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"Hiperurisemia atau yang disebut peningkatan asam urat bisa menjadi risiko untuk terjadinya penyakit lain seperti stroke. Stroke diketahui berhubungan juga dengan nilai viskositas darah. Peneliti ingin mengetahui lebih lanjut tentang hubungan antara viskositas darah dengan hiperurisemia. Untuk mengetahui viskositas darah di laboratorium dengan harga alat yang mahal, maka dibuat alat mikrokapiler digital untuk mempermudah pasien mengecek viskositas darah.Maka dari itu dilakukan penelitian dengan menggunakan alat mikrokapiler digital untuk melihat hubungan pasien penderita hiperurisemia dengan hiperviskositas darah. Penelitian ini menggunakan desain cross-sectional dengan mengambil data sekunder dari pemeriksaan kadar asam urat dan viskositas darah (n = 193) pada pasien yang datang ke Pos Binaan Terpadu (Posbindu) binaan Departemen Ilmu Kesehatan Komunitas Fakultas Kedokteran Universitas Indonesia di bulan Januari dan Maret 2015 dan data orang sehat dari Al Rasyid, dkk8.Pada hasil analisis data diketahui terdapat proporsi pasien hiperurisemia sebesar 21,2% (n = 41) dan pasien hiperviskositas 86,5% (n=167). Pada hasil uji Chi ? Square terdapat perbedaan bermakna antara pasien hiperurisemia dengan orang sehat dari data Al Rasyid, dkk8 sebagai kontrol. Digunakan uji korelasi Spearman untuk menganalisis hubungan hiperurisemia dengan hiperviskositas darah. Didapatkan hasil uji korelasi yaitu tidak terdapat hubungan yang bermakna diantara nilai asam urat dengan viskositas darah pasien yang datang ke Posbindu.

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Hyperuricemia, or the increasing of uric acid level above normal level, is a risk factor for many diseases, such as stroke. Stroke is associated with blood viscosity. The measurement of blood viscosity can only be done in laboratory setting and the equipment is expensive, therefore digital microcapillary instrument is made to measure blood viscosity practically.The aim of this research was to determine the association between hyperuricemia and blood viscosity which is measured using digital microcapillary instrument. This cross-sectional study used secondary data from the blood viscosity and uric acid level of 193 people who came to Pos Binaan Terpadu (Posbindu) of Departemen Ilmu Kesehatan Komunitas Faculty of Medicine University of Indonesia between January and March 2015 and used secondary data of healthy patient from Al Rasyid,et al8. The proportion of hyperuricemia patients in this research is 21,2% (n=41) and 86,5% hyperviscosity patients (n=167). Hyperuricemia patients and healthy people from secondary data Al Rasyid,et al8 as control was analyzed using Chi - Square test and showed a significant difference. The association of hyperuricemia and blood hyperviscosity was then analyzed using Spearman test.The result showed that hyperuricemia and blood hyperviscosity was statistically insignificant with patient who came to Posbindu.hyperuricemia, hyperviscosity, uric acid, stroke, digital microcapillary instrumen."

"Pada diabetes melitus terjadi hiperglikemia kronik yang dapat menyebabkan komplikasi penyakit kardiovaskular, salah satunya adalah stroke. Pada stroke terjadi peningkatan nilai viskositas darah. Tujuan penelitian ini adalah untuk mencari hubungan antara DM dengan viskositas darah. Penelitian ini adalah penelitian cross-sectional yang melibatkan tiga kelompok subjek penelitian, yaitu pasien DM dan kontrol non DM yang berkunjung ke Posbindu Kelurahan Pisangan Timur pada bulan Januari dan Maret 2015, serta kontrol sehat dari hasil penelitian Rasyid tahun 2014. Data yang digunakan adalah data sekunder hasil pemeriksaan viskositas darah dengan Mikrokapiler Digital® dan pemeriksaan glukosa darah sewaktu. Mikrokapiler Digital® merupakan alat baru pengukur nilai viskositas darah yang mudah digunakan. Apabila dibandingkan dengan kontrol sehat, didapatkan perbedaan yang bermakna antara viskositas darah pasien DM dan kontrol sehat (p = 0,000). Berdasarkan data Posbindu didapatkan korelasi yang tidak bermakna antara kadar glukosa darah dan nilai viskositas darah (p = 0,221), demikian pula antara DM dengan viskositas darah (p = 0,566). Hal tersebut kemungkinan disebabkan adanya faktor risiko lain yang dapat mempengaruhi hasil viskositas darah pada kontrol non DM. Penelitian lanjutan diperlukan dengan memperhitungkan faktor perancu.

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Chronic hyperglycemia in diabetes mellitus can lead cardiovascular disorder complications, which one of them is stroke. There is increased blood viscosity level in stroke. The aim of this study is to find the relationship between diabetes mellitus and blood viscosity. This is a cross sectional study involving three groups: diabetes patients and non-diabetes controls visiting Posbindu Pisangan Timur in January and March 2015, also healthy controls from Rasyid study in 2014. The data used is secondary data of blood viscosity examined by Digital Microcapillary® and level of non-fasting blood sugar. Digital Microcapillary® is a new tool to measure blood viscosity value that is easy to use. Compare to healthy controls, there is a significant difference between blood viscosity of diabetes patients and healthy controls (p = 0,000). Posbindu data showed no significant correlation between blood glucose level and blood viscosity (p = 0,221), also between diabetes mellitus and blood viscosity (p = 0,566). It may be caused by the presence of other risk factors that may influence the results of blood viscosity in non-diabetes controls. Further study is needed and should consider all confounding conditions."

