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EVALUASI KEPATUHAN PETUGAS DALAM TATALAKSANA PNEUMONIA DI KABUPATEN TOLITOLI
Get PDFEVALUASI KEPATUHAN PETUGAS DALAM TATALAKSANA PNEUMONIA DI KABUPATEN TOLITOLIAbd Rahman1, Mohammad Hakimi2, Rina Triasih3ABSTRACTBackground: The infant mortality rate in Central Sulawesi Province is 52 per 1000 live births, which isthe fifth highest in Indonesia. The high rate of morbidity and mortality of acute respiratory infection andpneumonia in children under five in Tolitoli District in past year related to the implented efforts triandsARI eradication program. This is indeed related to how officers comply with pneumonia managementcorrectly.Objective: To evaluate officers’ compliance in implementing pneumonia manager Tolitoli Distric.Method: This was an observational study with cross-sectional study design, using quantitative approach,Data were collected through observation and interview using standardized questionnaire by tramednurses. Officer who handled pneumonia program in Tolitoli District and those in Publich Health Centreswere recruited as subjects.Result and Discussion: One hundred and nineteen subjects were recruited to this study. The percentaseof officers who complied with pneumonia management was 69%. The result of multivariate analysis thatwas training increased officers’ compliance in pneumonia management which was adjusted to education,knowledge and length of work had a significant relationship (PR: 1.79; 95% CI: 1,38 – 2,33) and theincreased value R2 of 6.3%, it mean.Conclusion: Trained officers were more compliant than untrained officers with the prevalence risk of1.79 times. Education, knowledge, and length of working service were related to officers’ compliance inpneumonia management.Keywords: training, officers’ compliance in pneumonia managementABSTRAKLatar belakang: Angka kematian bayi di Propinsi Sulawesi Tengah sebesar 52 per 1000 kelahiran hidupdan menempati urutan kelima tertinggi di Indonesia. Tingginya angka kesakitan dan angka kematian balitaakibat pneumonia di Kabupaten Tolitoli dalam beberapa tahun terakhir tidak terlepas dari seberapa jauhupaya program pemberantasan penyakit ISPA telah dilaksanakan. Hal ini sangat terkait dengan bagaimanakepatuhan petugas dalam melakukan tata laksana pneumonia secara tepat.Tujuan: Diketahuinya kepatuhan petugas dalam melakukan tatalaksana pneumonia di Kabupaten Tolitoli.Metode: Penelitian ini merupakan jenis penelitian observasional dengan rancangan cross sectional denganmenggunakan pendekatan kuantitatif. Data dikumpulkan melalui observasi dan wawancara dengan subyekpenelitian dengan menggunakan lembar observasi dan kuesioner.Hasil dan Pembahasan: Sebanyak 119 subyek diikutkan dalam penelitian ini. Rata-rata petugas yang patuhterhadap tata laksana pneumonia sebesar 69%. Hasil analisis multivariat menunjukkan bahwa variabelpelatihan dan kepatuhan petugas dalam tatalaksana pneumonia dengan mengikutsertakan variabel pendidikan, pengetahuan dan masa kerja untuk dianalisis secara bersama mempunyai hubungan yangsignifikan ((RP;1,79, IK 95%; 1,38 – 2,33) dan peningkatan nilai R2 sebesar 6,3%Kesimpulan: Petugas yang telah dilatih lebih patuh dibanding petugas yang belum dilatih dengan risikoprevalensi 1,53 kali. Faktor pendidikan, pengetahuan dan masa kerja berhubungan secara bermaknadengan kepatuhan petugas dalam tataksana pneumonia.Kata kunci: pelatihan, Kepatuhan petugas tatalaksana pneumonia1 Tolitoli Faculty of Medicine and Health Science2 Maternal and Child Health-Reproductive Health Graduate Program, FK-UGM3 Pediatric Department, Dr. Sardjito General Hospital, Yogyakart
Accuracy of Risanto's Formula Compared with Johnson's to Estimate Fetal Weight in Overweight Mothers
