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Background Thalassemia is a hemoglobin synthesis disorder that causes patients to need lifelong blood transfusions, leading to iron overload and alter organ function, including the liver. Hepcidin, produced by the liver, plays a role in iron homeostasis and should be increased in excess iron stores. However, the level decreases in thalassemia due to some factors, such as ineffective erythropoiesis and liver damage. Recent publications revealed that hepcidin could be associated with iron overload and also a marker of liver diseases. Objective To analyse the correlation between hepcidin level, markers of iron overload, and liver damage in beta-thalassemia major. Methods This cross-sectional study included all ?-thalassemia major age 2-18 years admitted to Dr. Mohammad Hoesin Hospital, Palembang, South Sumatera, who underwent blood transfusions from March to August 2022. We measured the level of iron overload markers, hepcidin, liver function test (LFT), and performed liver ultrasonography (USG). Results Of 97 subjects, median hepcidin level was 10.01 ng/mL and 68% of the subjects showed a decrease. The iron overload parameters were evaluated from serum iron levels (P=0.13), ferritin levels (P=0.90), and transferrin saturation (P=0.29) and 24.7% had abnormal liver USG findings. Spearman’s correlation revealed that only direct bilirubin (DB) (r=0.35; P=0.001) and liver USG (r=0.20; P=0.05) had positive correlations with decreased levels of hepcidin. Also, it had 91.7% sensitivity in predicting liver damage from ultrasound. Conclusion The hepcidin level was not significantly associated with iron overload markers.

Abstract Background Health-promoting schools (HPS) are acknowledged as a comprehensive approach to improving children’s health and educational outcomes through learning and school life. Principals are key players in HPS implementation. However, concrete leadership practices in HPS in low- to middle-income countries have not been clarified. Therefore, this study aimed to explore and generate themes surrounding the leadership practices of principals in implementation of school health in Indonesia, a predominantly Muslim country consisting of diverse religions that have expanded HPS at the national level. Methods In-depth interviews and focus group discussions (FGDs) were conducted with the principals, teachers, parent representatives, and school board committee members in 10 target schools. FGDs were conducted with school health supervisory board members in Mataram City. All interviews were recorded and transcribed. Thematic analysis was undertaken to generate themes. Results The principals demonstrated leadership practices based on their religious beliefs, values, and morals. This may suggest that beliefs and morals support an understanding of their responsibility to ensure the well-being of all school community members, regardless of religion, in a diverse environment that is predominantly Muslim but also multicultural and multi-religious. Further, these beliefs and morals might reinforce implementation of school health. Importantly, the principals’ coordination skills in cooperating with multiple sectors might contribute to successful implementation of school health. Also, principals emphasized they were tasked to develop capacity for implementation of school health. Thus, principals should understand leadership in the implementation of school health as their duty from the training stage to encourage health at the school level. Conclusion In this study, “have professional educators’ beliefs and religious beliefs and Indonesia’s morals” was generated as a new theme, whereas several common themes were found as in previous studies. The results of this study suggested the importance of leadership by principals in the implementation of school health. Strengthening the capacity of school principals by integrating the contents of school health leadership practice into pre- and in-service training through the development of a policy on principals’ duties in school health might contribute to the successful implementation of school health.

Coronaviruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continue to pose a significant public health challenge globally, even in 2024. Despite advancements in vaccines and treatments, the accurate classification of coronavirus protein sequences remains crucial for monitoring variants, understanding viral behavior, and developing targeted interventions. In this study, we investigate the efficacy of various classification methods in accurately classifying coronavirus protein sequences. We explore the use of K-nearest neighbor (KNN), fuzzy KNN (FKNN), support vector machine (SVM), and SVM with particle swarm optimization (PSO-SVM) algorithms for classification, complemented by feature selection techniques including principal component analysis (PCA) and random forest-recursive feature elimination (RF-RFE). Our dataset comprises 2000 protein sequences, evenly split between SARS-CoV-2 and non-SARS-CoV-2 sequences. Through rigorous analysis, we evaluate the performance of each classification model in terms of accuracy, sensitivity, specificity, and receiver operating characteristic area under the curve (ROC-AUC). Our findings demonstrate consistently high performance across all models, reflecting their efficacy in classifying coronavirus protein sequences. Notably, the PCA + PSO-SVM model emerges as the top-performing model, exhibiting the highest classification accuracy, specificity, and ROC-AUC score, demonstrating its effectiveness in distinguishing between SARS-CoV-2 and non-SARS-CoV-2 sequences. Overall, our study highlights the importance of employing advanced classification methods and feature selection techniques in accurately classifying coronavirus protein sequences. The findings provide valuable insights for researchers and practitioners in the field of bioinformatics and contribute to ongoing efforts in understanding and combating the COVID-19 pandemic and its evolving challenges.