"Hiperkolesterolemia merupakan salah satu faktor risiko terjadinya stroke. Diketahui bahwa nilai viskositas darah pada pasien stroke adalah diatas nilai normal. Pada penelitian ini peneliti ingin mengetahui apakah terdapat hubungan hiperkolesterolemia sebagai faktor risiko stroke dengan meningkatnya nilai viskositas darah. Pemeriksaan viskositas darah diukur menggunakan Mikrokapiler Digital®, yaitu suatu alat untuk mengetahui nilai viskositas darah yang mudah dilakukan dan tidak mengeluarkan biaya besar. Penelitian ini menggunakan desain cross-sectional. Data yang digunakan adalah data sekunder yang diperoleh dari rekam medis pasien Pos Binaan Terpadu (Posbindu) dan data subjek sehat dari penelitian sebelumnya oleh Al Rasyid dkk. Pasien dengan kolesterol tinggi dianggap sebagai subjek dengan hiperkolesterolemia dan pasien dengan kolesterol normal dianggap sebagai kontrol normal. Pada hasil analisis data diketahui proporsi pasien hiperkolesterolemia sebesar 51,3% (n=98) dan pasien hiperviskositas 88,5% (n=169). Berdasarkan hasil analisis data didapatkan hasil perbedaan bermakna antara nilai viskositas darah dengan pasien hiperkolesterolemia dengan subjek sehat dan tidak didapatkan perbedaan secara statistik antara pasien hiperkolesterolemia dengan kontrol normal. Kolesterol merupakan faktor risiko terjadinya hiperviskositas. Kontrol yang dianggap normal dari Posbindu tidak dapat mewakili populasi.

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Hypercholesterolemia is one of the factors causing Stroke. It is known that blood viscosity in stroke's patient is above the normal level. In this observation, the observer wants to know if there is a relationship between Hypercholesterolemia as the factor causing stroke with the increase on blood viscosity. The measurement of blood viscosity is measured by using Mikrokapiler Digital®, a tool used to know the level of blood viscosity in an easy and less costly way.

This observation uses the cross-sectional design. Data used in the observation is a secondary data, and it is gathered from the medical records of Pos Binaan Terpadu (Posbindu) and the the healthy subject data from the previous observation by Al Rasyid et al. Patients with high cholesterol are subjected to Hypercholesterolemia, and patients with normal level of cholesterol are subjected to normal control. On the result of the analysis, it is shown that the proportion of Hypercholesterolemia patient is at 51,3% (n=98) and Hyperviscocity patient at 88,5% (n=169).

Based on the result of the analysis, there is a significant difference between the blood viscosity with patients adopting hypercholesterolemia with healthy subject, and there is no significant difference statistically between patients adopting Hypercholesterolemia with normal control. Cholesterol is one of the factors causing hyperviscocity. Control is considered normal from Posbindu and it doens represent population."