Get PDFBackground: Estimated fetal weight (EFW) is becoming important because it is used as a guidence for determining mode of delivery. The use of estimated fetal weight based on fundal height has been widely used, but its use in overweight pregnant mothers was still limitted.Objective: To compare the accuracy of Risanto’s and Johnson’s formulas in estimating fetal weight based on fundal height in overweight mothers.Method: It was a cross-sectional study, conducted from March 2013 to July 2014 in Sardjito hospital and hospital networks. All pregnant mothers meeting the elligibility criteria were used as study subjects. Overweight mother was defined based on body mass index (BMI) and skinfold thickness on suprailiaca region. Fundal height (FH) was measured from the symphysis pubis to the midle of the upper border of the pregnant uterus. Accuracy of Risanto’s and Johnson’s formulas was dtermined by comparing the difference between EFW and actual infant birth weight (AIBW). Paired t-test was used for statistical analysis.Result and Discussion: There were 395 overweight pregnant mothers fulfilling the inclusion and exclusion criteria. The mean AIBW was 3060.3 ± 322.5 grams (ranged from 2360 to 3940 grams). The mean EFW using Risanto formula (R_EFW) was 3095.8 ± 320.3 grams (ranged from 2370 to 3870 grams ) while that of Johnson (J_EFW) was 3273,7 ± 378,1 grams (ranged from 2325 to 4185 grams). The mean difference between between AIBW and ∆R) EFW (was 109.85 grams while that of AIBW and J_EFW∆J) (was 198.41 grams ∆.RIt was clear that significantly smaller ∆J than with the mean difference minus 88.56 grams (95% CI -98.76 to -78.35; p value 0.000).Conclusion: The new Risanto’s formula was more accurate to estmate infant birth weight than Johnson’s in overweight mothers.Keywords: Risanto’s and Johnson’s Formulas, Estimated Fetal Weight, Overweight Mothers
Pengalaman Ibu Bekerja dalam Pemberian AIS Eksklusif di Lingkungan Universitas Muhammadiyah Magelang
Get PDFBackground: The percentage of breastfeeding within the last 24 hours is decreasing with increasing age of the baby with the percentage 6 month babies is only about 30.2%. The percentage Central Java reached 34.38%, the low, and became the 6th lowest at Indonesia. This is not met with the government’s target of 80% in 2010. In Magelang district, the number is decreased from 45.18% in 2011 and 25.6% in 2012. Total coverage of exclusive breastfeeding at Universitas Muhammadiyah Magelang is 13%.Objective: To identify employment mother’s experience for exclusive breastfeeding at Muhammadiyah Magelang University.Method: This is a qualitative study, transcendental phenomenological approach. The subjects of this study are employment mother at Muhammadiyah Magelang University who have babies 6-36 months. Data was collected with in-depth interviews, observation, and documentation. Sampling was carried out using purposive sampling technique. Data analysis using 6 stages Colaizzi data analysis. This study began in February 2014 - February 2015.Result and Discussion: This study resulted 6 categories: employment mother’s experiences for exclusive breastfeeding at work less fun, supporting factors of exclusive breastfeeding is complex, mother’s knowledge of exclusive breastfeeding is good, physical, technical, and pshycological preparation were necessary to give exclusive breastfeeding, and expectation of the workplace that support for exclusive breastfeeding.Conclusion: Employment mother’s experience for exclusive breastfeeding less fun. Mother’s effort to prepare for exclusive breastfeeding such as knowledge, physical, technical, and pshycological. Mother’s expectation is workplace that supports exclusive breastfeeding.Keywords: Experience, Employment mother, exclusive breastfeedin
HUBUNGAN ANEMIA DALAM KEHAMILBAayi NKeci luTntuRk MIaMsa KeEhaSmilTan E(KMRK) dTi RIS GDr. ASard jito TERHADAP KEJADIAN BAYI KECIL UNTUK MASA KEHAMILAN (KMK) DI RS DR SARDJITO
No full textHUBUNGAN ANEMIA DALAM KEHAMILBAayi NKeci luTntuRk MIaMsa KeEhaSmilTan E(KMRK) dTi RIS GDr. ASard jitoTERHADAP KEJADIAN BAYI KECIL UNTUK MASA KEHAMILAN(KMK) DI RS DR SARDJITOLili Ratnawati*, Rukmono Siswishanto*, Ova Emilia*ABSTRACTBackground: The high prevalence of anemia during pregnancy at Yogyakarta could be associated with theadverse pregnancy outcome as SGA. Previous study reported inconsitent result about association betweenanemia during third trimester and babies with SGA. Research is needed to determine the contribution ofanemia during third pregnancy to the adverse pregnancy outcome at RS Dr Sarjito.Objective: To compare the prevalance of SGA between pregnancy with and without anemia during thirdtrimester at RS Dr Sarjito.Method: Cross sectional study based on RS Dr Sardjito’s medical record. The subjects of study werepregnant women who took delivery at RS Dr Sarjito during third trimester from 2010 to 2011. Anemiadefine as haemoglobin level < 11g/dl which performed before delivery. Babies with brith weigth < 10percentile Lubchenco curve group into SGA. Association between anemia during third trimester and SGAanalyzed with Chi square test and Fisher’s exact test.Resul and Discussion: A total of 239 subjects were recruited and devided into 146 subjects with anemiaand 93 subjects without anemia. The anemia groups consist of 97,95% mild anemia, 2,05% moderateanemia, and none severe anemia. The prevalence of SGA in total population, group with anemia, andgroup without anemia was 14%, 15,8%, and 10% irrespectively. The prevalance of SGA between groupwith and without anemia was not different (p=0,27; RR 1,46; 95%CI 0,73-2,93). Maternal age, BMIpregestational, education, and parity did not influence the prevalence of anemia and SGA. Consideringmultivariat analysis, neither anemia, maternal age, BMI pregestational, education, nor parity did not affectthe prevalance of SGA.Conclusion: In this study, the prevalence of SGA in pregnancy with and without anemia during thirdtrimester did not different at RS Dr Sarjito.Kata kunci: Anemia in pregnancy, third trimester, SGA.ABSTRAKLatar Belakang: Prevalensi anemia dalam kehamilan di Yogyakarta masih cukup tinggi sehingga dapatmenyebabkan peningkatan dampak buruk anemia terhadap janin, salah satunya KMK. Penelitiansebelumnya menunjukkan perbedaan hasil tentang hubungan anemia trimester tiga terhadap kejadianKMK. Penelitian tentang hubungan anemia dalam kehamilan trimester tiga terhadap kejadian KMK di RSSarjito penting dilakukan untuk mengetahui besarnya dampak negatif yang timbul akibat anemia dalamkehamilan.Tujuan: Mengetahui perbedaan kejadian bayi KMK pada ibu hamil dengan anemia pada trimester tigadibandingkan ibu hamil tanpa anemia di RS Dr Sarjito.Metode: Penelitian ini menggunakan rancangan cross sectional bersumber data rekam medis pasien ibuhamil trimester tiga yang bersalin di RS Dr Sardjito pada tahun 2010 s.d. 2011. Subyek penelitian yangmemenuhi kriteria inklusi dibagi dalam kelompok anemia dan normal. Hubungan antara anemia dengankejadian bayi KMK dianalisis dengan Chi square test dan Fisher’s exact test.Hasil dan Pembahasan: Subyek penelitian yang memenuhi kriteria sebanyak 239 orang terdiri atas 146orang kelompok anemia dan 93 orang kelompok tanpa anemia. Kelompok anemia terbagi atas 97,95%anemia ringan, 2,05% anemia sedang, dan tidak didapatkan anemia berat. Kejadian bayi KMK sebesar14% pada total populasi, 15,8% pada kelompok anemia dan 10% pada kelompok tanpa anemia. KejadianKMK kelompok anemia tidak berbeda bermakna secara statistik dibandingkan kelompok tanpa anemia(p=0,27; RR 1,46; 95%CI 0,73-2,93). Usia ibu, IMT sebelum hamil, pendidikan, dan paritas sebagai variabelluar yang diteliti tidak berpengaruh terhadap kejadian anemia maupun bayi KMK. Hasil analisis multivariatmenunjukkan bahwa anemia, usia ibu, Indeks Masa Tubuh (IMT) sebelum hamil, pendidikan, dan paritastidak berpengaruh terhadap kejadian bayi KMK.Kesimpulan: Pada penelitian ini, kejadian bayi KMK di RS Dr Sardjito tidak berbeda pada ibu hamil trimestertiga dengan anemia dibandingkan ibu hamil trimester tiga tanpa anemia.Kata kunci: Anemia dalam kehamilan, trimester tiga, KMK* Bagian Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Gadjah Mada/RS Dr Sardjito Yogyakart
HUBUNGAN ANTARA PARITAS DENGAN KEJADIAN RUPTUR PERINEUM PADA PERSALINAN NORMAL DI KLINIK UTAMA ASRI MEDICAL CENTER YOGYAKARTA DAN RSUD PANEMBAHAN SENOPATI BANTUL