Abstract Background As a component of health promoting school, a school curriculum for health education was considered a fundamental. This survey aimed to identify the components of health-related topics and in which subjects were they taught. Methods Four topics were chosen: (i) hygiene, (ii) mental health, (iii) nutrition-oral Health, and (iv) environmental education related to global warming in Education for Sustainable Development (ESD). Before gathering the curricula from partner countries, school health specialists were gathered to discuss the appropriate components of a curriculum that required evaluation. The survey sheet was distributed to and answered by our partner in each country. Results About hygiene, individual practices or items that improve health-related were widely covered. However, items that imparted health-related education from an environmental perspective were not widely covered. About mental health, two types of country groups were identified. The first group included countries that taught mental health topics mainly as part of morals or religion; the second group included countries that imparted mental health topics mainly as part of health. The first group focused mainly on communication skills or coping methods. The second group focused not only on communication and coping skill but also on basic knowledge of mental health. About nutrition-oral education, three types of country groups were identified. One group imparted nutrition-oral education mainly in terms of health or nutrition. Another group imparted this topic mainly in terms of morals, home economics, and social science. The third group was the intermediate group. About ESD, a solid structure for this topic was not identified in any country. Many items were taught as part of science, while some were taught as part of social studies. Climate change was the most commonly taught item across all countries. The items related to environment were relatively limited compared to those related to natural disasters. Conclusions Overall, two different approaches were identified: the cultural-based approach, which promotes healthy behaviors as moral codes or community-friendly behaviors and the science-based approach, which promotes children’s health through scientific perspectives. Policymakers should initially consider the findings of this study while making decisions on which approach should be taken.

Abstract Introduction Comprehensive sexuality education (CSE) enables children and young people to learn about the cognitive, emotional, physical, and social characteristics of sexuality. Teachers experience conflicts in teaching CSE due to different cultural and religious backgrounds. This qualitative systematic review aimed to describe the conflicts experienced by teachers in the implementation of CSE in schools. Furthermore, this study aimed to identify the causes of conflict among teachers in implementing CSE. Methods This article focused on teachers’ conflicts in implementing CSE from 2010 to 2022. Online bibliographic databases, such as PubMed, Web of Science, and ERIC, were used to search for relevant articles. The following search term was used: Teacher, Comprehensive Sexuality Education, and Conflict. Results A total of 11 studies were included in the review. All 11 studies were conducted in countries with a predominantly Christian population. The majority of the studies were conducted in Africa. The study respondents included teachers, school principals, and school coordinators. The studies identified that CSE implementation is related to multiple conflicts, depending on the context of the country. Five themes on the causes of conflict emerged from the thematic meta-synthesis: (1) Hesitancy in talking about sex education among teachers due to the cultural and religious context; (2) non-integration of traditional sex education into comprehensive sexuality education, (3) fostering effective facilitation of CSE among teachers, (4) determining the appropriate age to start sex education, and (5) roles of stakeholders outside the school. Conclusions This qualitative systematic review and thematic meta-synthesis highlighted several conflicts among teachers in CSE implementation. Despite the teachers having a perception that sex education should be provided, traditional sex education has not yet transformed to CSE. The study findings also emphasize the need to identify the teacher’s role in CSE implementation. The thematic meta-synthesis also strongly reflected the context of Christianity in Europe and Africa; thus, further research on the religious context in other regions is needed.

