ANALISIS PERUBAHAN NT-proBNP SETELAH PEMBERIAN ANGIOTENSIN RECEPTOR BLOCKER (ARB) PADA PASIEN GAGAL JANTUNG (Penelitian Dilakukan di Poli Jantung RSUD Dr. Soetomo Surabaya)

BACKGROUND: NT-proBNP (N-Terminal pro Brain Natriuretic Peptide) is an inactive fragment of BNP (Brain Natriuretic Peptide) secreted by stretched ventricle as response to wall stress and elevated intracardiac pressure in patients with chronic heart failure. As a specific cardiac marker, elevated NT-proBNP correlates well with heart failure severity and class. The principle of heart failure therapy is modulation on neurohormonal activation, which activated in heart failure pathophysiology. One of the therapy that modulate neurohormonal is ARB. ARB can modulate neurohormon on RAA system, that result in decreasing NT-proBNP level and favorable outcomes. Reduction in NT-proBNP more than biologic variability (decrease > 25%) shows a therapy response. OBJECTIVES: To analyze change of NT-proBNP after ARB therapy in ambulatory HF patients at Cardiology Ambulatory Department Dr. Soetomo Teaching Hospital. METHODS: This observational prospective study was carried in Cardiology Ambulatory of Dr. Soetomo Teaching Hospital from September to December 2015. Blood sampling was performed on patients who meet the inclusion criteria of the study at first visit (baseline) and after 2 months therapy. NT-proBNP was measured by IMMULITE® as primary parameter and creatinin as secondary parameter. RESULT: There are 14 patients met the inclusion criteria of the study (11 males and 3 females). ARB therapy used in patients were Valsartan (64%), Telmisartan (22%) and Candesartan (14%). After 2 months ARB therapy, a decrease in level of NT-proBNP with initial baseline median 3092.5 (216 – 32112) pg/ml to 2135.5 (350 – 16172) pg/ml respectively were statistically significant (p = 0,003). And the secondary parameter creatini serum convert to eGFR shows a change in eGFR with initial baseline median 73.33 (37.05 – 266.68) ml/minute to 81.04 (39.31 – 167.02) ml/minute respectively were statistically not significant (p = 0.657). There were 7 patients (50%) have a decrease > 25%. CONCLUSION: In this study, we found that ARB therapy can change NT-proBNP level significantly after 2 months therapy. KEYWORDS: Natriuretic Peptides; NT-proBNP; Heart Failure; Angiotensin Receptor Blocke

PENGEMBANGAN MULTIMEDIA INTERAKTIF BERMUATAN KARAKTER BERBASIS ADOBE FLASH CS6 PADA MATA PELAJARAN BIOLOGI

ABSTRAK PENGEMBANGAN MULTIMEDIA INTERAKTIF BERMUATAN KARAKTER BERBASIS ADOBE FLASH CS6 PADA MATA PELAJARAN BIOLOGI Oleh INTAN KUSUMA DEWI Penelitian ini dilatarbelakangi oleh kurangnya pemanfaatan sarana, prasarana dan pengembangan teknologi dalam penggunaan media pembelajaran. Teknologi yang biasanya digunakan hanyalah LCD dan jumlahnya terbatas. Masalah lain yang ditemukan yaitu nilai karakter pada diri peserta didik masih dalam kategori sedang. Pendidik belum pernah menggunakan multimedia interaktif yang dapat menyisipkan nilai-nilai karakter. Pendidik dan peserta didik tertarik menggunakan multimedia interaktif bermuatan karakter berbasis Adobe Flash CS6. Penelitian ini menggunakan metode penelitian dan pengembangan (R&D). Prosedur yang digunakan dalam penelitian ini menggunakan teori Brog and Gall dengan tujuh tahapan meliputi tahap (1) penelitian dan pengumpulan informasi, (2) perencanaan, (3) pengembangan bentuk awal produk, (4) uji coba terbatas, (5) revisi hasil uji terbatas, (6) uji coba produk lebih luas, dan (7) revisi hasil uji lebih luas. Hasil penilaian produk multimedia interaktif bermuatan karakter berbasis Adobe Flash CS6 sangat layak digunakan dengan persentase nilai kelayakan ahli materi mencapai 98.88%, ahli media 87.77%, ahli bahasa 90.55% dan ahli soal 90.00%, hasil validasi praktisi pembelajaran (pendidik biologi) sebesar 92.50% dengan kategori sangat layak. Hasil olah data pada angket peserta didik untuk mengetahui kemenarikan memperoleh persentase sebesar 86.21% yang diinterpretasikan bahwa multimedia interaktif bermuatan karakter berbasis Adobe Flash CS6 pada materi sistem pencernaan manusia kelas XI SMA ―Sangat Menarik‖. Kesimpulan produk multimedia interaktif bermuatan karakter berbasis Adobe Flash CS6 sangat layak digunakan dalam proses pembelajaran biologi pada materi sistem pencernaan manusia Kelas XI SMA. Kata kunci: Multimedia Interaktif, karakter, Adobe Flash CS6, sistem pencernaan pada manusi

