirahat, saat valsava danmobilitas leher kandung kemih pada kontinensia berturut-turut adalah 26,9 (SB3,2) mm, 17,6 (SB 5,3) mm dan 10 (SD 4,1) mm. Rerata jarak leher kandungkemih ke simfisis pubis saat valsava pada inkontinensia urin jenis stres lebih kecildibandingkan kontinensia 6,3 (SB 7,1) mm VS 16,3 (SB 5,2) mm, p=0,0001.Rerata mobilitas leher kandung kemih pada inkontinensia urin jenis stres lebihbesar dibandingkan kontinensia 20,8 ( SB 7,0) mm VS 10,0 (SD 4,8) mm,p=0,0001.Kesimpulan : Rerata jarak leher kandung kemih ke simfisis pubis saat valsavapada inkontinensia urin jenis stres lebih kecil dibandingkan kontinensia. Reratamobilitas leher kandung kemih pada inkontinensia urin jenis stres lebih besardibandingkan kontinensia.

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ABSTRACTBackground : Stress urinary incontinence still be the world problem. Variousstudies compared decreasing bladder neck on stress urinary incontinence andcontinence have been done. Research with the same purpose has not been done inIndonesia. Based on that, need to study how the comparison decreasing ofbladder neck between stress urinary incontinence and continence groups inIndonesia with a difference in three aspects, such as diagnostic criteria,comparised group, and the observer.Aim : To analize difference bladder neck mobility on stress urinry incontinenceand continence.Methods : This study was an observational study. Main and additional researchquestions using a cross-sectional design . The target population in this study wereall women who undergo stress urinary incontinence and continence in Indonesia .The population of this study was affordable to all women who undergo stressurinary incontinence and continence were treated to the Outpatient Clinic ofGynecology Unit of Ciptomangunkusumo Hospital in the period Februari 2014 toJanuary 2015.Results : Mean of distance of bladder neck to the symphysis pubic at rest, valsavaand bladder neck mobility on stress urinary incontinence were 26,9 (SD 3,2) mm,5 (-29 - 22) mm and 24,3 (SD 7,9) mm. Mean of distance of bladder neck to thesymphysis pubic at rest, at valsalva and bladder neck mobility on continence were26,9 (SD 3,2) mm, 17,6 (SD 5,3) mm and 10,0 (SD 4,1) mm. There was nodifferences between the distance of bladder neck to the symphysis pubic at rest onstress urinary incontinence and continence 27,1 (SD 3,3) mm VS 26,3 (SD 3,5)mm, p=0,523. Mean of distance of bladder neck to the symphysis pubic atvalsava on stress urinary incontinenc was lower than continence 6,3 (SD 7,1) mmVS 16,3 (SD 5,2) mm, p=0,0001. Mean of bladder neck mobility on stress urinaryincontinence was greater than continence 20,8 ( SD 7,0) mm VS 10,0 (SD 4,8)mm, p=0,0001.Conclusion : Mean of distance of the bladder neck to the symphysis pubic atvalsava on stress urinary incontinenc was lower than continence. Mean ofbladder neck mobility on stress urinary incontinence was greater than continence, Background : Stress urinary incontinence still be the world problem. Variousstudies compared decreasing bladder neck on stress urinary incontinence andcontinence have been done. Research with the same purpose has not been done inIndonesia. Based on that, need to study how the comparison decreasing ofbladder neck between stress urinary incontinence and continence groups inIndonesia with a difference in three aspects, such as diagnostic criteria,comparised group, and the observer.Aim : To analize difference bladder neck mobility on stress urinry incontinenceand continence.Methods : This study was an observational study. Main and additional researchquestions using a cross-sectional design . The target population in this study wereall women who undergo stress urinary incontinence and continence in Indonesia .The population of this study was affordable to all women who undergo stressurinary incontinence and continence were treated to the Outpatient Clinic ofGynecology Unit of Ciptomangunkusumo Hospital in the period Februari 2014 toJanuary 2015.Results : Mean of distance of bladder neck to the symphysis pubic at rest, valsavaand bladder neck mobility on stress urinary incontinence were 26,9 (SD 3,2) mm,5 (-29 - 22) mm and 24,3 (SD 7,9) mm. Mean of distance of bladder neck to thesymphysis pubic at rest, at valsalva and bladder neck mobility on continence were26,9 (SD 3,2) mm, 17,6 (SD 5,3) mm and 10,0 (SD 4,1) mm. There was nodifferences between the distance of bladder neck to the symphysis pubic at rest onstress urinary incontinence and continence 27,1 (SD 3,3) mm VS 26,3 (SD 3,5)mm, p=0,523. Mean of distance of bladder neck to the symphysis pubic atvalsava on stress urinary incontinenc was lower than continence 6,3 (SD 7,1) mmVS 16,3 (SD 5,2) mm, p=0,0001. Mean of bladder neck mobility on stress urinaryincontinence was greater than continence 20,8 ( SD 7,0) mm VS 10,0 (SD 4,8)mm, p=0,0001.Conclusion : Mean of distance of the bladder neck to the symphysis pubic atvalsava on stress urinary incontinenc was lower than continence. Mean ofbladder neck mobility on stress urinary incontinence was greater than continence]"

