Gambaran Kadar Ureum Pada Pasien Penyakit Ginjal Kronik Stadium 5 Non Dialisis

: Chronic kidney disease (CKD) is a pathophysiological process with diverse etiology, resulting in a progressive decreased in renal function, and generally ends up with kidney failure. In CKD patient, the level of urea increases -uremia- a clinical syndrome that occurs in all organs due to the increased level of urea. During catabolism process, protein is broken down into amino acids and deamination ammonia which is further synthesized to become urea. Increased level of urea depends on the glomerular filtration rate (GFR). Decreased of GFR (<15ml / min) can cause renal failure and uremia. This study aimed to determine the levels of urea in patients with stage 5 CKD non-dialysis. This was an observational descriptive study. This study was conducted from December 2015 to January 2016 at two hospitals, Prof. Dr. R. D. Kandou Hospital and Adventist Hospital Manado. Samples were blood samples of all patients suffering from CKD stage 5 non-dyalisis within the specified time. The results of laboratory tests showed that of 35 patients diagnosed with stage 5 CKD non-dialysis all had increased urea levels (100%). Conclusion: There was an increase in urea level of patients with stage 5 chronic kidney disease non-dialysis either of outpatients or inpatients

Profil USAha Agroindustri Kerajinan Tempurung Kelapa “Gm Art” di Kota Tomohon

The objective of this research is to determine the profile of entrepreneurs and agroindustry enterprises handicrafts made from coconut shell in Tomohon municipality, and to know benefits achieved in one month. Data collection was conducted for three months, from January 2016 to March 2016. The data obtained are primary data and secondary data. The primary data obtained through interviews to business owners of GM Art in Tomohon. Secondary data were taken from the agencies involved in the research namely Tomohon City Government offices. The results of this study showed that the GM business Art located in Tomohon Tengah sub district, Tomohon municipality began operation in 1999 and began to establish training activities learning - teaching in 2006 until now. Enterprises GM Art operates in the field of small industries that use raw materials of coconut shell and the name of the business owner is Mr Gian Mansa derived from Luwuk Banggai. He has the initiative itself to open a craft business that is made from coconut shell in North Sulawesi, especially in Tomohon Tengah Sub district, Tomohon Municipality, Equipment that is in use Enterprises GM Art at the moment is the use of the machine but with the availability of the engine as an auxiliary key workers business owners have not had those perfect so that business owners create an engineering tool that can create products that are new and can be received by the public. GM Enterprises Art has the profit in January 2016 amounted to Rp. 5.915.392 and uses marketing in form of direct and online marketing

Analisis Pengelolaan Rantai Pasok Tepung Kelapa pada PT. Xyz di Sulawesi Utara

The purpose of this study are: (1) Identify the supply chain model of coconut desiccated at PT. XYZ and (2) to analyze the supply chain management of desiccated coconut at PT. XYZ. The research was conducted over 2 months ie from September to November 2016 and is located in PT. XYZ (pseudonym), in North Sulawesi. The data used in this research are primary and secondary data. The primary data obtained through field observation and direct interviews. Interviews were conducted with the company related logistics company to find a picture of the supply chain and supply chain management is done by the company. In addition, the researchers also conducted interviews with coconut farmers and collectors to determine the condition of the current coconut price as well as the flow of raw material coconuts from the famers to supplier. Secondary data were obtained from the relevant literature, as well as documents and reports that are owned by companies and agencies. This study focuses on the management of the flow of material and information flow of the supply chain of coconut flour at PT. XYZ. The results of observations and interviews were analyzed with descriptive qualitative analysis methods. The results showed that (1) Members of coconut flour supply chain at. XYZ, namely (a) the raw material supplier of coconut spread in some areas, (b) PT. XYZ for purchasing, sales, shipping and production, (c) Expediting Services to send products from Bitung harbor, next to the port of Tanjung Priok to be exported to the country of destination, (d) The customer, in this case the food companies that require raw materials coconut flour to be produced into chocolate bars, cookies, dessert, and so forth. (2) (a) Selection of supplier PT. XYZ is good enough, because every supplier who will supply the raw material to go through the interview stage, made a deal with the company and agree to the terms proposed by the company. PT. XYZ also maintain good relations with its suppliers with visits annually; (b) the flow of material and information flow is managed by PT. XYZ is good enough. Any information purchasing, sales, shipping and finance centered PT.XYZ headquarters is located in Manado and PT. XYZ manage information about the quantity of raw materials available in the warehouse and general condition of the plant

HUBUNGAN FAKTOR-FAKTOR SOSIAL EKONOMI PETANI DAN TINGKAT ADOPSI INOVASI BUDIDAYA PADI DI DESA KEMBANG MERTHA, KECAMATAN DUMOGA TIMUR, KABUPATEN BOLAANG MONGONDOW

