Obesity and Other Risk Factors Associated with Hypertension in Puskesmas Toluaan of Southeast Minahasa Regency

Hypertension, one of many non-communicable diseases, is becoming a worldwide health problem due to its high prevalence, one that continues to increase over time. Hypertension ranks as the third highest cause of premature death. The prevalence of hypertension in North Sulawesi placed the province in fifth place in Indonesia based on RISKESDAS (National Basic Research) 2013. There are several risk factors associated with hypertension, one of them being obesity. North Sulawesi ranks first with the highest prevalence of obesity in Indonesia. This research aimed to analyze risk factors associated with hypertension in Puskesmas (Public Health Center) Toluaan of Southeast Minahasa Regency. The type of research conducted was ananalytic surveywith case-control design. The study population was patients who seek treatment at the clinic in Puskesmas Toluaan. Total samples were 248 respondents, divided into 2 groups, cases and controls, each with124 respondents that were determined through purposive sampling method. Research used questionnaires and medical records as instruments. Data was processed through chi-square for bivariate analysis and logistic regression for multivariate analysis by using SPSS 22. Results showed that risk factors associated with hypertension in Puskesmas Toluaan were obesity, gender, alcohol consumption, and fat intake, whereas age, family history of hypertension, physical activity, smoking, and sodium intake were not associated with hypertension. Alcohol consumption was the most dominant factor associated with hypertension in Puskesmas Toluaan of Southeast Minahasa Regency,While obesity was shown to have significant association with hypertension. Keywords: hypertension, obesity, risk factors, north sulawes

Laju Tumbuh Umbi Tanaman Kentang Varietas Granola dan Supejohn di Dataran Medium dengan Pemulsaan

ABSTRACTResearch on growth rate of two cultivars of potato c.v. Granola and Supejohn at medium altitude using mulching methods was conducted at Paslaten village, Subdistrict of West Langowan, District of Minahasa, North Sulawesi. Research location was at medium altitude of 750 m above sea level. The objectives of this research were to determine growth rate of potato tuber grown at medium altitude and the most suitable mulch. The research was arranged in a randomized complete block design with two treatments and three replications. The first factor was potato cultivars (Granola and Supejohn) and second factor was mulching methods (no mulch, straw mulch and black silver plastic). Research result showed that straw mulch treatment increased growth rate of Granola and Supejohn cultivars 0.87 g plant-1 day-1 and 0.73 g plant-1 day-1, respectively while black silver plastic treatment only increased the growth rate of Granola and Supejohn cultivars 0.70 g plant-1 day-1and 0.59 g plant-1 day-1, respectively. The highest tuber dry weight was achieved by straw mulch. The best treatment was Granola grown in straw mulch. The lowest growth rate occurred at the mulch treatment which were 0.49 g plant-1 day-1 for Granola cultivar and 0.47 g plant-1 day-1 for Supejohn cultivar.Keywords: black silver plastic mulch, dry weight, growth rate, potato, straw mulch    ABSTRAKPenelitian tentang laju tumbuh tanaman kentang dengan 2 (dua) varietas yaitu Granola dan Supejohn di dataran medium dengan menggunakan mulsa dilakukan di Desa Paslaten, Kecamatan Langowan Barat, Kabupaten Minahasa Provinsi Sulawesi Utara. Lokasi penelitian berada di dataran medium dengan elevasi 750 m di atas permukaan laut. Penelitian bertujuan untuk mendapatkan besarnya laju tumbuh umbi tanaman kentang yang dikembangkan di dataran medium dan jenis mulsa yang paling sesuai. Penelitian menggunakan rancangan acak kelompok dengan 2 (dua) faktor dan 3 (tiga) ulangan yaitu faktor I tanaman kentang (varietas Granola dan Supejohn) dan faktor II yaitu perlakuan mulsa (tanpa mulsa, mulsa jerami dan mulsa plastik hitam perak). Hasil penelitian menunjukkan bahwa perlakuan mulsa jerami meningkatkan laju tumbuh umbi pada varietas Granola sebesar 0.87 g tanaman-1 hari-1 dan varietas Supejohn sebesar 0.73 g tanaman-1 hari-1. Perlakuan mulsa plastik hitam perak meningkatkan laju tumbuh umbi pada varietas Granola sebesar 0.70 g tanaman-1 hari-1 dan varietas Supejohn 0.59 g tanaman-1 hari-1. Bobot kering umbi tertinggi dicapai oleh mulsa jerami. Perlakuan terbaik ialah varietas Granola yang diberi mulsa jerami. Laju pertumbuhan terendah terdapat pada perlakuan tanpa mulsa sebesar 0.49 g-1 hari-1 untuk kultivar Granola dan 0.47 g-1 hari-1 untuk Supejohn.Kata kunci: bobot kering, kentang, laju tumbuh, mulsa jerami, mulsa plastik hitam pera

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Variation in postoperative outcomes of patients with intracranial tumors: insights from a prospective international cohort study during the COVID-19 pandemic

Background: This study assessed the international variation in surgical neuro-oncology practice and 30-day outcomes of patients who had surgery for an intracranial tumor during the COVID-19 pandemic. Methods: We prospectively included adults aged ≥18 years who underwent surgery for a malignant or benign intracranial tumor across 55 international hospitals from 26 countries. Each participating hospital recorded cases for 3 consecutive months from the start of the pandemic. We categorized patients’ location by World Bank income groups (high [HIC], upper-middle [UMIC], and low- and lower-middle [LLMIC]). Main outcomes were a change from routine management, SARS-CoV-2 infection, and 30-day mortality. We used a Bayesian multilevel logistic regression stratified by hospitals and adjusted for key confounders to estimate the association between income groups and mortality. Results: Among 1016 patients, the number of patients in each income group was 765 (75.3%) in HIC, 142 (14.0%) in UMIC, and 109 (10.7%) in LLMIC. The management of 200 (19.8%) patients changed from usual care, most commonly delayed surgery. Within 30 days after surgery, 14 (1.4%) patients had a COVID-19 diagnosis and 39 (3.8%) patients died. In the multivariable model, LLMIC was associated with increased mortality (odds ratio 2.83, 95% credible interval 1.37–5.74) compared to HIC. Conclusions: The first wave of the pandemic had a significant impact on surgical decision-making. While the incidence of SARS-CoV-2 infection within 30 days after surgery was low, there was a disparity in mortality between countries and this warrants further examination to identify any modifiable factors

Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study.

Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery