Gallstone and Diabetes Mellitus

Diabetes Mellitus (DM) is a metabolic disease which has high prevalence among the population. The prevalence is increasing in accordance to life style changes in the society. Gallstone is frequently found in diabetic patients especially in women with type 2 DM. Nevertheless, studies on the prevalence of gallstone among diabetic patients population have shown inconsistent/contradictive results. Insulin resistance which is frequently found in type 2 DM patients is the underlying factor that correlates obesity, central adiposity, and low physical activity with gallstone disease. Two important physiological reasons in diabetic patients that may increase the risk of gallstone formation are: (1) Increased total cholesterol synthesis that causes bile becomes more easily transformed into cholesterol stone (lithogenic); (2) Diabetic patients have larger size and probably reduced motility of the gallbladder that cause increased formation of cholesterol crystals. However, recent study demonstrated that DM that merely exists without any contribution of other factors is not significant to increase the risk of gallstone formation. The gallstone management in diabetic patients is the same as the management in non-diabetic patients. Elective surgery with laparoscopic cholecystectomy is the treatment of choice for symptomatic cases. Drug treatment is indicated for patients with cholesterol stone, small stone (diameter <5 mm), and well-functioned cystic duct

Pengaruh Pengunaan Media Audio Visual Terhadap Hasil Belajar Roll Depan Pada Senam Lantai Di Kelas XI IPA SMA Negeri 6 Pontianak

This study aims to determine how the use of media Audio Visualinfluence on learning outcomes of students on roll materials especially the floorexercises in class XI SMA 6 pontianak.Form of quasi-experimental research is the design of nonequivalent controlgroup design. For the entire population of students of class XI Science SMAN 6pontianak namely XI science 1, XI Science 2 XI Science 3. With the research sampleclass XI science 2 and class XI Science 3. Sampling purposive sampling technique.Consideration of the results of classroom teachers and researchers XI science 3 wasselected as the experimental class and class XI Science 2 was selected as the controlclass. A data collection tool in conducting performance tests gerakakan roll forward.Data Analysis with SPSS computerized accounting system using dispersion 19.he results showed an average score of student learning outcomes using audiovisualmedia is 70 higher than using the textbook for 57.6724. After testing pairedsamples T Test obtained t (9.851) ? TTable (2.048) at the level of 0.05 means thatthere is a difference between learning outcomes of students in the experimental classusing audio-visual media and the control class using the textbook. Effectiveness ofaudio-visual media is high (ES = 1.88) and accounted for 46.99%

Chronic Diarrhea Caused by Amebic Colitis and Inflammatory Bowel Disease

The diagnosis of intestinal amebiasis is easily established based on colonoscopy, i.e. there is a specific characteristic of ulcer/lesion “discrete flask-shape ulcer” with normal mucosa among the ulcers. However, most patients with amebic colitis have non-specific clinical manifestations and their colonoscopy findings are hardly distinguished from inflammatory bowel disease. In the present case, the patient had a chief complaint of chronic bleeding diarrhea and abdominal pain. The fecal analysis found trophozoites of Entamoeba histolytica. Serology test (sero-amebic) revealed negative result. The colonoscopy examination reveals hyperemic mucosa, edema, and multiple ulcers with various sizes covered with fragile and easily bleed debris, from the rectum to ascending colon, rigid colon, narrowing lumen and tumor/mass appearance on ascending colon. The differential diagnosis was severe amebic colitis and inflammatory bowel disease. Based on the colonoscopy biopsy, we found an active chronic colitis along with dysplasia. The patient received management and treatment of severe amebic colitis and inflammatory bowel disease

Kesesuaian Hasil Pemeriksaan CT Scan dan Klasifikasi Child-Pugh pada Sirosis Hepatis