Get PDFHUBUNGAN ANTARA PARITAS DENGAN KEJADIANRUPTUR PERINEUM PADA PERSALINAN NORMAL DI KLINIKUTAMA ASRI MEDICAL CENTER YOGYAKARTA DAN RSUDPANEMBAHAN SENOPATI BANTULApriani Susmita Sari1, Supriyatiningsih2, Sri Sumaryani3ABSTRACTBackground: Rupture perineal is the tear of the perineal at the time of the fetus born. The tear is onlytraumatic because the perineal could not hold a strain upon when a fetus passes. The parity is factor ofmother that can cause rupture perineal.Objective: This study aims to know the relation between parity with incidence of rupture perineal duringvaginal birth at the clinic of Asri Medical Center in Yogyakarta and District Hospital Bantul PanembahanSenopati.Method: This study was a quantitative descriptive study with cross sectional approach. Respondents inthis study were mothers vaginal birth as of February – March 2014, which was recorded in the medicalrecord. Sampling technique was purposive sampling techniques. Analysis of test used is the Fisher test.Result and Discussion: The research subjects who fulfilled the inclusion criteria were 152 people(primiparous: 89, multiparous: 63). Primiparous have more risks than parity ruptured perineum inmultiparous (primi rupture: 89 people, multi rupture: 56). Fisher’s exact test results showed a significantresult (p = 0.002) between parity with rupture of the perineum in normal labor.Conclusion: There is a significant relationship between parity with the rupture of the perineum in normaldeliveries at the Clinic Of Asri Medical Center In Yogyakarta and District Hospital Panembahan SenopatiBantul (p = 0.002).Keywords: Parity, Incidence Rupture PerinealABSTRAKLatar Belakang : Ruptur perineum adalah robeknya perineum pada saat janin lahir. Robekan ini sifatnyatraumatik karena perineum tidak kuat menahan regangan pada saat janin lewat. Paritas merupakan faktordari ibu yang dapat menyebabkan ruptur perineum.Tujuan : Penelitian ini bertujuan untuk mengetahui hubungan antara paritas dengan kejadian rupturperineum pada persalinan normal di Klinik Utama Asri Medical Center Yogyakarta dan RSUD PanembahanSenopati Bantul.Metode : Penelitian ini adalah penelitian deskriptif kuantitatif dengan pendekatan cross sectional.Responden dalam penelitian ini adalah ibu bersalin normal terhitung dari bulan Februari – Maret 2014 yang tercatat di rekam medik. Teknik pengambilan sampel adalah dengan menggunakan teknik purposive sampling. Analisis yang digunakan adalah uji Fisher test.Hasil : Subyek penelitian yang memenuhi kriteria inklusi adalah 152 orang (primipara: 89, multipara: 63).Primipara memiliki risiko lebih banyak mengalami ruptur perineum dibandingkan paritas multipara (primiruptur: 89 orang, multi ruptur: 56 orang). Hasil Fisher test menunjukan hasil yang signifikan (p=0,002)antara paritas dengan kejadian ruptur perineum pada persalinan normal.Kesimpulan : Terdapat hubungan yang bermakna antara paritas dengan kejadian ruptur perineum padapersalinan normal di Klinik Utama Asri Medical Center Yogyakarta dan RSUD Panembahan Senopati Bantul(p = 0.002).Kata Kunci: Paritas, Kejadian Ruptur Perineum1 Program Studi Ilmu Keperawatan Fakultas Kedokteran dan Ilmu KesehatanUniversitas Muhammadiyah Yogyakarta2 Departemen Obstetri dan Ginekologi Fakultas Kedokteran dan Ilmu KesehatanUniversitas Muhammadiyah Yogyakarta3 Program Studi Ilmu Keperawatan Fakultas Kedokteran dan Ilmu KesehatanUniversitas Muhammadiyah Yogyakart
Pengetahuan dan Sikap Residen Obstetri dan Ginekologi tentang Keselamatan Pasien di Kamar Bersalin RSUP Dr. Sardjito Yogyakarta
Get PDFBackground: The traditional medical Oath of ‘first do no harm’ is something that is very rarely breached either intentionally by a doctor, nurse or other health practitioner. Resident is health workers who perform services directly to patients that’s why their knowledge and attitudes towards patient safety are very usefulObjective: To determine the relationship of the level of knowledge with the attitudes about patient safety in obstetrics and gynecology resident while services in delivery room at Dr DR Sardjito hospital.Method: Descriptive methods with cross sectional approach, accompanied by a qualitative research The study involved 90 residents of Obstetrics and Gynecology at Sardjito Hospital Yogyakarta , by filling out a questionnaire. Knowledge assessed based on the number of correct answers and categorized into good and bad. Attitudes toward patient safety was assessed using a Safety Attitude Questionnaire (SAQ) labor and delivery version. Reliability was measured using Cronbach’s alpha. The qualitative data collection (interviews) conducted to support the descriptive data.Result and Discussion: Cronbach’s Alpha value for SAQ= 0.862, and the question of knowledge = 0.702. Between 77 responden who had good level of knowlage, only 53,2% had a good level