Iron deficiency anemia in a woman’s life cycle and its impact

According to WHO, iron deficiency anemia is a condition where the body lacks iron, which is proven by signs of iron deficiency in the tissues and insufficient iron reserves in the body, accompanied by a decrease in hemoglobin levels of >2 standard deviations from the reference value in the same population. Iron deficiency anemia is one of the most common micronutrient deficiencies that occurs in a woman's life cycle due to menstruation (blood loss), pregnancy (needs for the mother and fetus), and bleeding during childbirth.aanem

PREDIKSI CURAH HUJAN MENGGUNAKAN ALGORITMA HYBRID NEURAL NETWORK DAN EVOLUTIONARY PROGRAMMING

ABSTRAK Pertumbuhan dan kualitas hasil pertanian tergantung pada beberapa faktor, salah satunya adalah faktor lingkungan. Tanah merupakan salah satu faktor lingkungan yang berkaitan erat dengan curah hujan karena air sebagai pengangkut unsur hara dari tanah ke akar dan kemudian dilanjutkan pada proses fotosintesis. Hal inilah alasan mengapa prediksi curah hujan patut diketahui. Untuk tugas akhir ini, diterapkan metode peramalan Simple Moving Average (SMA) dan untuk membangun sistemnya digunakan hybrid Artificial Neural Network (ANN) dan algoritma Evolutionary Programming (EP). Moving average merupakan salah satu metode dalam peramalan yang berfungsi smoothing data untuk mengestimasikan siklus trend (kecenderungan). Namun, perlu diperhatikan adalah tidak semua data bersifat baik apabila terlalu smooth. Hal ini dikarenakan akan cenderung kehilangan informasi. Pada tugas akhir kali ini, digunakan metode SMA dengan 3-MA dan 5-MA. Akurasi yang lebih baik akan menunjukkan metode mana yang lebih baik untuk mengolah data pada tugas akhir ini. Evolving ANN merupakan suatu sistem evolusi yang menggabungkan ANN dan algoritma Evolutionary Algorithm (EAs) yang mana salah satu algoritmanya yaitu EP. Berbeda dengan algoritma Eas lainnya, EP menggunakan mutasi sebagai operator rekombinasi genetik atau bisa dikatakan bahwa satu-satunya proses dalam menghasilkan kromosom baru. Hal ini yang menjadikan kelebihan EP untuk mengevolusi ANN sehingga EP akan mengoptimasi ANN. Untuk mendapatkan arsitektur dan bobot ANN optimal dibangkitkan 20000 solusi individu dengan kombinasi ukuran populasi 50 dan generasi 400 dengan akurasi rata-rata pelatihan dan pengujian sebesar 79,24% pada arsitektur 3-1-1 metode 3-MA. Sedangkan untuk 5-MA menghasilkan akurasi rata-rata sebesar 78,45% pada arsitektur 5-2-1. Kata Kunci : time series, moving average, ANN, Evolutionary Algorithm, Evolutionary Programming

The Role of Obstetrician in Reducing the Risks of Childhood Allergy Related to Cesarean Birth: A Literature Review

Women’s decision on birth mode should consider its risks and benefits, including long-term risks of caesarean among children. This study aims to present the current available evidences on the risks of caesarean towards childhood allergy and how an obstetrician could prevent this outcome through nutrition and education. We searched articles from several online databases about the link between caesarean, childhood allergy, and prenatal intervention. There were significant risks of childhood asthma and food allergy, but it was still unclear for allergic rhinitis and atopic dermatitis. Nutritional intervention could be done for pregnant women with consumption of probiotics and vitamin D supplementation. In addition, prenatal education is necessary to prepare better childhood outcomes

Impact single versus double layer uterine closure in caesarean section to uterine rupture

Caesarean section (CS) is one of the most frequent delivery methods in the world whereas the rates of CS were varied according to developing (from 3.5 to 29.2%) and developed countries (21.1%). The study aims to known the impact of single versus double layer uterine closure to uterine rupture in the history of cesarean section (CS). In this case report, the clinical question is single versus double-layer uterine closure on the previous CS, gives better outcome to reduce the risk of uterine rupture. To answer this question, we search the evidence from Pub Med and Cochrane database with the keywords: “cesarean section" and "uterine rupture" and “uterine closure”. The inclusion criteria are written in English and focused comparing single and double layer uterine closure to uterine rupture in the previous CS. From the searching literature, we found 3 systematic reviews and 23 articles which were relevant to the topic. After screening the abstract and language, we got 2 systematic reviews and 4 articles. At the end, only 4 articles consisting of 1 systematic review and 3 articles were included to be appraised. Based on evidences, single layer uterine closure did not increase the risk of uterine rupture. Apart from that, shorter operative times and lower estimated blood loss became the superiority of single-layer uterine closure

Implementasi Dan Analisis Konsep Personal Learning Environment Pada Learning Management System