Abstrak Sirosis hepatis merupakan hasil akhir dari kerusakan kronis hepar akibat berbagai etiologi, ditandai dengan kerusakan parenkim mengarah kepada fibrosis yang luas dan regenerasi nodular. Fibrosis hepar berlangsung lambat dan bertahap menuju sirosis hepatis dekompensata. Derajat sirosis hepatis akan sangat membantu jika dapat ditentukan baik secara klinis maupun dengan pencitraan non-invasif. Derajat sirosis hepatis secara klinis dikaitkan dengan klasifikasi Child-Pugh sedangkan CT scan merupakan modalitas utama yang digunakan pada pasien dengan sirosis hepatis karena dapat menilai dengan baik serta akurat perubahan intrahepatik yang terjadi. Penelitian ini merupakan penelitian retrospektif dan menggunakan data rekam medik 26 sampel penderita sirosis hepatis yang memenuhi kriteria inklusi. Data dianalisis menggunakan korelasi Spearman’s Rank. Hasil penelitian menunjukkan adanya kesesuaian derajat sirosis hepatis yang memiliki korelasi yang kuat dan bermakna antara CT scan dengan klasifikasi Child-Pugh dalam menilai total volume hepar (r= -0,719; p=0,001); nilai rata-rata tiga diameter vena hepatika dengan rasio lobus kaudatus lobus kanan hepar (ld/CRL-r) (r= -0,760; p=0,001); dan perubahan kontur hepar (r= 0,812; p=0,001).Kata kunci: Sirosis hepatis, morfologi hepar, CT scan, klasifikasi Child-Pugh Abstract Liver cirrhosis is the final result of chronic damage to the liver from various etiologies, characterized by parenchymal injury leading to extensive fibrosis and nodular regeneration. Hepatic fibrosis proceeds slowly and gradually toward decompensated cirrhosis. It would be helpful if it were possible to determine the severity of liver cirrhosis clinically and by noninvasive imaging. The severity of liver cirrhosis is clinically evaluated with Child-Pugh classification while the CT scan is the primary modality used in patients with liver cirrhosis because it can assess properly and accurately the changes that occur intrahepatic. This research is a retrospective study using medical records of 26 liver cirrhosis patients who met the inclusion criteria. Data were analyzed using Spearman’s Rank correlation. There were strong and significant correlations between CT scan and Child-Pugh classification on total liver volume (r = -0.719; p=0.001), ld/CRL-r (r = -0.760; p=0.001), and the contour of the liver (r = 0.812; p=0.001).Keywords: liver cirrhosis, liver morphology, CT scan, Child-Pugh classificatio

Combination of Aspartate Aminotranferase and Tumor Necrosis Factor-alfa as Non Invasive Diagnostic Tools for Non Alcoholic Steatohepatitis (NASH)

Aim: to develop a non-invasive diagnostic test for non-alcoholic steatohepatitis NASH. Methods: this is a cross-sectional study on non-alcoholic fatty liver disease (NAFLD) subjects. Sample was taken by consecutive sampling method. Diagnostic criteria of NAFLD were confirmed by liver biopsy. Clinical variables include metabolic syndrome, aspartate aminotransferase (AST), alanine aminotransferase (ALT), adiponectine, TNF-alfa, insulin, homeostatic model assessment insulin resistance (HOMA-IR) index and liver biopsy. Patients were divided into two groups based on their liver biopsy, group 1: Non-NASH (NAFLD activity score 4). Statistical analyses were performed using Student’s t-test, Mann Whitney U, chi-square, the ROC curve, sensitivity and specificity test. Results: fifty NAFLD patients were recruited, 30 males and 20 females. Among these patients, 12 (24%) had type 2 diabetes, 36 (72%) had metabolic syndrome, the remaining 2 (4%) did not fulfilled metabolic syndrome. Liver biopsy confirmed 21 (42%) non- NASH and 29 (58%) NASH respectively. Level of AST and ALT, plasma level of adiponectine and TNF-alfa were statistically different between two groups. The AST level (>25 U/L) in combination with TNF-a (>3.28 pg/cc) demonstrated a good diagnostic accuracy for NASH (Accuracy 82%, Sensitivity 76%, Specificity 90%, PPV 92%, and NPV 73%). Conclusion: the combined diagnostic tests of AST and TNF-alfa plasma levels demonstrated a good accuracy for the detection of NASH among NAFLD patients. This combination test can be used as a noninvasive method to diagnose NASH.Key words: AST, TNF-a, diagnostic test, NASH