Abstract Background Comprehensive sexuality education (CSE), which aims to help young people make responsible choices and acquire scientific knowledge and skills, has been promoted by UNESCO. Teachers experience conflicts in implementing CSE when teaching sexual topics in the local context, especially as the delivery of sexual knowledge and contraceptive methods is often prohibited by religious and traditional cultural norms. It was reported that there were multiple challenges in the implementation of sex education due to the religious and cultural background of societies and communities in Islamic countries. This study aimed to clarify the process of overcoming the conflicts, explore teachers’ recognition and perception related to the implementation of CSE, and to suggest recommendations for promoting CSE in Islamic areas. Methods This qualitative study combined the methods of focus group discussions (FGDs) and in-depth interviews (IDIs) to explore the conflict among teachers. Ten ordinary public senior high schools in Mataram City, Indonesia, agreed to participate, and in total, 59 participants were involved in this study. FGDs were conducted with teachers (n = 49), and IDIs were focused on school principals (n = 10) in each school. The collected interview data were analyzed using a deductive thematic analysis and the findings triangulated for both the FGDs and IDIs. Results Overall, the teachers experienced conflicts in relation to religion, cultural background, and gender inequality in implementing CSE. The present study revealed the mutual recognition among teachers and acceptance of diverse backgrounds in the implementation of CSE at ordinary public senior high schools in Mataram City. Despite teachers reporting multiple conflicts, they made efforts to overcome these conflicts through mutual recognition and provided comprehensive guidance. The present findings indicated that teachers adapted CSE to follow multiple religions and cultural backgrounds. Conclusions The teachers accepted diverse backgrounds and provided CSE by collaborating with related educational subjects and external institutions to overcome conflicts. To provide more specialized education, it would be necessary to advocate a formal policy that might be accepted by diverse societies. Further research is necessary to apply the findings and recommendations for CSE implementation globally in the contexts of different countries.

Background: Test anxiety is one of the medical student’s problems that need attention in medical education. Test anxiety can have negative effect on students such as negative self-evaluation beliefs, low motivation, poor performance, and decreased concentration which can result in increased dropout rates and trigger general anxiety. Test anxiety can affect performance on clinical skill examination and outcomes. Aim: To identify factors correlated with medical students’ anxiety in clinical skills examination. Methods: This was a cross-sectional study involving the second and fourth year medical students in Universitas Mataram. Possible Anxiety Determinant Instrument (PADI) was used to measure factors associated with test anxiety and Performance Test Anxiety (PTA) inventory to measure students’ anxiety in clinical skills examination. Data collection took place after the clinical skill exam. Pearson and Spearman correlation test were used in analyzing the data. Results: Total of 185 students participated in this study (response rate 96,9%). Factors found to be correlated with test anxiety score were internal belief factors (r = -0,686), health and lifestyle factors (r = -0,424), curriculum factors (r= -0,414), social support factors (r = -0,395), learning atmosphere factors (r = -0,312), and examination factors (r = -0,270). Preparedness and experience of examination were not correlated with the test anxiety. Conclusion: Students’ internal belief was found to have the strongest correlation with the test anxiety, while examination factor showed the weakest correlation. These findings can guide medical education institution in developing strategies to reduce students’ anxiety toward the clinical skills examination.

Background: The COVID-19 pandemic has caused tremendous and abrupt changes in all aspects of social life, including healthcare and education. It has caused stress and psychological impact on physicians and other healthcare workers globally. Exposure to chronic occupational stress can lead to burnout. The multiple responsibilities of academic physicians potentially lead to a higher risk of burnout, particularly during this pandemic. This study aimed to obtain burnout profiles in academic physicians and factors associated with burnout during the COVID-19 pandemic. Methods: This was a cross-sectional study. The MBI-HSS was used to measure the three dimensions of burnout. Academic physicians' perception of distance learning, involvement in the clinical care of COVID-19 patients, involvement in faculty management, and healthcare facilities management were also included in the survey. Results: Among 42 participants (response rate 56%), 45.2% provided care to COVID-19 patients, 42.9% were involved in the management of healthcare facilities, and 35.7% in faculty management. Median of Emotional Exhaustion (EE) was 12 (1-35), Depersonalization (DP) 6 (0-19) and Personal Accomplishment (PA) 32.5 (16-47). Based on Z-score for each dimension, 23.8% have high EE, 16.7% high DP, 50% low PA, and 11.9% categorized as burnout. Involvement in healthcare facilities management and providing care for COVID-19 patients were significantly associated with higher EE (p = .030 and p = .029 respectively), while the perception of the workload of distance learning associated significantly with higher EE (p = .046) and DP (p = .014). Conclusion: Workload related to clinical work, healthcare management, and distance learning, associated with higher burnout in academic physicians during COVID-19 pandemic.