OPTIMASI FORMULA SEDIAAN SNEDDS (SELF-NANOEMULSIFYING DRUG DELIVERY SYSTEM) DARI EKSTRAK KLOROFORM DAUN JAMBU BIJI(Psidium guajava Linn.)

Daun Jambu biji digunakan secara turun-temurun untuk pengobatan berbagai penyakit. Ekstrak daun jambu biji memiliki kelarutan rendah yang berakibat pada bioavailabilitas oral yang kurang maksimal.Penelitian bertujuan untuk membuat sediaan SNEDDS ekstrak kloroform daun jambu biji yang homogen serta dapat memenuhi kriteria sebagai sediaan nanoemulsi meliputi nilai transmitansi lebih dari 90%, emulsification time kurang dari 1 menit, ukuran tetesan kurang dari 100nm dan extract loading yang tinggi . Metode penelitian yang digunakan adalah eksperimental yang dilakukan dengan mengekstraksi daun jambu biji menggunakan metode maserasi dengan pelarut kloroform.Kemudian dilakukan optimasi formulaSNEDDS yang homogen dengan program Design Expert. Dari sediaan yang homogen dilakukan pengamatan terhadap nilai transmitansinya untuk memilih formula terbaik. Kemudian dilakukan beberapa uji diantaranya pengamatan emulsification time, ukuran dan distribusi ukuran partikel, terhadap formula yang optimal. Hasil penelitian menunjukkan SNEDDS yang optimal memiliki perbandingan Tween 80 (surfaktan) :PEG 400 (kosurfaktan): minyak kemiri (minyak pembawa) = 1:5:1. Sediaan tersebut memiliki nilai transmitan sebesar 77,38% dan emulsification time¬ media aquades dan AGF kurang dari 5 menit. Sediaan SNEDDS tersebut dapat membentuk nanoemulsi dalam air dengan ukuran partikel sebesar14,0nm

The relationship between listening to religious music and reading al-Qur'an to anxiety levels of medical students

Background: The rate of anxiety in students of the Faculty of Medicine, University of Muhammadiyah Surakarta is still high at 57.1% for moderate anxiety, while those including mild anxiety levels are 36.7% and severe anxiety levels are 6.1%. Tranquility in the soul can be obtained from listening to religious music and reading the Qur'an (recitations). This study aims to determine the relationship of listening to religious music and reading the Qur'an (recitations) to the level of anxiety.Methods: This study was an analytic observational study with a cross sectional approach. Samples were taken by purposive sampling. This study uses the TMAS questionnaire to assess anxiety. The number of samples is 54. Analysis of the data used is Chi-square and Logistic Regression.Results: The results of Chi-Square test about the relationship listening to religious music to anxiety levels showed p = 0.000 and the relationship of reading Al-Qur'an (tilawah) to anxiety showed p = 0.000 which p<0.05 present a significant correlation between two variables. Logistic Regression test results of listening to religious music to anxiety levels showed p = 0.008 and OR = 7.164 and the relationship of reading Al-Qur'an (tilawah) to anxiety levels showed p = 0.002 and OR = 8.244.Conclusions: There is a significant correlation between listening to religious music and reading the Qur'an (tilawah) with the level of anxiety of students in the Faculty of Medicine, Muhammadiyah University of Surakarta. Students who listen to religious music and often read the Qur'an (recitations) will reduce the risk of anxiety. Reading the Qur'an (recitations) is more influential on reducing the level of anxiety than listening to religious music

Determinan Perilaku Deteksi Dini Kanker Serviks pada Pegawai di Pemerintah Kabupaten Badung