Sebagai aplikasi e-learning, Learning Management System (LMS) cenderung lebih memfasilitasi kebutuhan institusi dimana tools dan konten belajar ditentukan oleh pengajar atau institusi, serta disimpan dan dikelola secara terpusat. Akibatnya, LMS kurang fleksibel bagi pelajar untuk mengelola lingkungan belajarnya sendiri, serta berkolaborasi dan berbagi pengetahuan dengan pelajar lain. Keterbatasan itu dapat ditangani dalam konsep Personal Learning Environment (PLE) yang memfasilitasi pelajar membangun lingkungan belajarnya sendiri serta mendukung kolaborasi dan berbagi pengetahuan dengan pelajar lain tanpa terikat institusi. Pada penelitian ini, dikemukakan bagaimana konsep PLE dapat diterapkan pada LMS melalui sebuah aplikasi yang mendukung konsep PLE kemudian mengintegrasikannya dengan LMS. Ini memungkinkan pelajar membangun PLE-nya melalui LMS sehingga hal baru yang perlu dipelajari dapat dikurangi. Pada akhir penelitian dilakukan expert evaluation untuk mengetahui kualitas aplikasi dari segi kemudahan navigasi, program bantuan atau tutorial, teknis dan estetika, serta kualitas aplikasi dalam membangun sebuah PLE. Hasil evaluasi menunjukkan bahwa dari sudut pandang expert dua aspek terakhir dinilai sudah cukup baik

FAKTOR-FAKTOR YANG MEMPENGARUHI KUALITAS DIET PADA IBU HAMIL: TINJUAN LITERATUR

Kehamilan merupakan periode yang sangat penting. Kualitas diet merupakan salah satu alat ukur yang dapat digunakan untuk dapat menghindari hasil kehamilan yang tidak diinginkan. Penelitian ini bertujuan untuk menganalisis artikel dari berbagai jurnal agar dapat memberikan informasi yang terpercaya mengenai  faktor-faktor yang mempengaruhi kualitas diet selama masa kehamilan. penelitian ini menggunakan metode literature review. Penelusuran literatur dilakukan melalui Google Scholar dan Pubmed dengan kata kunci ‘kualitas diet ibu hamil. Kriteria inklusi yaitu publikasi nasional dan internasional free full text, publikasi yang bertujuan untuk mengetahui faktor yang mempengaruhi kualitas diet pada ibu hamil, dan publikasi yang diterbitkan dalam 5 tahun terakhir.  Berdasarkan hasil telaah dari lima jurnal yang relevan dengan tujuan penelitian, terdapat dua faktor utama yang mempengaruhi kualitas diet pada ibu hamil, yaitu status sosial ekonomi dan pengetahuan terkait gizi. Perlu adanya pertimbangan terkait kesenjangan sosial ekonomi dalam program intervensi kepada ibu hamil, dan diperlukan pemberian edukasi gizi, baik sebelum kehamilan dan selama masa kehamilan

A Significant Increase in Maternal Blood Uric Acid Levels Accompanies the Severity of Hypertensive Disorders in Pregnancy: Peningkatan Signifikan Kadar Asam Urat Darah Ibu menyertai Keparahan Gangguan Hipertensi pada Kehamilan

Objective: To asses the relationship between maternal serum uric acid level and severity of hypertensive disorders in pregnancy and perinatal outcomes.Methods: A cross sectional study was conducted at Persahabatan Hospital from January 2014 to December 2018. Subject were pregnant women with hypertensive disorder. Serum uric acid levels were taken from a venous blood sample at the time the patient came for delivery. The severity of hypertensive disorders in pregnancy were grouped into chronic hypertension, gestational hypertension, preeclampsia without severe feature, preeclampsia with severe feature, and preeclampsia with severe feature and organ involvement. The perinatal outcomes were the gestational age at birth, birth weight, and the first minute APGAR score. The relationship between maternal serum uric acid level and severity of hypertensive disorders in pregnancy and perinatal outcomes were analyzed using Mann Whitney and Kruskall Wallis test.Result: A total of 704 out of 880 pregnant women with hypertensive disorder have met the criteria as research subjects. Maternal uric acid levels were found to increase significantly (p <0.001) with increasing severity of hypertensive disorders in pregnancy. Maternal who experienced preterm delivery had significantly higher blood uric acid levels (p <0.001) than those who experienced a term delivery. Maternal blood uric acid levels of infants with small birth weight for gestational age and first minute Apgar score <7 were slightly higher but not significant compared to maternal blood uric acid levels of normal birth weight infants and first minute Apgar score >7.Conclusions: Maternal blood uric acid levels increased significantly accompanying the severity of hypertensive disorders in pregnancy. Blood uric acid levels tend to be higher in maternal who have poor perinatal outcomes.Keywords: APGAR score, hypertensive disorders in pregnancy, preeclampsia, uric acid. AbstrakTujuan: Untuk menilai hubungan antara kadar asam urat serum ibu dan keparahan gangguan hipertensi pada kehamilan dan luaran perinatal.Metode: Studi potong lintang dilakukan Rumah Sakit Persahabatan periode Januari 2014 sampai Desember 2018. Subjek penelitian adalah ibu hamil dengan gangguan hipertensi. Kadar asam urat darah diambil dari sampel darah vena pada saat ibu hamil datang untuk melahirkan. Tingkat keparahan gangguan hipertensi pada kehamilan dikelompokkan menjadi hipertensi kronik, hipertensi gestasional, preeklamsia tanpa gejala berat, preeklamsia dengan gejaka berat, dan preeklamsia dengan gejala berat dan keterlibatan organ. Luaran perinatal adalah usia kehamilan saat lahir, berat badan bayi lahir, dan skor APGAR menit pertama. Hubungan antara kadar asam urat darah ibu dan tingkat keparahan gangguan hipertensi pada kehamilan dan luaran perinatal dianalisis menggunakan uji Mann Whitney atau uji Kruskall Wallis.Hasil: Sebanyak 704 dari 880 ibu hamil penderita hipertensi telah memenuhi kriteria sebagai subjek penelitian. Kadar asam urat darah ibu meningkat secara signifikan (p <0,001) dengan meningkatnya keparahan gangguan hipertensi pada kehamilan. Ibu yang melahirkan preterm memiliki kadar asam urat darah yang lebih tinggi secara bermakna (p < 0,001) dibandingkan ibu yang melahirkan aterm. Kadar asam urat darah ibu dari bayi dengan berat lahir kecil untuk usia kehamilan dan skor Apgar menit pertama < 7, sedikit lebih tinggi tetapi tidak signifikan, dibandingkan kadar asam urat darah ibu dari bayi berat lahir normal dan skor Apgar menit pertama pertama > 7.Kesimpulan: Kadar asam urat darah ibu meningkat secara signifikan menyertai beratnya gangguan hipertensi pada kehamilan. Kadar asam urat darah cenderung lebih tinggi pada ibu yang memiliki luaran perinatal kurang baik.Kata kunci: APGAR, asam urat, hipertensi dalam kehamilan, preeklamsia