"ABSTRAK Diagnosis infark miokard akut ditegakkan apabila memenuhi 2 dari 3 kriteria, yaitu klinis, perubahan EKG, dan peningkatan kadar penanda biokimia jantung. Troponin merupakan penanda biokimia jantung yang spesifik untuk infark miokard, akan tetapi memiliki keterbatasan yaitu kurang sensitif apabila dilakukan pada fase awal karena troponin akan meningkat dalam darah setelah 4 -10 jam setelah infark miokard. Copeptin merupakan penanda stres endogen, yang dapat meningkat pada awal onset infark miokard akut, namun kurang spesifik. Penelitian tentang copeptin-us sebagai penanda biokimia jantung masih sedikit dan di Indonesia penelitian tentang copeptin-us sebagai penanda biokimia jantung belum pernah dilakukan.Penelitian ini mengikutsertakan 91 pasien tersangka sindrom koroner akut yang terbagi atas 15 (16,5%) NSTEMI, 43 (47,3%) UA, dan 33 (36,3%) non SKA. Diagnosis ditegakkan oleh dokter di IGD RS Jantung dan Pembuluh Darah Harapan Kita. Karakteristik pasien yang memenuhi kriteria inklusi dan eksklusi dicatat dan kemudian dilakukan pemeriksaan copeptin-us.Nilai rerata copeptin-us pada NSTEMI adalah 151,80 ± 130,03 pmol/L, median copeptin-us pada UA adalah 7,12(1,145 ? 62,23) pmol/L, dan rerata copeptin-us pada non SKA adalah 7,36 ± 4,17 pmol/L. Nilai cut off copeptin-us untuk membedakan NSTEMI dengan UA/non SKA adalah 13,97 pmol/L. Area under curve (AUC) kombinasi hs-cTnT saat masuk rumah sakit dengan copeptin-us adalah 0,941 (0,882 ? 1,00), hs-cTnT saat masuk rumah sakit 0,885 (0,790 ? 0,98), dan AUC hs-cTnT 3 jam kemudian adalah 0,925 (0,824 ? 1,00). Nilai median hs-cTnT saat masuk RS pada NSTEMI adalah 114(29-1102) pg/mL, pada UA adalah 16 (3-3352) pg/mL, dan pada non SKA adalah 6(3-366) pg/mL. Nilai median hs-cTnT 3 jam pada NSTEMI adalah 488 (81-18437) pg/mL, pada UA 14(3-2224) pg/mL, dan pada non SKA adalah 3(3-679) pg/mL. Kombinasi copeptin-us ≥ 13,97 pmol/L dan hs-cTnT ≥ 14 pg/mL dan untuk membedakan NSTEMI dengan UA/non SKA memberikan sensitivitas 100%, spesifisitas 90,78%, NPP 68,18%, dan NPN 100%.Uji diagnostik kombinasi copeptin-us dan hs-cTnT saat masuk RS lebih baik dibandingkan hs-cTnT saat masuk RS saja dan dapat digunakan untuk rule out NSTEMI.ABSTRACT Diagnosis of acute myocardial infarction is made when two of the followed criterias are met; clinical, ECG changes, and increased levels of cardiac biochemical markers. Troponin is a specific cardiac biochemical marker for myocardial infarction but has limitation. It is less sensitive when measured in the early phase, because troponin will increase in blood after 4 -10 hours post myocardial infarction. Copeptin is an endogenous stress marker, it level increases in the early onset of acute myocardial infarction but study on copeptin-us as cardiac biochemical marker are limited and in Indonesia there is no study on copeptin-us has been done.In this study 91 consecutive patients fulfilled the inclusion and exclusion criteria, consist of 15 (16,5%) NSTEMI, 43 (47,3%) unstable angina, and 33 (36,3%) non acute coronary syndrome. Diagnosis was made by the emergency physician at Harapan Kita cardiovascular centre. Characteristics of these subject were recorded and then the copeptin-us levels were measured.The mean value of copeptin-us in NSTEMI is 151,80 ± 130,03 pmol/L, median copeptin-us in UA is 7,12(1,145 ? 62,23) pmol/L, and the mean copeptin-us in non ACS is 7,36 ± 4,17 pmol/L. Cut off value of copeptin-us to distinguish NSTEMI from UA/non ACS is 13,97 pmol/L. Area under curve of the combination hs-cTnT on admission and copeptin-us is 0,941 (0,882 ? 1,00), hs-cTnT on admission is 0,885 (0,790 ? 0,98), and hs-cTnT 3 hours laters is 0,925 (0,824 ? 1,00). Median value hs-cTnT on admission in NSTEMI is 114(29-1102) pg/mL, in UA is 16 (3-3352) pg/mL, and in non ACS is 6(3-366) pg/mL. Median hs-cTnT 3 hours in NSTEMI is 488(81-18437) pg/mL, in UA is 14(3-2224) pg/mL, and in non ACS is 3(3-679) pg/mL. Combination of copeptin-us ≥ 13,97 pmol/L and hs-cTnT ≥14 pg/mL to distinguish NSTEMI from UA/non ACS has sensitivity 100%, specificity 90,78%, PPV 68,18%, and NPV 100%.The diagnostic value of combination on copeptin-us and hs-cTnT is better than only hs-cTnT on admission so that it can be used to rule out NSTEMI.;Diagnosis of acute myocardial infarction is made when two of the followed criterias are met; clinical, ECG changes, and increased levels of cardiac biochemical markers. Troponin is a specific cardiac biochemical marker for myocardial infarction but has limitation. It is less sensitive when measured in the early phase, because troponin will increase in blood after 4 -10 hours post myocardial infarction. Copeptin is an endogenous stress marker, it level increases in the early onset of acute myocardial infarction but study on copeptin-us as cardiac biochemical marker are limited and in Indonesia there is no study on copeptin-us has been done.In this study 91 consecutive patients fulfilled the inclusion and exclusion criteria, consist of 15 (16,5%) NSTEMI, 43 (47,3%) unstable angina, and 33 (36,3%) non acute coronary syndrome. Diagnosis was made by the emergency physician at Harapan Kita cardiovascular centre. Characteristics of these subject were recorded and then the copeptin-us levels were measured.The mean value of copeptin-us in NSTEMI is 151,80 ± 130,03 pmol/L, median copeptin-us in UA is 7,12(1,145 ? 62,23) pmol/L, and the mean copeptin-us in non ACS is 7,36 ± 4,17 pmol/L. Cut off value of copeptin-us to distinguish NSTEMI from UA/non ACS is 13,97 pmol/L. Area under curve of the combination hs-cTnT on admission and copeptin-us is 0,941 (0,882 ? 1,00), hs-cTnT on admission is 0,885 (0,790 ? 0,98), and hs-cTnT 3 hours laters is 0,925 (0,824 ? 1,00). Median value hs-cTnT on admission in NSTEMI is 114(29-1102) pg/mL, in UA is 16 (3-3352) pg/mL, and in non ACS is 6(3-366) pg/mL. Median hs-cTnT 3 hours in NSTEMI is 488(81-18437) pg/mL, in UA is 14(3-2224) pg/mL, and in non ACS is 3(3-679) pg/mL. Combination of copeptin-us ≥ 13,97 pmol/L and hs-cTnT ≥14 pg/mL to distinguish NSTEMI from UA/non ACS has sensitivity 100%, specificity 90,78%, PPV 68,18%, and NPV 100%.The diagnostic value of combination on copeptin-us and hs-cTnT is better than only hs-cTnT on admission so that it can be used to rule out NSTEMI.;Diagnosis of acute myocardial infarction is made when two of the followed criterias are met; clinical, ECG changes, and increased levels of cardiac biochemical markers. Troponin is a specific cardiac biochemical marker for myocardial infarction but has limitation. It is less sensitive when measured in the early phase, because troponin will increase in blood after 4 -10 hours post myocardial infarction. Copeptin is an endogenous stress marker, it level increases in the early onset of acute myocardial infarction but study on copeptin-us as cardiac biochemical marker are limited and in Indonesia there is no study on copeptin-us has been done.In this study 91 consecutive patients fulfilled the inclusion and exclusion criteria, consist of 15 (16,5%) NSTEMI, 43 (47,3%) unstable angina, and 33 (36,3%) non acute coronary syndrome. Diagnosis was made by the emergency physician at Harapan Kita cardiovascular centre. Characteristics of these subject were recorded and then the copeptin-us levels were measured.The mean value of copeptin-us in NSTEMI is 151,80 ± 130,03 pmol/L, median copeptin-us in UA is 7,12(1,145 ? 62,23) pmol/L, and the mean copeptin-us in non ACS is 7,36 ± 4,17 pmol/L. Cut off value of copeptin-us to distinguish NSTEMI from UA/non ACS is 13,97 pmol/L. Area under curve of the combination hs-cTnT on admission and copeptin-us is 0,941 (0,882 ? 1,00), hs-cTnT on admission is 0,885 (0,790 ? 0,98), and hs-cTnT 3 hours laters is 0,925 (0,824 ? 1,00). Median value hs-cTnT on admission in NSTEMI is 114(29-1102) pg/mL, in UA is 16 (3-3352) pg/mL, and in non ACS is 6(3-366) pg/mL. Median hs-cTnT 3 hours in NSTEMI is 488(81-18437) pg/mL, in UA is 14(3-2224) pg/mL, and in non ACS is 3(3-679) pg/mL. Combination of copeptin-us ≥ 13,97 pmol/L and hs-cTnT ≥14 pg/mL to distinguish NSTEMI from UA/non ACS has sensitivity 100%, specificity 90,78%, PPV 68,18%, and NPV 100%.The diagnostic value of combination on copeptin-us and hs-cTnT is better than only hs-cTnT on admission so that it can be used to rule out NSTEMI."