Latar Belakang: Kanker serviks adalah salah satu penyebab kematian tertinggi kedua pada wanita setelah kanker payudara. Berdasarkan data WHO, insiden kanker serviks pada tahun 2012 di perkirakan&nbsp; terjadi sebanyak 528.000 kasus yang terjadi di seluruh dunia dan sebesar 90% dari kasus tersebut diperkirakan terjadi pada negara-negara berkembang. Pemberian vaksinasi HPV merupakan salah satu cara yang dapat dilakukan untuk mencegah terjadinya kanker serviks. Pemberian vaksinasi HPV lebih efektif diberikan pada wanita dengan usia 9-26 tahun dan belum pernah melakukan hubungan seksual. Berdasarkan laporan CDC, pada wanita usia subur yang telah mendapatkan vaksin HPV dan telah berhubungan seksual secara aktif sebaiknya mau melakukan deteksi dini kanker serviks.&nbsp; Tujuan: Tujuan dari penelitian ini adalah untuk mengetahui faktor determinan yang mempengaruhi perilaku untuk melakukan deteksi dini kanker serviks pada pegawai yang telah mendapatkan vaksinasi HPV di Pemkab Badung. Metode: Penelitian ini adalah penelitian crosectional deskriptif dengan total jumlah sampel sebanyak 150 orang, dengan teknik pengambilan sampel menggunakan metode PPS. Hasil: Hasil dari penelitian ini menunjukkan bahwa dari 7 variabel yang diteliti yaitu: pengetahuan, sikap, dukungan keluarga, dukungan teman, adanya faktor risiko kanker serviks dan adanya gejala kanker serviks terhadap perilaku deteksi dini kanker serviks, yang memiliki hubungan yang signifikan dengan perilaku deteksi dini kanker serviks pada responden yang telah mendapatkan vaksinasi HPV adalah pengetahuan (OR = 4,45;CI 95% = 1,399-18,589), dukungan keluarga (OR = 3,53;CI 95% = 1,197-12,6), dukungan teman (OR = 6,06;CI 95% = 2,292-16,055) dan dari 16 responden yang memiliki gejala kanker serviks 11 diantaranya telah melakukan deteksi dini. Sedangkan variabel sikap dan adanya faktor risiko kanker serviks. Kesimpulan: Saran yang dapat diberikan dari hasil penelitian ini adalah perlunya peningkatan dalam pemberian komunikasi, informasi dan edukasi (KIE) mengenai cara pencegahan dari penyakit kanker serviks. &nbsp; Kata Kunci: Faktor Determinan, Kanker Serviks, Deteksi Dini, Vaksinasi HPV, Pemkab Badun

A function of Bioslurry Organic for Solid Fertilizer

Indonesia is an agricultural country in which people mostly work as farmers and produce abundant farming outcomes. On one hand, the use of chemical fertilizer supports the plants growing well. On the other hand, it decreases the soil fertility and farming product quality. The alternative way to reduce or substitute the chemical fertilizer is by using organic fertilizer which can be made through composting method for 2 months mixing the leaf waste and rice straw. Before mixing both materials, the values of C, N, P, K and the water content of Bioslurry were respectively 15.17%, 0.27%, 0.3%, 0.05%, and 67.07%. Meanwhile, the values of C, N, P, K and the water content of leaf waste were consecutively 41.12%; 1.22%; 1.16%; 8.94%; and 28.77%. Moreover, the values of C, N, P, K, and the water content of rice straw were sequentially 39.42%; 1.20%; 1.05%; 10.07%; and 31.23%. After mixing both materials through composting method, the results of rice straw fertilizer got C-Organic 20.87%; N 2.01%; P 0.16%; K 5.64%; water 22.31%, and C/N ratio 16.38%. Meanwhile, the composting process of leaf waste yielded C-Organic 25.44%; N 1.18%; P 0.18%; K 7.95%; water 11.85%, and C/N ratio 21.55%

Pola Pembelajaran Full Day School Di SMA Muhammadiyah 1 Karanganyar Tahun Ajaran 2017/2018

The purposed of this research are: (1) describe how the implementation of full days school program, (2) describe how the learning patterns of full day school,(3) describe the problems faced in the implementation of learning patterns full day school, (4) describe how the work which is done in the faced of these problems. The type of this research is qualitative. The technique of collecting data through observation, interviews and documentation. The validity of the data obtained by the triangulation technique is done by comparing the results of observation, interviews and documentation. Data analysis techniques in this study by data reduction, data presentation, conclusion and verification. The results of this study are (1) the implementation of full day school program in SMA Muhammadiyah 1 Karanganyar using the curriculum 2013 with the development of the concept of Islam as well as character education of students, (2) learning patterns of full day school in SMA Muhammadiyah 1 Karanganyar not maximized and fun so many students whose bored and tired, (3) the problems in the implementation of this program is that students who are not yet ready to follow the learning full day school from morning to evening and the weakness of LCD in each class, (4) the work done SMA Muhammadiyah 1 Karanganyar in overcoming the fun learning pattern by providing games in the learning process, learning outdoors and learning the GCC more freely. Fulfillment of the infrastructure are still lacking. The role of the implementation of full day school is a step to improve school quality and character education of students