of attitudes, and between 13 who has bad level of knowlage, there were 10 responden with good level of attitudes (76,9%) (RP 0,69;95%CI 0,44-1,04; p= 0,11). Elements of stress recognition on the attitude were getting the lowest average value (3.50 ± 0.56). From the qualitative data were known that the resident had desire for a reduction in working hours as well as improved communication and collaboration between teams. Althogh most of resident had a good level of knowledge and attitudes about patient safety, there were no meaning because of p value was >0,05 (OR 2,69;95%CI 0,66-10,9; p= 0,17).Conclusion: Clinically, a good level of knowledge about patien safety improving a good level of attitude towards patient safety.Keywords: Knowledge- attitude- patient safety- resident obstetric
The Impact of Obstetrician/Gynecologist Hospitalists on Neonatal Quality of Care in Sardjito General Hospital Yogyakarta, Indonesia: A Retrospective Cohort Study
Get PDFABSTRACT Background : The hospitalist model in obstetric care which was introduced over the last decades now has an important role in care delivery management with the potential positive impact on neonatal outcomes.Methods : This research design was retrospective cohort. Participants included is the patient in the time before and after implementation of obstetrician/gynecologist full-hospitalist policy during October 2013 until September 2014. The outcome measured were mean response time, APGAR score at 5 minutes, , NICU admission. Univariate and multivariable analyses was conducted to evaluate and determine the factor which significantly contribute to neonatal outcomes.Results and Discussion: We included total 71 patients (37 on-call obstetrician group and 34 full-time hospitalist group). Univariate analysis indicated mean response time was significantly differ in full-time hospitalist group when compared to the on-call obstetrician group (65,3 + 25,89 vs. 84 + 22,29 mins; p = 0,002). Implementation of full-time hospitalist did not impact the NICU admission and APGAR score at 5 minutes. Conclusion : Implementation of full-time hospitalist model is not affecting neonatal outcomes.Keywords : Infant and Maternal Mortality, Obtericians / Gynecologist Hospitalist, Labor and Delivery, Maternal and Neonatal Care, ICU Response Time.
Peran Intervensi Grup Psikoterapi Suportif untuk Memperbaiki Keadaan Depresi pada Wanita Infertil di Klinik Permata Hati RSUP Dr. Sardjito Yogyakarta
Get PDFBackground: Infertility is a worldwide problem, relates to a devastating condition that can destroy couples striving to have children. It can affect both men and women, and cause psychological related distress, depression, and low self- -esteem. Most interventions using directional, complete, and integrated approach have been focused on improving the quality of life of infertile men or women. Supportive psychotherapy is an example of such interventions.Objective: The study aimed to measure the effectiveness of supportive psychotherapy intervention in treating depression among infertile women.Method: A quasi experiment design using a pre and post- -test with a control group was employed in this study. Subjects were women (n=80) with infertility cases who sought for treatment at PermataHati Clinic Dr. Sardjito hospital. during the period from April to September 2014. A modified short supportive psychotherapywas to groups of patients over the course of four sessions. The sessions were managed by trained facilitatorscomprising psychiatrist and psychologist. Personal data and Beck Depression Inventory (BDI)were then used to assess the patients depression state.Result and Discussion: Findings indicated that 59.37% of the study subjects were found to have mild depression, whereas the other 40.63% had moderate depression. A significant change in BDI scores within the treatment group was found after intervention.Conclusion:Modified short supportive psychotherapy intervention can effectivelly reduce depression on infertile women.Keywords: modified short supportive psychotherapy, depression, infertile wome
EFEK PEMANFAATAN PROGRAM PEMANTAUAN DAN PROMOSI PERTUMBUHAN TERHADAP STATUS GIZI BALITA DI KOTA CIREBON