"ABSTRAKLatar Belakang: Program Skrining Hipotiroid Kongenital Nasional di Indonesia menunjukkan angka insidensi hipotiroid kongenital cukup tinggi. Salah satu faktor risiko yang bertanggung jawab adalah bayi berat lahir rendah. Pada bayi berat lahir rendah, maturitas organ relatif belum matur, sehingga mengganggu fungsi organ termasuk kelenjar tiroid dan hipofisis.Tujuan: Penelitian cross-sectional ini bertujuan untuk mengetahui persentase bayi berat lahir rendah di Indonesia, nilai rujukan TSH neonatus berdasarkan berat lahir, korelasi antara berat lahir bayi dengan fungsi kelenjar tiroid, serta hubungan antara status berat lahir dengan nilai rerata TSH neonatus.Metode: Dari 2.987 subjek yang didapatkan dari 10 provinsi pada program skrining hipotiroid kongenital nasional pada bulan Mei sampai Juni 2017 di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, sebanyak 1.700 subjek memenuhi kriteria inklusi dan eksklusi yang diperoleh melalui teknik consecutive sampling. Nilai TSH didapatkan melalui metode Fluorometri dengan reagen Labsystem. Subjek dibagi menjadi dua kelompok yaitu 1.573 subjek untuk kelompok bayi berat lahir normal dan 127 subjek untuk kelompok bayi berat lahir rendah. Sampel kemudian dianalisis menggunakan uji Mann-Whitney dengan SPSS versi 20.0 untuk diketahui hubungannya dengan nilai rerata TSH neonatus dan MedCalc versi 17.9 untuk menghitung nilai rujukan TSH neonatus.

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ABSTRACTBackground: National Congenital Hypothyroidism Screening Program in Indonesia showed high incidence of Congenital Hypothyroidism. One of responsible risk factors is low birth weight. In low birth weight, organ maturity is relatively immature, thus disrupting organ function including thyroid and hypophysis gland. Objective: This cross-sectional study was aimed to determine the percentage of low birth weight in Indonesia, neonatal TSH reference values based on birth weight, the correlation between birth weight and thyroid gland function, as well as the association between birth weight status with neonatal TSH level.Methods: Of the 2,987 subjects obtained from 10 provinces in national congenital hypothyroidism screening program data from May to June 2017 in Dr. Cipto Mangunkusumo National General Hospital, as many as 1,700 subjects fulfilled the inclusion and exclusion criteria obtained through consecutive sampling. TSH value was obtained by Fluorometri method with Labsystem reagent. Subjects were divided into two groups, 1,573 subjects for normal birth weight and 127 subjects for low birth weight. Then, samples were analyzed by Mann-Whitney test with SPSS version 20.0 to investigate association to neonatal TSH level and MedCalc version 17.9 to calculate neonatal TSH reference values.Results: Low birth weight was 7.5%. The TSH reference value in all neonates, normal birth weight, and low birth weight were 1.40-8.04 mU/L with median 3.10 (1.00-19.80), 1.50-8.06 mU/L with median 3.20 (1.00-19.80), and 1.00-9.06 mU/L with median 2.50 (1.00-13.80) respectively. There was a positive significant correlation between low birth weight and thyroid function (r = 0.367, P<0.001). There was also a significant difference between birth weight status with neonatal TSH level (P<0.001). Discussion: The percentage of low birth weight in Indonesia is half the percentage of babies born in the world according to WHO. The neonatal TSH reference values in Indonesia is close to 10 mU/L as cut off in developed countries. Birth weight influences neonatal TSH level. It correlates with delayed in hypothalamus-hypophysis-thyroid axis maturity."