ARAHAN ZONASI DAN PENGEMBANGAN KAWASAN SITUS CAGAR BUDAYA PATIAYAM KABUPATEN KUDUS

Konservasi merupakan suatu upaya pelestarian lingkungan dengan tetap mempertahankan keberadaan setiap komponen lingkungan untuk pemanfaatan dimasa depan. Kegiatan pelestarian sedapat mungkin tidak hanya mempertahankan keaslian dan perawatan, namun juga mendatangkan nilai ekonomi atau manfaat lain bagi pemilik atau masyarakat luas.Salah satu lokasi yang perlu adanya pelestarian adalah di Kawasan Situs Cagar Budaya Patiayam di Desa Terban Kabupaten Kudus. Kawasan Situs Cagar Budaya Patiayam merupakan kawasan yang memerlukan tindakan pelestarian terhadap kebudayaan dan lingkungannya. Permasalahan di Kawasan Situs Cagar Budaya Patiayam adalah belum adanya upaya keberlanjutan dalam menjaga dan melindungi kawasan situs cagar budaya serta belum adanya upaya pengembangan kebudayaan lokal pada kawasan tersebut. Hal ini mengakibatkan penurunan fungsi kawasan tersebut yang sebelumnya telah ditetapkan dalam perarturan sebagai kawasan situs cagar budaya dan kawasan wisata budaya.Berdasarkan permasalahan tersebut upaya yang dilakukan untuk meningkatkan fungsi dari kawasan adalah dengan membuat zonasi atau pembagian fungsi lahan yang jelas. Tujuan akhir yang diharapkan adalah untuk memberikan arahan zonasi pada setiap kawasan yang dijadikan sebagai kawasan konservasi dan kawasan wisata budaya. Hal ini dilakukan untuk meningkatkan fungsi lahan sesuai dengan ketetapan peraturan yang berlaku

ANALYSIS OF CHANGE IN NT-proBNP AFTER ANGIOTENSIN RECEPTOR BLOCKER (ARB) THERAPY IN PATIENT WITH HEART FAILURE

NT-proBNP is an inactive fragment of BNP secreted by stretched ventricle as response to wall stress in patients with heart failure. As a specific cardiac marker, elevated NT-proBNP correlates well with heart failure severity. The principle of heart failure therapy is modulation on neurohormonal activation. ARB can modulate neurohormon on RAA system, that result in decreasing NT-proBNP level and favorable outcomes. Reduction in NT-proBNP more than biologic variability (> 25%) shows a therapy response.This study was to analyze change of NT-proBNP after ARB therapy in ambulatory HF patients. This observational prospective study was carried from September to December 2015. Blood sampling was performed on patients who meet the inclusion criteria of the study at first visit and after 2 months therapy. NT-proBNP was measured by IMMULITE® as primary parameter and creatinin as secondary parameter. There are 14 patients met the inclusion criteria of the study (11 males and 3 females). ARB therapy used in patients were Valsartan (64%), Telmisartan (22%) and Candesartan (14%). After 2 months ARB therapy, a decrease in level of NT-proBNP with initial median 3092.5 (216 – 32112) pg/ml to 2135.5 (350 – 16172) pg/ml respectively were statistically significant (p=0.003). And the secondary parameter creatinin serum convert to eGFR shows a change in eGFR with initial median 73.33 (37.05 – 266.68) ml/minute to 81.04 (39.31 – 167.02) ml/minute respectively were statistically not significant (p=0.657). There were 7 patients (50%) have a decrease > 25%. In this study, we found that ARB therapy can change NT-proBNP level significantly after 2 months therapy

Implementasi MPRL dan Hough Transform Untuk Segmentasi dan Ekstraksi Fitur Pada Citra Gaya Berjalan

Human gait is unique. It has different characteristics and have a high ability to distinguish a person. "Gait” analysis, mapping human body points is todays advanced technology. Stages of "gait" processing start from segmentation, extraction until recognition. This paper discusses the segmentation and extraction of gait features. Thinning methods with Most Prominent Ridge Line (MPRL) algorithms to form the skeleton bones of human beings is used. The resulting skeleton image is used for features gait extraction through annular analysis. Method for feature extraction used is Hough transformation. The resulting features are grouped according to distance and angle. This grouping determines the location of features on an image skeleton. The next process is to calculate the distance between feature and angle formed. There are ten features obtained. Four features of a group spacing distance of the front foot until the heel of the hind legs, hands up to the front axle center of the chest, arms rear axle until the middle of the chest and arms front to the back of the hand. Six other features are the result of measurement angle of the front knee, ankle front, rear ankle, knee hind legs, forearms and elbows behind the elbow sleeves