Get PDFEFEK PEMANFAATAN PROGRAM PEMANTAUAN DAN PROMOSI PERTUMBUHAN TERHADAP STATUS GIZI BALITA DI KOTA CIREBONLia Nurcahyani 1, Mohammad Hakimi 2, Toto Sudargo 3ABSTRACT Background: Undernourishment is the main cause of mortality in underfives, one of which is the lack of growth monitoring and promotion program utilization. Cases of undernourishment at Cirebon Municipality exceed the provincial and national figures. In 2008, community participation in growth monitoring and promotion program increased 19% from the previous year, however cases of undernourishment also increased 0.23%.Objective: To study the effect of growth monitoring and promotion program utilization toward nutritional status of underfive.Method: The study was observational with retrospective cohort design. Subject consisted of 246 underfives of 17-59 months and mothers that met inclusion and exclusion criteria. Sampling used three stage combined with purposive and random sampling technique. Data consisted of primary and secondary data obtained from questionnaire, growth chart, nutrition registry, monthly report of underfive weighing at Cirebon Municipality in 2008, digital scale, measurement board/microtoise and 2006 is WHO anthropometric software. Data analysis used univariate, bivariate with chi square, and multivariate with logistic regression. The study was supported with qualitative data obtained from observation and indepth interview with 6 cadres and 2 nutrition staff to identify input and process indicators and constraints in the utilization of growth monitoring and promotion program.Result and Discussion: The utilization of growth monitoring and promotion program affected nutritional status of underfive significantly p<0,05. Incidence of undernourished underfives that did not utilize the program regularly was 2.7 times greater than in those utilizing the program regularly after considering the contribution of knowledge and attitude of mothers and age of underfives. Input indicator especially role of cadres in the process of growth monitoring and promotion program at Cirebon Municipality was not optimum. Constraints in program utilization consisted of individual (health reason), provider (social reason) and community (geographical reason).Conclusion: Monthly growth monitoring should be prioritized on underfives for the first 24 month. Target of growth monitoring and promotion program could be achieved when there is comprehensive support from people that received the service, service providers and policy makers.Keywords: nutritional status, underfives, growth monitoring, promotion program, program utilization ABSTRAK Latar Belakang: Kurang gizi adalah penyebab utama mortalitas balita, salah satunya karena kurangnya penggunaan pemantau pertumbuhan dan promosi program. Kasus kurang gizi di Kotamadya Cirebon melebih angka provinsi dan nasional. Di tahun 2008, partisipasi masyarakat dalam pemantauan pertumbuhan dan program promosi meningkat 19% dibanding tahun sebelumnya, namun kasus kurang gizi tetap meningkat 0,23%.Tujuan: Untuk meneliti efek pemanfaatan pemantauan pertumbuhan dan program promosi terhadap status gizi balita.Metode: Penelitian ini merupakan studi observasional dengan rancangan retrospective cohort. Subyek terdiri dari 246 balita usia 17-59 bulan dan ibu yang memenuhi kriteria inklusi dan eksklusi. Sampling memakai tiga tahap dikombinasikan dengan teknik sampling purposif dan acak. Data berasal dari data primer kuesioner dan sekunder, grafik pertumbuhan, register gizi, laporan bulanan berat badan balita di Kotamadya Cirebon tahun 2008, timbangan berat badan, papan pengukur/microtoise dan WHO anthropometric software 2006. Analisis data memakai univariat, bivariat dan multivariat dengan regresi logistik. Penelitian ini juga didukung data kualitatif dari hasil observasi dan wawancara mendalam dengan 6 kader dan 2 staf gizi untuk mengidentifikasi indikator input dan proses serta hambatan dalam penggunaan pemantau pertumbuhan dan program promosi.Hasil dan Pembahasan: Penggunaan pemantau pertumbuhan dan program promosi mempengaruhi status gizi balita secara signifikan p<0,05. Insidensi kurang gizi balita yang tidak memanfaatkan program secara reguler 2,7 kali lebih tinggi dibanding yang memanfaatkan. Kemungkinan kontribusi pengetahuan dan sikap