Modified Background Subtraction Statistic Models for Improvement Detection and Counting of Active Spermatozoa Motility

An important early stage in the research of sperm analysis is the phase of sperm detection or separating sperm objects from images/video obtained from observations on semen. The success rate in separating sperm objects from semen fluids has an important role for further analysis of sperm objects. Algorithm or Background subtraction method is a process that can be used to separate moving objects (foreground) and background on sperm video data that tend to uni-modal. In this research, some of the subproject model statistics of substrata model are Gaussian single, Gaussian Mixture Model (GMM), Kernel Density Estimation and compared with some basic subtraction model background algorithm in detecting and counting the number of active spermatozoa. From the results of the tests, the Grimson GMM method has an f-measure value of 0.8265 and succeeded in extracting the sperm form near its original form compared to other method

EVALUASI KEMAMPUAN PEMBANGKIT LISTRIK TENAGA MIKROHIDRO (PLTMH) CHECK DAM V KALI JARI KABUPATEN BLITAR KARENA PERUBAHAN JUMLAH DAN DISTRIBUSI BEBAN

Jatuh tegangan dan rugi daya yang besar pada jaringan listrik menyebabkan berkurangnya kualitas jaringan Pembangkit Listrik Tenaga Mikrohidro (PLTMH). Di samping itu masuknya jaringan PLN tahun 2014 menyebabkan terjadinya penurunan jumlah pelanggan yang ada di Dusun Jari Sukomulyo. Pada tahun yang sama terjadi peristiwa erupsi Gunung Kelud yang menyebabkan rusaknya PLTMH milik Dusun Purwodadi dan Dusun Notorejo. Akibatnya warga kedua Dusun tersebut dan warga Perkebunan Ngusri beralih ke jaringan listrik PLTMH Check Dam V Kali Jari. Selanjutnya pada proses pemasangan jaringan baru, pengelola dan operator mengalami kendala mengidentifikasi fasa R, S, dan T. Oleh sebab itu operator menyambungkan jaringan terdekat tanpa mengetahui ketiga fasanya sehingga terjadi ketidakseimbangan beban. Untuk memaksimalkan potensi PLTMH pada siang hari pengelola dan operator mengoperasikan mesin pengolah kopi dan pengolah pupuk organik. Dari evaluasi diperoleh data bahwa potensi yang masih dapat dibangkitkan PLTMH Check Dam V Kali Jari secara teori sebesar 21,395 kW dengan debit air sebesar 0,568 m3⁄detik dan tinggi jatuh air 8 m. Setelah dilakukan konfigurasi ulang dan penyetimbangan beban maka ditemukan tiga hal. Pertama, arus beban pada fasa R, S, dan T berturut-turut adalah 9,95 A; 9,85 A; dan 9,99 A. Kedua, rugi daya fasa R, S, dan T yang hilang pada penghantar jaringan tegangan rendah berturut-turut adalah 139,8569 W; 191,8837 W; dan 87,6480 W. Terakhir, jatuh tegangan paling ujung jaringan tegangan rendah pada fasa R 12,2550 V (5,5705%); S 18,7287 V (8,5130%); dan T 8,4968 V (3,8622%). Selanjutnya diperoleh jumlah daya listrik setara dari kedua mesin pengolah adalah 7,46 kW atau masih sebesar 34,9% dari potensi daya keseluruhan.Kata kunci—Kemampuan PLTMH, perubahan jumlah beban, distribus

Seroprevalence Study of HbsAg Positive in Entrant Candidates of Specialist Doctoral Program at Dr. Kariadi Hospital Semarang