"ABSTRAKNilai rujukan thyroid stimulating hormone TSH penting digunakan dalam skrining penyakit hipotiroid kongenital HK yang saat ini insidensinya di Indonesia lebih tinggi dibandingkan insidensi di dunia. Nilai rujukan merupakan nilai normal yang ditentukan dari individu sehat dan dapat dipengaruhi kondisi fisiologis, seperti usia dan jenis kelamin, dan kondisi patologis. Penelitian cross-sectional ini bertujuan untuk mengetahui perbandingan nilai rujukan TSH neonatus di Indonesia berdasarkan kelompok usia dan jenis kelamin. Sebanyak 3.320 sampel diperoleh dari data skrining hipotiroid kongenital SHK Nasional bulan Mei-Juli 2017 dengan metode fluorometri dengan reagen Labsystem di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo RSUPN-CM . Pengelompokkan total sampel dilakukan berdasarkan dua variabel bebas, yaitu lima kelompok usia dan kelompok jenis kelamin, dan dianalisis perbedaan nilai TSH antar kelompok tiap variabel bebas menggunakan SPSS versi 20. Interval rujukan TSH berdasarkan kedua variabel bebas akan dianalisis menggunakan MedCalc versi 17.9.7. Hasil menunjukkan bahwa terdapat perbedaan nilai TSH yang bermakna.

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ABSTRACTTSH reference value was important in detection of congenital hypothyroidism, which incidence was higher in Indonesia than in the world. Reference value was a normal categorized value obtained from a healthy individual and influenced by physiological conditions, like age and sex differences, and pathological conditions. This cross sectional study aimed to analyze the comparison of neonatal TSH reference value in Indonesia according to age and sex difference. 3,320 subjects were obtained from National Congenital Hypothyroidism Screening data from May July 2017 by fluorometry method with Labsystem reagent in National Referral Hospital Cipto Mangunkusumo. Groupings were done based on two independent variables five age groups and gender groups, which were analyzed by using SPSS version 20. Neonatal TSH reference interval according to both independent variables were analyzed by using MedCalc version 17.9.7. There was significant difference in TSH value p"

"ABSTRAKLatar Belakang: Hipotiroid kongenital merupakan salah satu penyebab paling umum terjadinya retardasi mental. Padahal, terjadinya komplikasi hipotiroid kongenital dapat dicegah sejak dini. Oleh karena itu, skrining hipotiroid kongenital dengan mengukur kadar TSH menjadi penting terutama pada bayi yang berisiko lebih tinggi terkena hipotiroid kongenital. Usia prematur diduga menjadi salah satu faktor risiko hipotiroid kongenital karena terkait imaturitas organ.Tujuan: Penelitian ini dilakukan dengan tujuan mengetahui persentase bayi prematur, nilai rujukan TSH neonatus di Indonesia, dan hubungan antara kadar TSH neonatus dan status prematuritas.Metode: Desain penelitian yang digunakan adalah studi potong lintang dengan subjek berasal dari data skrining hipotiroid kongenital RSUPN Dr. Cipto Mangunkusumo yang sampel darahnya dianalisis dengan cara Fluorometri dengan reagen Labsystem. Data berasal dari bulan Mei dan Juni 2017 yang diperoleh melalui teknik consecutive sampling. Dari 2987 subjek, terdapat 1700 subjek yang memenuhi kriteria inklusi dan eksklusi. Subjek dibagi menjadi kelompok bayi prematur n=111 dan bayi lahir cukup bulan n=1589 . Sampel kemudian dianalisis menggunakan SPSS versi 20.0 untuk mengetahui hubungan kadar TSH dan status prematuritas dengan uji Mann-Whitney dan uji korelasi, serta MedCalc versi 17.9 untuk mencari nilai rujukan TSH neonatus di Indonesia.Hasil: Persentase bayi prematur yang didapatkan yaitu sebesar 6,5 . Nilai rujukan TSH neonatus berdasarkan kelahiran prematur didapatkan nilai 1,0-8,9 mU/L dengan median 2,5 1,0-12,8 mU/L dan berdasarkan kelahiran cukup bulan sebesar 1,5-8,0 mU/L dengan median 3,2 1,0-19,8 mU/L. Analisis menggunakan uji Mann-Whitney, didapatkan hubungan bermakna antara kadar TSH neonatus dan status prematuritas p.