ABSTRAK Jamur tiram putih (Pleurotus ostreatus) merupakan salah satu produk makanan yang mudah mengalami kerusakan dan mempunyai waktu simpan pendek yaitu 1-2 hari. Produksi jamur tiram di Indonesia semakin tahun mengalami peningkatan sehingga dibutuhkan alternatif dalam menjaga umur simpan pada jamur. Salah satu teknologi yang masih terus berkembang adalah teknologi plasma ozon. Teknologi ini menggunakan plasma dingin untuk menghasilkan ozon (O3). Baru-baru ini, beberapa peneliti telah mengembangkan teknologi ozon untuk mejaga umur simpan pada produk pasca panen hortikultura. Penelitian bertujuan untuk mengetahui pengaruh penyimpanan jamur tiram putih (Pleurotus ostreatus) dengan teknologi plasma ozon yang dibangkitkan dengan teknik Double Dielectric Barrier Discharge Plasma (DDBDP). Hasil kosentrasi ozon pada penelitian ini yaitu 65 ppm dengan kapasitas ozon sebesar 5.85 gram/jam pada flowrate 1.5 (L/min) dan tegangan 9,5 kV. Ozon dialirkan ke dalam plastik yang berisi sampel jamur pada perlakuan (5, 10, 15, 20 dan 25) menit. Berdasarkan hasil uji perubahan susut yang dilakukan, diperoleh perubahan susut tidak terlalu significant mengalami penurunan pada perlakuan ozone 20 menit dan 25 menit. Kata kunci: Jamur tiram; ozone; Double Dielectric Barrier Discharge Plasma; produk hortikultura ABSTRACT White oyster mushroom (Pleurotus ostreatus) is a food product that is easily damaged and has a short shelf life of 1-2 days. The production of oyster mushrooms in Indonesia is increasing every year so that an alternative is needed to maintain the shelf life of mushrooms. One technology that is still developing is plasma ozone technology. This technology uses cold plasma to produce ozone (O3). Recently, several researchers have developed ozone technology to maintain shelf life in post-harvest horticultural products. This study aims to determine the effect of storing white oyster mushrooms (Pleurotus ostreatus) with ozone plasma technology generated by the Double Dielectric Barrier Discharge Plasma (DDBDP) technique. The results of the ozone concentration in this study were 65 ppm with an ozone capacity of 5.85 grams/hour at a flowrate of 1.5 (L/min) and a voltage of 9.5 Kv. Ozone was flowed into a plastic containing mushroom samples in the treatment (5,10,15, 20 and 25) minutes. Based on the results of the shrinkage change test carried out, it was found that the shrinkage change was not too significant and decreased in the 20 minute and 25 minute ozone treatment Keywords: Oyster mushroom; ozone; Double Dielectric Barrier Discharge Plasma; horticultural products.

Tradisi mangaji kamatian merupakan salah satu bentuk akulturasi budaya Minangkabau dan Islam di saat Islam masuk ke Minangkabau. Masyarakat pun memaknai tradisi tersebut sebagai bentuk pengamalan dari sunnah Rasulullah SAW. Namun ada juga yang memaknai bentuk tradisi ini dalam hal suatu perbuatan bid’ah dan ada pula yang memahami sebagai bentuk amalan jahiliyah yang haram dilaksanakan. Penelitian ini menggunakan metode field research (penelitian lapangan) dengan menggunakan pendekatan fenomenologi dengan model living hadis. Hasil penelitian ini menunjukkan, bahwa tradisi mangaji kematian yang hidup di masyarakat Lareh Nan Panjang merupakan akultuasi antara ajaran Islam yang memiliki dalil yang jelas dalam al-Quran dan hadis Nabi dengan adat dan budaya yang ada di daerah tersebut. Secara histori tradisi mangaji kamatian merupakan bentuk interprestasi Syaikh Burhanuddin yang merupakan ulama yang menyebarkan Islam di Padang Pariaman pada abad 16-17 terhadap ayat al-Quran dan hadis Nabi Muhammad SAW yang berkaitan dengan ta’ziyah. Masyarakat yang saat itu meratap di saat tertimpa musibah kematian, perlahan-lahan dirobah oleh Syaikh Burhanuddin dengan prosesi pembacaan ayat al-Quran, shalawat, zikir, tahlil dan doa. Dalam pelaksanaan tradisi mangaji kamatian, apa saja yang dibaca sudah disusun dalam buku panduan mangaji kematian. Mangaji kamatian hanya boleh dipimpin oleh tuangku atau labai. Secara esensi mangaji kamatian mengandung nilai-nilai yang sangat banyak, di antaranya ibadah, pendidikan, sikap empati, menjaga harmonisasi, menghilangkan jiwa individualisme masyarakat, tolong menolong dan peduli, Nilai solidaritas, persaudaraan dan kasih sayang.