ibu serta usia balita juga mempengaruhi. Indikator input terutama peran kader dalam proses pemantauan pertumbuhan dan program promosi di Kotamadya Cirebon belum optimal. Hambatan penggunaan meliputi faktor individu (alasan kesehatan), petugas kesehatan (alasan sosial) dan komunitas (alasan geografis).Kesimpulan: Pemantauan pertumbuhan balita bulanan harus diprioritaskan untuk 24 bulan pertama. Target pemantauan pertumbuhan dan promosi dapat dicapai bila ada dukungan dari sisi kebutuhan masyarakat yang menerima layanan, dukungan tenaga kesehatan dan kebijakan pengambil kebijakan.Kata kunci: status gizi, balita, pemantau pertumbuhan, program promosi, pemanfaatan program 1 Politeknik Kesehatan Cirebon, Program Kebidanan, Tasikmalaya2 Magister Kesehatan Ibu dan Anak – Kesehatan Reproduksi, Fakultas Kedokteran Universitas Gadjah Mada3 Magister Kesehatan dan Gizi, Fakultas Kedokteran Universitas Gadjah Mad
THE MECHANISM OF HUMAN OVARIAN PRIMORDIAL FOLLICULAR ASSEMBLY AND DEVELOPMENT
Get PDFYosep Sutandar1, Suryono S.I. Santoso2 ABSTRAK Latar Belakang: Pembentukan dan perkembangan folikel primordial merupakan aspek yang penting pada sistem reproduksi perempuan, tetapi mekanismenya masih kurang dipahami. Pembentukan folikel primordial adalah proses dimana folikel primordial ovarium terbentuk. Sebuah folikel primordial terdiri dari oosit yang berada di profase jika pembelahan meiosis yang pertama dan dikelilingi oleh satu lapisan sel-sel pra-granulosa. Proses ini secara langsung memengaruhi jumlah oosit yang tersedia bagi seorang wanita sepanjang usia reproduksinya. Kelainan pada perkembangan folikel primordial menyebabkan sejumlah patofisiologi, tetapi mekanisme terjadi masih belum dapat dipahami.Tujuan: Untuk memahami mekanisme perakitan dan pengembangan manusia ovarium folikel primordial. Metode: Review artikelKesimpulan: Pembentukan folikel primordial adalah proses dimana folikel primordial ovarium terbentuk. Pembentukan folikel primordial dihambat oleh progesteron untuk tingkat yang lebih besar daripada estrogen, namun kedua steroid tersebut menghambat proses pembentukan. Proses apoptosis oosit secara acak dalam sarang oosit diperlukan untuk pembentukan folikel dan tumor necrosis factor-alpha (TNF) tampaknya juga terlibat dalam proses ini. Baru-baru ini, penelitian telah menunjukkan bahwa KL, basic fibroblast growth factor (bFGF), leukemia inhibitory factor (LIF), KGF, dan bone morphogenic protein -4 (BMP-4) dapat memengaruhi perkembangan folikel primordial.Kata kunci: folikel, primordial, pembentukan, perkembangan. ABSTRACT Backgrounds: primordial follicle assembly and development is a critical aspect of female reproduction, but poorly understood process on mechanistic level. Primordial follicle assembly is the process by which ovarian primordial follicles are formed. A primordial follicle is composed of an oocyte arrested in prophase if the first meiotic division and surrounded by a single layer of pre-granulosa cells. These processes directly affect the number of oocytes available to a female throughout her reproductive life. Abnormalities in primordial follicle development lead to a number of pathologies, but the mechanism are poorly understood.Objective: To understand the mechanism of assembly and development of human ovarian primordial follicle. Method: Literature reviewConclusion: Primordial follicle assembly is the process by which ovarian primordial follicles are formed. Primordial follicle assembly was inhibited by progesterone to a greater degree than estrogen, but both steroids inhibited the assembly process. The apoptosis of random oocytes in the oocyte nests is required for primordial follicle assembly and tumor necrosis factor-alpha (TNFβ) appears to be involved in this process. More recently, studies have demonstrated that KL, basic fibroblast growth factor (bFGF), leukemia inhibitory factor (LIF), KGF, and bone morphogenic protein-4 (BMP-4) can influence primordial follicle development.Key words: follicle, primordial, assembly, development1,2 Division of Reproductive Medicine, Department of Obstetrics and Gynecology Faculty of Medicine University of Indonesia, National Center Hospital Dr. Cipto Mangunkusumo Telephone: 081294037518. Email: [email protected]