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ABSTRACTBackground Congenital hypothyroid is one of the most common causes of mental retardation. Actually, this complication can be prevented since earlier. Therefore, congenital hypothyroid screening by measuring TSH level is important to every infants, especially in higher risk of developing congenital hypothyroid. Prematurity is hypothesised as one of risk factor for congenital hypothyroid related to organ immaturity.Objective The aim of this study is to determine the percentage of preterm birth, neonatal TSH reference values in Indonesia, and association between neonatal TSH level with prematurity status.Methods This cross sectional study used subjects which was obtained from congenital hypothyroid screening data in General National Hospital Dr. Cipto Mangunkusumo from May to June 2017 by consecutive sampling. The screening of congenital hypothyroid used Fluorometry with Labsystem reagen to analyse blood samples. From 2987 subjects, 1700 subjects fulfilled the inclusion and exclusion criteria. Subjects were divided into two groups preterm infants n 111 and term infants n 1589 . Then, samples were analysed with SPSS version 20.0 to investigate association between neonatal TSH level with prematurity status by Mann Whitney test and correlation test, also MedCalc version 17.9 to calculate neonatal TSH reference values.Results The percentage of preterm infants was 6.5 . Neonatal TSH reference values based on preterm birth infants were 1.0 8.9 mU L with median 2.5 1.0 12.8 mU L and based on term infants were 1.5 8.0 mU L with median 3.2 1.0 19.8 mU L. There was also a significant association between neonatal TSH level and prematurity status Mann Whitney test, p"

"ABSTRAKLatar belakang: Hipotiroid kongenital merupakan suatu kelainan endokrin dimana terjadi penurunan sintesis hormon tiroid saat bayi baru lahir. Hipotiroid kongenital merupakan salah satu penyebab paling umum dari penurunan kecerdasaan intelektual retardasi mental yang sebenarnya dapat dicegah. Salah satu faktor risiko yang mendukung kejadian hipotiroid kongenital adalah status konsumsi garam beriodium ibu.Tujuan: Penelitian cross-sectional ini dilakukan untuk melihat apakah terdapat perbedaan antara nilai TSH neonatus dengan status konsumsi garam beriodium cukup ibu.Metode: Penelitian ini melibatkan 2.978 subjek yang terdiri atas bayi dan anak yang memperoleh uji saring hipotiroid kongenital di Rumah Sakit Umum Pusat Nasional RSUPN Dr. Cipto Mangunkusumo pada Bulan Mei hingga Bulan Juni 2017. Dari seluruh peserta uji saring hipotiroid kongenital tersebut, terdapat 1.687 subjek yang memenuhi kriteria inklusi dan eksklusi peneliti, kemudian dibagi menjadi dua kelompok, yaitu kelompok bayi yang dilahirkan oleh ibu yang tinggal di daerah dengan persentase konsumsi garam beriodium cukup per rumah tangganya rendah 90 . Jumlah sampel minimal yang harus dipenuhi oleh peneliti dengan menggunakan rumus besar sampel analitik numerik tidak berpasangan adalah 322 sampel. Setelah ditelaah, terdapat 149 subjek untuk kelompok bayi yang dilahirkan oleh ibu yang tinggal di daerah dengan persentase konsumsi garam beriodium cukup per rumah tangganya tinggi dan 173 bayi yang dilahirkan oleh ibu yang tinggal di daerah dengan persentase konsumsi garam beriodium cukup per rumah tangganya rendah. Sampel kemudian dianalisis menggunakan uji Mann-Whitney untuk diketahui hubungannya dengan nilai rerata TSH neonatus.Hasil dan Diskusi: Terdapat perbedaan bermakna nilai rerata TSH pada bayi yang dilahirkan oleh ibu yang tinggal di daerah dengan persentase konsumsi garam beriodium cukup per rumah tangganya rendah dan kelompok bayi yang dilahirkan oleh ibu yang tinggal di daerah dengan tingkat konsumsi garam beriodium cukup per rumah tangganya tinggi.

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ABSTRACTBackground Congenital hypothyroidism is an endocrine disorder in which there is a decrease in thyroid hormone synthesis at birth. Congenital hypothyroidism is one of the most common causes of a decline in intellectual intelligence mental retardation that can be prevented. One of the risk factors that affects the incidence of congenital hypothyroidism is the consumption status of the mother 39 s iodized salt.Objective This cross sectional study was conducted to see if there was any difference between neonatal TSH value and iodized salt consumption status.Methods The study involved 2,978 subjects consisting of infants and children who received a congenital hypothyroid filter test at the National General Hospital RSUPN . Cipto Mangunkusumo from May to June 2017. From the congenital hypothyroid test participants, 1,687 subjects fulfilled the inclusion and exclusion criteria of the researcher, then divided into two groups, the group of neonates born to mothers living in the area with the percentage of consumption iodized salt per household is low 90 . The minimum number of samples that must be met by the researcher by using the formula of unpaired numerical analytic sample is 322 samples. Upon examination, there were 149 subjects for groups of neonates born to mothers living in areas with a high percentage of iodized salt intake per household and 173 neonates born to mothers living in areas with sufficient iodized salt intake percentage per household. The samples were then analyzed using the Mann Whitney test to be known to correlate with the mean values of neonatal TSH.Results and Discussions There was a significant difference in mean TSH values in neonates born to mothers living in areas with a moderate percentage of low iodized salt intake per household and neonates born to mothers living in areas with high iodized salt intake per household P 0.001 . This is in line with the theory that if the diet of iodized salt is adequate then TSH levels in the circulation will be normal, whereas if the iodized salt diet is inadequate then TSH levels in the circulation will be high, due to negative feedback of the least amount of thyroid hormones in the circulation due to the raw material of its formation , ie iodides derived from iodized salt are not met. Also there was a significant difference in mean birth weight of neonates born to mothers living in areas with a fairly low percentage of iodized salt intake per household and neontaes born to mothers living in areas with sufficient iodized salt intake per household P "