Background With advances in supportive and risk-stratified therapy, the 5-year survival rate of acute lymphoblastic leukemia has reached 85.5%. The ALL-2006 treatment protocol was modified and renamed the ALL-2013 protocol, with dose and duration changes. Objective To compare outcomes of the ALL-2006 and ALL-2013 protocols, with regards to mortality, remission, relapse, and three-year survival rates. Methods This was retrospective cohort study. Subjects were acute lymphoblastic leukemia (ALL) patients treated from 2011 to 2018 in Mohamad Hoesin Hospital, Palembang, South Sumatera. The three-year survival rates, relapse, remission rates and comparison of ALL-2006 and ALL-2013 protocols were analyzed with Kaplan-Meier method. Results Mortality was significantly correlated with age at diagnosis 10 years, hyperleukocytosis, and high-risk disease status. Patients aged 1 to 10 years, with leukocyte count 0.05). Relapse was also not significantly different between the two groups (ALL-2006: 29.4% vs. ALL-2013: 17.9%; P>0.05). Probability of death in the ALL-2006 group was 0.3 times lower than in the ALL-2013 group (P10 years, hyperleukocytosis, and high-risk group are significantly correlated with higher mortality and lower remission rates. However, these three factors are not significantly different in terms of relapse.

Background Endocrine disorders in thalassemia major children patients occur due to iron overload and hemosiderosis in endocrine organs. Early detection is needed to prevent complications and improve the quality of life. An association between serum ferritin and endocrine disorders in thalassemia patients has been inconclusive to date. Objective To analyze for possible associations between serum ferritin and endocrine disorders (short stature, delayed puberty, delayed bone age, hypothyroidism, impaired glucose tolerance, and diabetes mellitus) and the incidence of each disorder in thalassemia major. Methods There were 115 thalassemia major patients aged 10-18 years involved in our cross-sectional study from June 2019 - June 2020 in the Pediatrics Department, DR. M Hosein Hospital, Palembang, South Sumatera. Anthropometry and socioeconomic status informations were collected from physical examination and interview. Ferritin, FT4, TSH, Hb and glucose levels measured by using standard methods for each item in the laboratory, mean while the skeletal age assessment was determined by using FELS method. Results This study included 83 (72.2%) girls and 32 (27.8%) boys. There were 89 (77.4%) subjects with short stature, 74 (64.4%) with delayed bone age, 30 (26.1%) with impaired glucose tolerance, 25 (21.7%) with delayed puberty, 4 (3.5%) with diabetes mellitus (DM), and none with hypothyroidism. Bivariate and multivariate analyses revealed no associations between serum ferritin and short stature, delayed bone age, impaired glucose tolerance, delayed puberty, and DM. Conclusion There is a high prevalence of endocrine disorders in pediatric thalassemia patients, especially short stature and delayed bone age. However, there are no associations between serum ferritin and endocrine disorders in these patients.

This study aims to determine the quality of the hadith about Islamic remission of leaving Friday prayer in coincidence with Eid al-Fitr or Eid al-Adha, both from the sanad and matan. This study is also to find out the hadith’s meanings. By means of takhrij al-hadith and fiqh al-hadith methods, it is concluded that the hadith about Islamic remission of living Friday prayer in coincidence with the 'Idain is dhaif because the sanad, Iyas bin Ramlah and Israil got jarah of the Muslim scholars in all channels of the hadith’s sanad. Meanwhile, for the understanding of Muslim scholars about the Islamic remission of leaving Friday prayer on the 'Idain, it is permissible as long as there are certain syar'i cases causing not to be able to perform Friday prayer, such as: rainy days, sickness, travelers, or being in the domicile far from the places that hold Friday prayer

Background: Transition to clinical clerkships involves significant changes for students in terms of learning environment and approach to learning. As clinical supervisors, doctors are one of the essential learning resources who also provide access for participation in a clinical environment. This study explored undergraduate medical students’ experiences during the transition to clinical clerkships to understand how these experiences affect their learning.This paper aims to report factors affecting students’ interaction with supervisors during the transition period. Method: This was a qualitative phenomenological study. Participants were selected purposely to represent gender and group of student rotations. Eight 4th year medical students (five female, three male) submitted audio diaries during their first 12 weeks of clinical clerkships. Forty-six of the 73 audio diaries collected in the study contained interactions with supervisors, and these interactions were captured in 76 excerpts. Results: Six themes emerged regarding factors affecting the interaction: (1) characters of the supervisors including the willingness to teach, showing concerns, asking questions to test comprehension, inviting explicitly; (2) supervisors’ workload; (3) students’ clinical knowledge and skills; (4) students’ initiatives: actively participating, asking questions; (5) curriculum and organization: the chance to do mutual interaction (i.e.,mini-CEX), clarity of students’ roles and educational goals; (6) senior peers. Conclusions: Interactions between students and supervisors during the transition to clinical clerkships were influenced by factors internal to both parts and external factors like curriculum and organization, workload,and the presence of senior peers. However, during this phase, where students had not developed a situational understanding of the new environment, supervisors’ characters strongly influenced the interactions through the provision of affective support.