Association Between Folic Acid and Zinc Concentration with Incidence of Bacterial Vaginosis in the First Trimester of Pregnancy

Bacterial vaginosis (BV) in pregnancy is associated with the increase of adverse pregnancy outcomes such as premature rupture of membranes and preterm labor. One of the multifactorial causes of BV is thechange in vaginal immunity. Malnutrition, including micronutrient deficiency, increases the vulnerability toinfections. This study aim to investigate the association between folic acid and zinc concentration with theincidence of bacterial vaginosis in the first trimester of pregnancy. This descriptive cross sectional studyinvolved 139 mothers with first trimester pregnancy, aged between 17-39 years old. The study was conductedat dr. Cipto Mangunkusumo Hospital from September 2013 until August 2014. Vaginal secretions was sampledto diagnose BV under nugent criteria. Folic acid and zinc in the serum were measured. From 139 subject,18.7% (n=26) were found to be BV positive (nugent score =7). No deficiency of folic acid (<7 ng/mL) and40.3% (n=56) of zinc deficiency (<60  µg/dL) were found. Bivariate analysis used Kruskal-Wallis test betweenfolic acid and zinc concentration with BV incidence gives p value of 0.668 and 0.478 respectively. Prevalenceof BV in this study was 18.7%. The relation between the maternal statuses of folic acid with BV in the firsttrimester of pregnancy was not found

Plasma Folate, Vitamin B6 and B12 in Their Relationship to the Presence of Probiotic Strain Bifidobacterium animalis subsp. Lactis HNO19 (DR10TM) Among Indonesian Pregnant Women in Their Third Semester

Introduction Vitamin B12 plays a role during pregnancy in maintaining folate metabolism. Together with folate and vitamin B6, B12 is involved as a coenzyme in DNA synthesis and various methylation reactions in developing embryos. This study aims to compare plasma folate, vitamin B6 and B12 blood levels with respect to the presence of probiotic strain Bifidobacterium animalis subsp. lactis HNO19 (DR10TM) among pregnant women in Indonesia. Methods: This study is part of a larger study entitled “Effects of Bifidobacterium animalis subsp. lactis HNO19 (DR10TM), inulin, and micronutrient fortified milk on fecal DR10TM, immune markers, and maternal micronutrients among Indonesian pregnant women.” Further analyses were performed using independent-t test or Mann Whitney test, GLM-repeated measures and chi-square test, to compare folate, vitamin B6 and B12 intake and blood concentration during pregnancy with presence (n=22) and absence (n=55) subjects of fecal DR10TM at third trimester. Results: At the first trimesters there was no difference in plasma vitamin B6 and vitamin B12 levels between the two groups, based on the presence or absence of fecal DR10TM. However, at the second and third trimester, vitamin B6 blood concentration (p=0.034 and p=0.001) and vitamin B12 blood concentrations at the third trimester (p=0.035) were significantly higher in the fecal DR10TM positive group, while having a similar vitamin B6 and B12 intake. Conclusion: Consumption of pre- and probiotics during the periconceptional period may be a useful strategy for improving maternal vitamin B’s vitamins, especially vitamin B6 and B12 status and therefore provide benefits for the offspring’s quality of life