"Benzena merupakan bahan kimia yang masih diperlukan di berbagai industri, tetapi mempunyai dampak negatif terhadap kesehatan pekerjanya walaupun proses terjadinya dalam jangka waktu lama, dapat berakibat fatal. Dampak ini dapat diperkecil dengan melakukan pemantauan lingkungan kerja terpajan benzena dan kesehatan pekerjanya secara teratur. Penelitian mengenai akibat pajanan benzena di lingkungan kerja masih sedikit dilakukan di Indonesia. Penelitian ini bertujuan untuk mengetahui gambaran kelainan akibat pajanan benzena, yaitu hubungan antara kadar fenol urin dan kelainan darah di lingkungan kerja terpajan, hubungan antara lama keira di lingkungan kerja terpajan benzena dengan kadar fenol urin dan kelainan darah serta faktor-faktor risiko yang dapat mempengaruhi. Penelitian ini dilakukan di suatu pabrik cat di Jakarta. Parameter yang dipakai pada penelitian ini adalah kadar fenol aria, parameter darah (hemoglobin, leukosit, trombosit, retikulosit, eritrosit, hernatokrit, MCV, MCH, MCHC, hitting jenis leukosit). Penelitian ini menggunakan desain pendekatan kros seksional, menjaring data melalui waarancara terstruktur, pemeriksaan fisik, pemeriksaan sampel urin dan darah terhadap 128 subjek penelitian yang terdiri dari 64 subjek penelitian di lingkungan kerja terpajan tinggi dan 64 subjek penelitian di lingkungan kerja terpajan rendah. Kesimpulan dan saran: Kadar uap benzena di lingkungan kerja terpajan tinggi melebihi nilai ambang batas yang diperbolehkan (NAB 25 ppm). Peningkatan kadar fenol urin pada pekerja di lingkungan terpajan tinggi lebih besar dari lingkungan terpajan rendah (p = 0,003), serta meningkat dengan pertambahan lama kerja. Pemeriksaan darah menunjukkan kecenderungan penularan jumlah retikulosit pada pekerja di lingkungan kerja terpajan tinggi 17 x dibandingkan dengan lingkungan kerja terpajan rendah (p = 0,01, OR 16,89, CI = 1,71 - 166,73) dan terdapat hubungan antara rata-rata retikulosit dengan lama kerja. Juga terdapat hubungan bermakna antara peningkatan jumlah rata-rata leukosit (p = 0,055), peningkatan jumlah rata-rata basofil (mann Whitney p = 0,02) dan peningkatan jumlah tenaga kerja dengan limfosit atipik dengan pajanan benzena (OR = 7,19, CI = 3,39 - 15,24). Faktor risiko yang berpengaruh pada penelitian ini adalah umur di atas 40 tahun dan lama kerja. Dari hasil penelitian ini dapat disarankan agar pemantauan lingkungan terpajan benzena dilakukan secara teratur tiap 6 bulan dengan memperhatikan sistim produksi, ventilasi dan tata letak ruang. Perlu dilakukan pemeriksaan pekerja yang akan bekerja di lingkungan kerja terpajan benzena (pra kerja), yang sedang bekerja di lingkungan terpajan benzena (berkala dan khusus) yang terdiri atas pemeriksaan kadar fenol urin dan pemeriksaan laboratorium darah (hemoglobin, leukosit, trombosit dan retikulosit), serta diberikan penyuluhan tentang bahaya bekerja di lingkungan terpajan benzena, dan cara pemakaian masker yang baik dan tepat. Pemakaian metode kolorimetri untuk pemeriksaan kadar fenol urin. Pemeriksaan diperketat pada pekerja di atas 40 tahun dan kadar fenol urin di atas 40 mg/liter. Penatalaksanaan pajanan terhadap benzena perlu di standarisasikan. Perlu dikembangkan kerjasama Departemen Tenaga Kerja, Departemen Kesehatan, Departemen Perindustrian & Perdagangan dan lembaga pendidikan (Program Kesehatan dan Keselamatan Kerja Pascasarjana Universitas Indonesia atau lembaga pendidikan terkait) dalarn menetapkan parameter yang lepat untuk digunakan dalam pemantauan lingkungan kerja terpajan benzena serta memantau dampak negatifnya.

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Methods and Materials: Benzene is still required in many industries, but this chemical has negative impact towards workers' health, especially over long periods of exposure, it can be fatal. This hazard can be prevented by monitoring regularly, both exposure area and the workers' health. The study on this topic in Indonesia is still rare up to now.

The aims of this study are to search for benzene exposure disorders, the correlation between urine phenol level, and haematologic disorders, hazard, risk factors in the work place environment and time factor. This study was conducted at a paint factory in Jakarta. The parameters used in this study are phenol level in urine, haematologic examinations (haemoglobin, leucocyte, trombocyt, reticulocyt, erythrocyte, haematocrit, MCV. MCH, MCHC, differential count).