"Imaging is crucial in the multidisciplinary approach to head and neck cancer management. The rapid technological development of recent years makes it necessary for all members of the multidisciplinary team to understand the potential applications, limitations, and advantages of existing and evolving imaging technologies. It is equally important that the radiologist has sufficient clinical background knowledge to understand the clinical significance of imaging findings. This book provides an overview of the findings obtained using different imaging techniques during the evaluation of head and neck neoplasms, both before and after therapy. All anatomic areas in the head and neck are covered, and the impact of imaging on patient management is discussed in detail. The authors are recognized experts in the field, and numerous high-quality images are included. This second edition provides information on the latest imaging developments in this area, including the application of PET-CT and diffusion-weighted magnetic resonance imaging."

"Latar belakang: Kanker kepala dan leher KKL di Indonesia prevalensinya cukup tinggi mencapai 4,7 per 100.000 penduduk. Ada penelitian melaporkan ERCC6 G399A sebagai hal baru polimorfisme nukleotida tunggal yang berkaitan dengan kanker rongga mulut. ERCC6 Excision Repair Cross Complementing 6 memiliki peran dalam transkripsi dan perbaikan eksisi nukleotida Nucleotide Excision Repair.Tujuan: Mendeteksi pola polimorfisme gen ERCC6 G399A pada penderita KKL yang dibandingkan dengan individu sehat kontrol.Metode: Studi deskriptif yang dianalisa menggunakan metode PCR-RFLP dengan sample 50 penderita KKL dan 50 individu sehat.Hasil: Presentase polimorfisme pada sampel KKL 78 dan pada kontrol 84.Kesimpulan: Terlihat adanya pola polimorfisme ERCC6 G399A pada penderita KKL namun tidak ada perbedaan bermakna antara distribusi polimorfisme dengan KKL.

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Background Pevalence of head and neck cancer in Indonesia quite high around 4.7 100,000. A study reported ERCC6 G399A as novel single nucleotide polymorphism associated with oral cancer. ERCC6 Excision Repair Cross Complementing 6 plays a role in transcription and nucleotide excision repair NER.Objective Detect ERCC6 G399A polymorphism in patients with head and neck cancer HNC compared with healthy individuals control.Methods This descriptive study analysed with PCR RFLP method with sample of 50 HNC patients and 50 control patients.Results The precentage of polymorphism in HNC was 78 , and in healthy control was 84 .Conclusion There are ERCC6 G399A polymorphism in HNC but no significant difference between ERCC6 G399A polymorphism and HNC."

"Biomassa adalah produk organik dari makhluk hidup dan berasal dari perkebunan atau pertanian, hutan, ternak atau bahkan sampah, juga dapat disediakan karena kandungan karbon yang tinggi dari kompon. Biomassa lebih lanjut dapat disajikan ke dalam bahan bakar dan pengawet, namun dari sudut pandang ekonomi, bahan bakar yang didapat dari penawaran biomassa kontras dengan pemanfaatannya sebagai pengawet, sehingga biomassa sebagai pengawet adalah Asap Cair. Asap cair diperoleh dari pendinginan uap proses pirolisis. Pirolisis adalah metode termokimia untuk mendekomposisi senyawa kimia dengan menaikkan suhu bahan baku. Proses pirolisis memerlukan tiga alat utama, ada pemanas, pipa penghubung yang biasa dikenal dengan Neck Reactor, dan LCS (Liquid Collecting System). Setelah bahan baku dan berubah menjadi uap, itu akan mengalir melalui kredit untuk didinginkan, sehingga asap cair bisa diperoleh. Pada suatu sudut tertentu reaktor leher akan mengubah suhu dan kecepatan uap. Untuk mengirimkan uap LCS melalui perlu pipa bengkok untuk menghubungkan mereka. Namun, data kinerja pipa masih belum diketahui bengkoknya. Oleh karena itu, simulasi menggunakan Ansys CFX adalah hasil dari mengoptimalkan pengiriman uap. Alasan menggunakan Ansys CFX adalah karena telah ditulis sebelumnya. Variasi reaktor leher diperlukan. Akan ada tiga jenis reaktor leher untuk disimulasikan yaitu 70° seperti aslinya dari percobaan, 60° dan 85°. Hasil dari simulasi ini dapat dihasilkan dalam dua jenis, tampilan samping dan fokus pada Reaktor Leher dan Outlet Pipa. Setelah mengumpulkan hasil dengan data dari Ansys CFX, dari tabel yang menunjukkan kondisi reaktor leher dibuat. Data yang diperoleh dapat digunakan untuk meningkatkan desain reaktor leher di masa depan.

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Biomass is organic product of living things and come from plantation crops or agriculture, forests, livestock or even garbage, also can provide heat because of the hdycarbon content of the compond. Further biomass can be serve into fuel and preservative, however at the point when seen from the economic viewpoint, fuel got from biomass has an offering worth contrasted with its utilization as an preservative, Thus biomass as preservative is Liquid Smoke. Liquid smoke is obtained from the steam cooling of the pyrolysis process.

Pyrolysis is a thermochemical method for decomposing chemical csompounds by rising the temperature on raw materials. Pyrolysis process is need three major tools, there are heater, connecting pipe or usually known as Neck Reactor, and LCS ( Liquid Collecting System). After raw material is heated and change into vapor, it will flow through neck reactor than goes to LCS to be cooled, thus the liquid smoke can be obtain. At some angle of neck reactor will change the temperature and velocity of the vapor.

To deliver the vapor through LCS need a bend pipe to connect them. However, the data for performance bend pipe still unknown. Therefore simulation using Ansys CFX is needed to simulate and gather the results to make optimation of deliver the vapor. The reason of using Ansys CFX is because this application is able to simulate flow with the effect of ambient temperature and can get the details of data for each notes that has been specify beforehand. By trying to get a good amount of yield at the product, the variation of neck reactor is needed. There will be three type of neck reactor to simulate which is 70° as the original from experiment, 60° and 85°.

The results from this simulation can be generated in to two type, side view and focus on Neck Reactor and Outlet Pipe. After collected the results with data from Ansys CFX, than the table that shows the condition of neck reactor is created. The data obtained may be utilized to improve the better and safer  designs for neck reactor in the future."

"Head and Neck Surgery and Oncology, by Drs. Jatin P. Shah Snehal G. Patel, and Bhuvanesh Singh, offers you authoritative, multidisciplinary guidance on the latest diagnostic and multidisciplinary therapeutic approaches for head and neck cancer. With this medical reference book, you'll have all the help you need to offer your patients the best possible prognoses and to optimally preserve and restore form and function. Overcome any challenge in head and neck surgery with comprehensive coverage of the scalp, skull base, paranasal sinuses, oral cavity, pharynx, larynx, cervical lymph"

"For practitioners at all stages of experience, diseases of the parathyroid glands are not easily deciphered. There are many subtleties to its pathology and diagnosis. Today, the wealth of new information from molecular medicine makes it very challenging for the individual practitioner to have a complete picture of these entities. Diseases of the parathyroid glands addresses these issues by offering a concise, user-friendly text that provides state-of-the-art background on mineral physiology and its regulation and couples this to a variety of clinical topics of parathyroid gland pathology. Introductory chapters cover calcium regulation and parathyroid gland physiology, drawing upon many of the new aspects of glandular control mechanisms beyond the classical ones associated with calcium alone. The majority of the text covers clinical problems. Although most chapters address problems in adult medicine, three separate chapters are devoted to pediatric problems of hyper- and hypoparathyroidsm and parathormone resistance states. In addition, there are several chapters on less common but equally challenging problems such as parathyroid cancer, calciphylaxis, cystic lesions of the glands, and ectopic glandular disease. The final chapters detail the techniques of parathyroid gland imaging and surgical treatment. "