Background: Hepatitis B Virus (HBV) infection is one of main diseases that infects human kind and constitutes a serious health problem in community. As a consequence of their job, health personnel have gained higher risk to HBV infection. Medical personnel (doctors) are determined as one of the high-risk group of the HBV infection through blood transmission.The objective of this study was to determine the prevalence of HBsAg positive in doctors who were entrant candidates of medical specialist program at Dr. Kariadi hospital. Method: The study was conducted retrospectively by reviewing medical record of 1,145 doctors who were entrant candidates of medical specialist program at Dr. Kariadi hospital since April 2000 to October 2004. The HBsAg assay as a marker of HBV infection was analyzed by EIA (Enzyme Immuno Assay) Method. Results: Among the 1,145 doctors examined , the range of age was 29.34 ± 3.04 years, and more than 3-year work period as doctor was 64% (733/1,145), and less than 3-year work period as doctor was 36% (412/1,145). The prevalence of HBsAg positive in population was 3.9% (45/1,145). The seropositive of HBsAg in the group of doctors with more than 3-year work period was significantly higher than the group with less than 3-year work period (5.1% (38/73) vs. 1.6% (7/412) with p < 0.05. Conclusion: The prevalence of HBsAg positive in doctors who were entrant candidates of specialist doctoral program at Dr. Kariadi hospital was 3.9%. The prevalence of infection was higher in the group of doctors with more than 3-year work period

EVALUASI KEMAMPUAN PEMBANGKIT LISTRIK TENAGA MIKROHIDRO (PLTMH) CHECK DAM V KALI JARI KABUPATEN BLITAR KARENA PERUBAHAN JUMLAH DAN DISTRIBUSI BEBAN

Jatuh tegangan dan rugi daya yang besar pada jaringan listrik menyebabkan berkurangnya kualitas jaringan Pembangkit Listrik Tenaga Mikrohidro (PLTMH). Di samping itu masuknya jaringan PLN tahun 2014 menyebabkan terjadinya penurunan jumlah pelanggan yang ada di Dusun Jari Sukomulyo. Pada tahun yang sama terjadi peristiwa erupsi Gunung Kelud yang menyebabkan rusaknya PLTMH milik Dusun Purwodadi dan Dusun Notorejo. Akibatnya warga kedua Dusun tersebut dan warga Perkebunan Ngusri beralih ke jaringan listrik PLTMH Check Dam V Kali Jari. Selanjutnya pada proses pemasangan jaringan baru, pengelola dan operator mengalami kendala mengidentifikasi fasa R, S, dan T. Oleh sebab itu operator menyambungkan jaringan terdekat tanpa mengetahui ketiga fasanya sehingga terjadi ketidakseimbangan beban. Untuk memaksimalkan potensi PLTMH pada siang hari pengelola dan operator mengoperasikan mesin pengolah kopi dan pengolah pupuk organik. Dari evaluasi diperoleh data bahwa potensi yang masih dapat dibangkitkan PLTMH Check Dam V Kali Jari secara teori sebesar 21,395 kW dengan debit air sebesar 0,568 m3â„detik dan tinggi jatuh air 8 m. Setelah dilakukan konfigurasi ulang dan penyetimbangan beban maka ditemukan tiga hal. Pertama, arus beban pada fasa R, S, dan T berturut-turut adalah 9,95 A; 9,85 A; dan 9,99 A. Kedua, rugi daya fasa R, S, dan T yang hilang pada penghantar jaringan tegangan rendah berturut-turut adalah 139,8569 W; 191,8837 W; dan 87,6480 W. Terakhir, jatuh tegangan paling ujung jaringan tegangan rendah pada fasa R 12,2550 V (5,5705%); S 18,7287 V (8,5130%); dan T 8,4968 V (3,8622%). Selanjutnya diperoleh jumlah daya listrik setara dari kedua mesin pengolah adalah 7,46 kW atau masih sebesar 34,9% dari potensi daya keseluruhan.Kata kunci—Kemampuan PLTMH, perubahan jumlah beban, distribus