The design of this study was cross sectional. Data were collected by interview, physical examination; urine and blood examinations of 128 subjects consisting of 64 subjects in a high exposure area and 64 subjects in a low exposure area.

Results and Conclusion: Benzene vapor level in high exposure area is higher than the permissible threshold limit value (NAB 25 ppm). Phenol level in urine of workers in high exposure area are higher than workers in low exposure area (p = 0,003) and this increase coincided with the duration of work The results of haematological examination showed 17 x decreasing tendency of the reticulocyt count of workers in the higher exposure than workers in low exposure (p = 0,01, OR = 16,89, CI = 1,71 - 166,73) and this low reticulocyt count has significant correlations with the duration of work It also correlates significantly with increasing mean leucocyt count (p = 0,055), mean basophyl count (mann-whitney p = 0,02) and atypic lymphocyt count (OR = 7,19, CI = 3,39 - 15,24). The risk factors in this study include, more than 40 years old workers and long duration of exposure time.

Based on the results of this study, I suggest the establishment of a standard benzene exposure management and monitoring of benzene exposure area unit The monitoring should be carried out every 6 months regularly. Attention should be directed to the production system, room ventilation and workplace design. Pre-employment, and periodical examination of workers, especially for urine phenol level examination should be carried out, as well as haematologic examinations (hemoglobin, leucocyt, thrombocyt and reticulocyt). Communication, information, education on the danger of benzene exposure and the correct manner of mask usage should be the important task in this management.

This study was carried out by using colorimetric method for the examination of urine phenol. The examinations are restricted to more than 40 years old workers and more than 40 mg/liter phenol level in urine. A cooperation among Occupational Department, Health Department, Industry and Trade Department and other Institutions (Occupational Health & Safety, University of Indonesia or other relevant institutes) should draw up correct parameters and regulations for monitoring benzene vapor and hazards in work environments."

"ABSTRAKRuang Lingkup dan Cara penelitian : Benturan berulang akibat getaran yang ditimbulkan alat bor 'rack drill' , dapat merupakan jejas pada eritrosit dalam pembuluh darah telapak tangan para pengebor yang menggunakannya, sehingga dapat menimbulkan hemolisis intravaskuler dan hemoglobinuria. Untuk membuktikan hal tersebut dilakukan penelitian terhadap 31 orang pengebor yang menggunakan 'rock drill' di suatu Pertambangan Emas. Kepada para pengebor tersebut dilakukan anamnesis dan pemeriksaan jasmani. Sebelum dan sesudah menggunakan 'rock drill', para pengebar diperiksa kadar Hb, nilai Ht, kadar Hb plasma, hemoglobinurin dan hemosiderinurinnya.Hasil dan Kesimpulan : Sesudah menggunakan 'rock drill', kadar Hb plasma para pengebor meningkat (p < 0,002); ini menunjukkan adanya hemolisis intravaskuler. Jumlah hemolisis yang terjadi dipengaruhi oleh lamanya pemajanan getaran (is = 0,422 ; p < 0,002), dan cara memegang handel 'rack drill' (p = 0,04), tetapi tidak dipengaruhi oleh umur pengebor (p > 0,10), masa kerja sebagai pengebor (p > 0,105, dan kekuatan getaran 'rock drill' yang digunakan (p > 0,05). Hemolisis yang terjadi akibat pemajanan getaran 'rock drill' selama 1 jam 15 menit sampai dengan 3 jam 20 menit, tidak menimbulkan penurunan kadar Hb (p > 0,10), maupun nilai Ht (p > 0,05). Hemoglobinuria dijumpai pada 6 (19,35 pengebor (p > 0,10), sedangkan hemosiderinuria ditemukan pada semua pengebor yang menunjukkan bahwa proses hemolisis intravaskuler tersebut telah berlangsung kronis dan berulang.

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ABSTRACT

Scope and Method of Study: Repeated trauma due to rock drill vibration can cause intravascular Hemolysis and traumatic hemoglobinuria to the rock drillers. This study was carried out on 31 rock drillers in a gold mine to prove the occurrence of intravascular hemolysis and hemoglobinuria on the rock drillers. The study consists of interview, physical examination, and determination of hemoglobin level, hematocrite value, plasma hemoglobin level, hemoglobinurine, and hemosiderinurine before and after rock drill vibration exposure.

Findings and Conclusions: After rock drill vibration exposure, the plasma hemoglobin level of the rock drillers increased ( p < 0,002). This finding indicates that there was an intravascular hemolysis. The degree of the hemolysis depended on the duration of the exposure (rs = 0,422; p < 0,002), and the manner of holding the rock drill handle- (p = 0,04), but it wasn't influenced by age (p > 0,10), work duration (p > 0,10), and the vibration intensity (p > 0,05). After one exposure ranging between 1 hour 15 minutes and 3 change the hemoglobin level (p > 0,10) nor the hematocrite value (p > 0,05). Hemoglobinuria was detected in 6 (19,35 7.) of the rock drillers (p > 0,10), and hemosiderinuria were found in all study subjects. The latter showed that the intravascular hemolysis was a chronic recurrent process."