Background. β-Thalassemia has a very wide clinical variation, depending on the severity of the patient’s condition. Individuals with β-thalassemia traits are usually asymptomatic; however, laboratory examination will show mild anemia with microcytic hypochromic erythrocytes morphology with wide variation depending on the genotype. This study was conducted to determine the reference value of hematological parameters and hemoglobin (Hb) analysis based on the phenotype of β-thalassemia (β0 and β+) and determine the differences of hematological characteristics between the two phenotypes. Methods. This cross-sectional study was conducted by evaluating the hematological parameters and Hb analysis of the β-thalassemia trait in the family of thalassemia patient population. The subjects were divided into β0 and β+. The subject with normal Hb analysis with or without iron deficiency was excluded. Results. A total of 203 subjects with thalassemia traits were included from the families of thalassemia patients, consisting of 101 subjects with β0-thalassemia, 82 subjects with β+-thalassemia, and the mutation had not been found in 20 subjects. There was a relationship in the mean/median of hematological parameters, HbA2 and HbF, between β0-thalassemia and β+-thalassemia (P

Background: Student perceptions of the learning environment can influence student participation in learning. Both of these variables can possibly affect students’ academic performance. The purpose of this study was to assess the correlation between perceptions of the learning environment, participation in PBL tutorials, and academic performance of the pre-clinical stage students of the Faculty of Medicine Universitas Mataram. Methods: This was a cross-sectional study. Student perceptions of the learning environment were assessed using The Dundee Ready Education Environment Measure (DREEM) questionnaire. Participation in PBL tutorials was measured by an instrument that assess preparation for the tutorial, interactions during the tutorial, and students’ self-management. Academic performance was measured from the block’s main exam score. A total of 286 out of 303 medical students from year 1 to year 4 (94.39%) participated in this study. Results: The mean of the total DREEM score, participation score, and academic performance respectively were 135.94 ± 17.27; 83.20 ± 9.48; and 61.48 ± 13.47. There was a correlation between student participation and academic performance (r 0.569, p < 0.001), student perceptions of the learning environment and student participation (r = 0.225, p < 0.001), and student perceptions of the learning environment and academic performance (r = 0.190, p < 0.001). Conclusion: Student participation in tutorials is related to student academic performance. Participation possibly mediates the relationship between student perceptions of the learning environment and academic performance.

Latar belakang. Peningkatan angka kelangsungan hidup pasien thalassemia menyebabkan terdeteksinya berbagai penyakit komorbid termasuk komplikasi pada ginjal. Anemia kronis, kelebihan besi, dan pemakaian kelasi besi, terutama kelasi besi oral diduga berpengaruh pada fungsi ginjal. Berbagai derajat disfungsi tubular dan abnormalitas laju filtrasi glomerulus (LFG) dideteksi dengan berbagai macam pemeriksaan. Tujuan. Membandingkan laju filtrasi ginjal (tubulus dan glomerulus) pada pasien thalassemia yang mendapatkan kelasi besi oral. Metode. Penelitian potong lintang ini dilakukan di Pusat Thalassemia RS. Cipto Mangunkusumo Jakarta pada bulan Maret – Juli 2017. Kriteria inklusi adalah pasien thalassemia major berusia

Background: Medical students’ transition to clinical clerkship has been shown to be challenging. Students need to effectively adjust to the new learning environment. This study aims to explore the role of senior peers in students’ experiences during transition to clinical clerkships. Methods: A qualitative methodology was adopted for this study. Eight 4th year medical students (5 female, 3 male) submitted audio diaries during their first 12 weeks of clinical clerkships. 73 audio diaries were collected in total. Data were analyzed thematically. Twenty-five out of the 73 audio diaries contained interactions with senior peer students and these interactions were captured in 38 excerpts. These excerpts were analyzed further to understand the role of senior peer students during the transition. Results: Senior peer students helped to ease out transition to clinical clerkship by serving three roles: (1) transferring information on ways of working in a clinical environment, on social aspects of clinical environments and on learning issues; (2) providing exemplars in performing clinical tasks as well as learning tasks; (3) as co-workers who provided access and support students’ participation. Conclusions: Senior peer students in a clinical clerkship helped newcomers to navigate themselves in a clinical environment by helping them to build situational awareness, by supporting vicarious learning and supporting students’ participation in a clinical environment.

Latar belakang. Pasien imunokompromais lebih berisiko terinfeksi kuman Mycobacterium tuberculosis. Sensitivitas uji tuberkulin pada pasien anak dengan keganasan berkurang karena penurunan T helper 1 (Th 1). Diperlukan dua kali uji tuberkulin untuk meningkatkan sensitivitas uji tuberkulin pada anak dengan keganasan. Tujuan. Mengetahui penggunaan dua kali uji tuberkulin lebih sensitif mendeteksi infeksi tuberkulosis pada anak dengan keganasan dibandingkan satu kali uji tuberkulin. Metode. Penelitian cross sectional dilakukan Juli 2016 sampai 31 Maret 2017 pada pasien anak yang baru terdiagnosis penyakit keganasan, usia 6 bulan sampai 18 tahun di Rumah Sakit Dr. M. Hoesin (RSMH). Uji tuberkulin dilakukan pada semua subjek. Anak dengan hasil uji tuberkulin negatif saat uji tuberkulin pertama, dilakukan uji tuberkulin kedua setelah 2 sampai 4 minggu uji tuberkulin pertama. Hasil positif bila indurasi ≥5 mm. Hasil. Lima puluh pasien anak dengan keganasan ikut dalam penelitian. Tigapuluh dua subjek laki-laki, 18 subjek perempuan. Jenis penyakit keganasan terbanyak adalah leukemia limfoblastik akut 27 (54%). Pada uji tuberkulin pertama didapatkan hasil positif pada 4 subjek dan pada uji tuberkulin kedua didapatkan hasil positif pada 7 subjek. Terdapat perbedaan signifikan (p

Latar belakang. Pasien thalassemia dapat mengalami toksisitas besi yang dapat menyebabkan gangguan laju pertumbuhan. Parameter untuk memprediksi laju pertumbuhan agar gangguan pertumbuhan dapat terdeteksi lebih dini sangat diperlukan. Kadar ferritin serum dan saturasi transferin merupakan petanda iron overload yang rutin diperiksa pada anak thalassemia. Tujuan. Mengetahui apakah kadar ferritin serum dan saturasi transferin akurat untuk memprediksi laju pertumbuhan pada pasien thalassemia mayor. Metode. Penelitian uji diagnostik pada pasien thalassemia mayor usia 3 tahun - prepubertas dilakukan di bangsal anak RSUP dr. Mohammmad Hoesin bulan April – Desember 2015. Pengukuran ferritin serum dan saturasi transferin dilakukan pada semua subyek saat masuk penelitian. Laju pertumbuhan ditentukan mengikuti pertambahan tinggi badan hingga enam bulan. Dilakukan analisis receiver operator curve (ROC) untuk menentukan nilai diagnostik kadar ferritin serum dan saturasi transferin untuk memprediksi gangguan pertumbuhan pada anak thalassemia. Hasil. Terdapat 66 subyek berusia 3,5-15 tahun. Kadar ferritin serum memiliki sensitivitas 58,9%, spesifisitas 60%, dan akurasi 59,1%, sedangkan saturasi transferin memiliki sensitivitas 56,9%, spesifisitas 53,3% dan akurasi 56% dalam memprediksi pertumbuhan terlambat. Proporsi usia tulang terlambat pada kelompok subyek dengan gangguan pertumbuhan lebih besar meski perbedaannya secara statistik tidak bermakna. Kesimpulan. Kadar ferritin serum dan saturasi transferin tidak cukup akurat untuk memprediksi laju pertumbuhan.

Latar belakang. Pada pertengahan tahun 2000 terjadi peningkatan jumlah kasus difteri dan tetanus yang dirawat di Rumah Sakit Mohammad Hoesin (RSMH) Palembang. Peningkatan ini diperkirakan karena menurunnya konsistensi pelaksanaan program imunisasi sebagai dampak krisis multi dimensi yang menimpa Indonesia. Tujuan. Mengukur kadar anti toksin antidifteri (IgG difteri) dan antitetanus (IgG tetanus) pada anak SD kelas 1 di Palembang pada bulan Oktober 2008, untuk menggambarkan efektivitas imunisasi DPT pada anak yang lahir antara tahun 2001 – 2003 di Palembang. Metode. Subyek penelitian adalah murid SD kelas 1 dari 5 SD negeri di 5 Kecamatan di Kota Palembang. Kadar IgG antidifteri dan tetanus ditetapkan dengan cara ELISA dan dikelompokkan menjadi terproteksi penuh jika kadar IgG ≥0,1 IU/ml, proteksi dasar jika kadar 0,01 IU/ml - 0,1 IU/ml dan tanpa proteksi jika kadar

Latar belakang. Thalassemia-α merupakan kelainan genetik yang dapat menyebabkan gejala klinis berat pada pasien. Deteksi mutasi thalassemia-α di Indonesia umumnya menggunakan metode PCR sebagai baku emas. Saat ini, telah dikembangkan suatu metode tes strip α-globin strip assay yang lebih mudah, cepat, dan murah pengerjaannya. Tujuan. Mengetahui sensitivitas dan spesifisitas α-globin strip assay dalam mendeteksi mutasi thalassemia-α dibandingkan dengan PCR rutin. Metode. Uji diagnostik dilakukan mulai bulan Oktober 2014 sampai Maret 2015 terhadap seluruh pasien thalassemia-α beserta keluarga intinya yang berobat di RS Cipto Mangunkusumo dan Lembaga Biomolekular Eijkman. Seluruh subyek diperiksa darah perifer lengkap, indeks eritrosit, analisis Hb, morfologi darah tepi, PCR dan α-globin strip assay. Dihitung kesesuaian, sensitivitas dan spesifisitas α-globin strip assay terhadap PCR rutin dalam mendeteksi mutasi thalassemia-α. Hasil. Didapatkan 35 subyek, 17 pasien thalassemia-α dan 18 keluarga intinya. Tujuh jenis mutasi ditemukan, mutasi Hb CS dan 3,7 kb merupakan jenis dengan jumlah terbanyak (25,7% dan 17,1%). Empat subyek yang merupakan orang tua pasien ditemukan tidak memiliki mutasi. Pemeriksaan α-globin strip assay memiliki kesesuaian penuh terhadap PCR rutin sehingga didapatkan nilai sensitivitas dan spesifisitas sebesar 100%. Kesimpulan. Metode α-globin strip assay akurat dalam mendeteksi mutasi thalassemia-α sehingga dapat menjadi alternatif yang baik terhadap PCR rutin.

Perlambatan usia tulang pada pasien talasemia dipengaruhi oleh kadar serum feritin, kadar hb pretransfusi, usia, faktor nutrisi, kecepatan pertumbuhan, dan tingkat kepatuhan konsumsi kelasi besi. Tujuan penelitian ini adalah mengetahui gambaran usia tulang pada pasien talasemia dengan perawakan pendek di bagian Ilmu Kesehatan Anak RSMH Palembang. Penelitian ini merupakan penelitian observasional dengan desain potong lintang dari bulan Oktober-November 2013.Populasi pada penelitian ini yaitu pasien talasemia anak di RSMH Palembang sedangkan sampelnya yaitu pasien talasemia anak dengan perawakan pendek di RSMH Palembang. Analisis statistik menggunakan uji Kai kuadrat. Sebagian besar pasien talasemia mengalami perlambatan usia tulang (57,6%). Faktor risiko terjadinya perlambatan usia tulang yaitu kadar serum feritin, kadar hb pretransfusi, usia, faktor nutrisi, kecepatan pertumbuhan, dan tingkat kepatuhan konsumsi kelasi besi (OR>1) namun hanya usia dan kecepatan pertumbuhan memiliki hubungan yang sangat bermakna (p

The purpose of this study is to know the effect of intellectual capital on financial performance on bank go public listed on the Indonesia Stock Exchange in 2009-2012. The sampel are several bank go public. The research method in this study uses correlation study. The research model in this study employs panel data analysis with random effect approach on model 1a and fixed effect approach on model 1b. The empirical results show that intellectual capital that proxy with Value Added Capital Employed (VACA), Value Added Human Capital (VAHU) have positive significant effect on Earning per Share (EPS) but Structural Capital Value Added (STVA) has negative and no significant effect on Earning per Share (EPS). While, Value Added Capital Employed (VACA), Value Added Human Capital (VAHU) and Structural Capital Value Added (STVA) have positive significant effect on Return On Assets (ROA).