The objective of the research is to determine farmer’s socio-economic characteristics, the paddy’s cultivation innovation adoption degree and the relationship between farmer’s socio-economic factors with the degree of paddy’s (Oryza sativa L.) cultivation innovation adoption in Kembang Merta Village. This research is using descriptive statistic analytic method with survey technique. The study location is taken on purpose base. Kembang Mertha Village was chosen because it is one of rice production center in Bolaang Mongondow Regency. The sample was taken from 48 people by using stratified random sampling technique based on the farmer’s rice field area. The correlation test of Rank Spearman using SPSS 17 Program is used to examine the relationship between farmer’s socio-economic factors with the degree of paddy (Oryza sativa L.) cultivation innovation adoption. Research result showed that mostly respondents have 1.1 – 2 Ha paddy field area with income about Rp. 11.000.000- Rp. 15.000.000 every planting season. Mostly respondents are 40 to 50 years old that classified as productive ages and mostly were senior school graduates. The non-formal education only once to four times a year and the cosmopolitan respondents only three times a year. The degree of Paddy (Oryza sativa L.) cultivation innovation adoption observed from paddy’s cultivation stages. The soil plowing process in median 5, planting paddy in median 5, fertilization in median 4, irrigation in median 5, the pests, diseases and weeds control in median 5 and harvest and post-harvest in median 5. Correlation test indicated that land area, income, formal education and cosmopolitan level are significant to rice cultivation innovation adoption, whereas non-formal education and ages indicated insignificant relation to rice cultivation innovation adoption. *jn

Pengaruh suntikan depo medroxy progesteron asetat terhadap profil lipid

Tujuan: Mengetahui pengaruh pemberian DMPA terhadap profil lipid akseptor. Rancangan/rumusan data: Pre test - post test. Bahan dan cara kerja: Penelitian dilakukan mulai Januari 2006 sampai Maret 2007 di Kota Tomohon. Pada penelitian ini direkrut 250 orang akseptor DMPA yang memenuhi kriteria inklusi. Sebagai subjek dalam penelitian ini adalah wanita usia 20 - 35 tahun berstatus menikah, masih mengalami menstruasi, tidak menggunakan kontrasepsi hormonal selama 3 bulan terakhir. Sampel dipilih secara simple random sampling, ditentukan 26 orang subjek yang akan dilakukan pemeriksaan laboratorium bertahap pada 1, 3, 6, 9, dan 12 bulan. Selanjutnya dilakukan pengumpulan data, ditabulasi, dan disajikan dalam bentuk tabel untuk karakteristik subjek, perubahan profil lipid sebelum dan sesudah penyuntikan DMPA dilakukan analisis dengan uji T - Berpasangan. Hasil: Pada penelitian ini sebagian besar akseptor berusia 31 - 35 tahun 40,8 %, pendidikan SLTA 45,2 %, dan tidak bekerja (IRT) 83,6 %, paritas 2 40,8 %, dan IMT rata-rata 24,6. Kadar kolesterol total baseline, 1, 3, 6, 9, 12 bulan (188,31; 174,42; 182,35; 184,08; 182,50; 184,30; p>0,05). Kadar HDL baseline, 1, 3, 6, 9, 12 bulan (57,00; 51,35; 51,19; 49,92; 51,31; 48,38; p0,05). Kadar Trigliserida baseline, 1, 3, 6, 9, 12 bulan (97,31; 88,92; 81,81; 94,60; 99,50; 111,04; p>0,05). Kesimpulan: Terjadi penurunan kadar kolesterol total selama pemakaian DMPA 12 bulan, namun secara statistik tidak bermakna. Tidak terjadi perubahan kadar LDL, trigliserida secara bermakna, namun terjadi penurunan kadar HDL secara bermakna setelah pemberian DMPA selama 12 bulan, bila diukur dari baseline. Penggunaan kontrasepsi DMPA pada calon akseptor yang memiliki risiko tinggi PJK harus dihindari. Perlu dilakukan pemeriksaan profil lipid secara rutin terhadap semua akseptor kontrasepsi DMPA jangka panjang > 1 tahun. [Maj Obstet Ginekol Indones 2008; 32-3: 153-60] Kata kunci: DMPA, kolesterol total, HDL, LDL, trigliserida

Signet-Ring Cell Carcinoma of the Ampulla of Vater

Signet-ring cell carcinoma (SRCC) of the ampulla of Vater is a very rare case and only 28 cases have beed reported in the English literature. Herein, we report a 59-year-old woman with SRCC of the ampulla of Vater. She developed symptoms of obstructive jaundice at early stage of disease and underwent pylorus-preserving Whipple procedure as definitive treatment. Histopathology examination showed numerous tumor cells with intracytoplasmic mucin and eccentric nuclei. Her tumor has already invaded the serosa of duodenum, but no infiltration to the stomach, pancreas, and lymphovascular structure. Her surgical margins and regional lymph nodes were free of tumor. She was diagnosed with T2N0M0 SRCC of the ampulla of Vater. No adjuvant treatment was given and she has been doing well for five months after surgery

Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs