PENERAPAN PERILAKU HIDUP BERSIH DAN SEHAT PADA TATANAN SEKOLAH DI SLTP NEGERI 10 KOTA TERNATE

ABSTRAKAnak usia sekolah merupakan usia yang rentan menderita penyakit infeksi tertular seperti diare, kecacingan dan gangguan pencernaan lainnya. Kebiasaan mengkonsumsi makanan jajanan di sekolah serta lingkungan sekolah yang kotor sebagai salah satu faktor penyebab sehingga perlu kesadaran bersama dalam menerapkan perilaku hidup bersih dan sehat di lingkungan sekolah. Tujuan kegiatan pengabdian ini adalah untuk meningkatkan pemahaman peserta didik terhadap perilaku hidup bersih dan sehat di sekolah sebagai upaya pencegahan penyakit dalam meningkatkan derajat kesehatan. Metode yang dilakukan dalm bentuk ceramah melalui penyuluhan kesehatan dengan sasaran 39 orang peserta didik SLTP Negeri 10 Kota Ternate yang berada di kecamatan Pulau Hiri. Tahapan yang dilakukan berupa persiapan, pelaksanaan dan evaluasi menggunakan pre-post test Hasil yang diperoleh dari analisis uji t dependen adalah adanya peningkatan pengetahuan (p=0,018), sehingga menunjukkan adanya pengaruh penyuluhan dalam peningkatan pengetahuan peserta didik tentang perilaku hidup bersih dan sehat. Saran yang dapat direkomendasikan perlunya dukungan kebijakan penerapan dan praktik perilaku hidup bersih dan sehat oleh seluruh komponen sekolah atau masyarakat sekolah mulai dari kepala sekolah, guru, peserta didik, staf sekolah lainnya untuk menciptakan lingkungan yang sehat. Kata kunci: peserta didik; PHBS; sekolah ABSTRACTSchool-age children are an age that is vulnerable to contracting infectious diseases such as diarrhea, worms, and other digestive disorders. The habit of consuming snacks at school is one of the causal factors, so that there is a need for joint awareness in implementing clean and healthy living behaviors in the school environment. The purpose of this service activity is to increase students' understanding of clean and healthy living behavior in schools as an effort to prevent disease in improving health status. The method is carried out in the form of lectures through health counseling with a target of 39 studentsi SLTP Negeri 10 Kota Ternate who are on Hiri Island. The steps taken are in the form of preparation, implementation and evaluation using the pre-post test. The results obtained from the dependent t test analysis were an increase in knowledge (p = 0.018), thus indicating the existence of effect counseling to increase students' knowledge about clean and healthy living behaviors. Suggestions that can be recommended are the need for policy support  implementation and practice of clean and healthy living behavior by all components of the school starting from students, teachers, other school staff to create a healthy environment. Keywords: learners; PHBS; schoo

SOSIALISASI TENTANG DIABETES MELITUS PADA MASYARAKAT DI KELURAHAN TOGOLOBE

Diabetes melitus merupakan suatu kelompok penyakit metabolik yang ditandai dengan dengan kadar gula darah yang melebihi nilai normal. Prevalensi diabetes melitus setiap tahunnya mengalami peningkatan, penyebabnya adanya peningkatan jumlah populasi, umur, obesitas dan kurangnya aktivitas fisik. Upaya pencegahan yang dapat dilakukan dengan sosialisasi dan pemeriksaan kesehatan secara rutin. Tujuan kegiatan ini untuk meningkatkan pemahaman masyarakat terhadap upaya pencegahan dan pengendalian diabetes melitus dalam meningkatkan derajat kesehatan. Metode yang digunakan yaitu ceramah melalui sosialisasi kesehatan dengan sasaran sebanyak 20 orang masyarakat yang berada di Kelurahan Togolobe. Tahapan yang dilakukan berupa persiapan, pelaksanaan dan evaluasi dengan menggunakan kuesioner. Hasil yang diperoleh bahwa setelah diberikan sosialsiasi tentang diabetes melitus terjadi peningkatan pemahaman dilihat dari sebagian besar jawaban peserta benar. Dengan adanya sosialisasi ini diharapkan masyarakat dalam kehidupan sehari-hari dapat menerapkan pola hidup sehat sebagai upaya pencegahan penyakit diabetes melitus

Randomized clinical trial to compare the traditional teaching method and the simulated-scenario teaching method in the acquisition of skills for the identification of acute respiratory disease signs in paediatric patients

Introducción. La infección respiratoria aguda es un problema de salud pública en menores de 5 años; la detección e identificación tempranas de sus signos disminuye la mortalidad en este grupo de edad y es una meta de la formación médica. Objetivo. Comparar en estudiantes de medicina el método educativo tradicional y el escenario simulado para el reconocimiento de signos de enfermedad respiratoria aguda en niños de 2 meses a 5 años. Sujetos y métodos. Se realizó un ensayo clínico para estudiantes de medicina, aleatorizados en dos grupos: A (clase teórica y ayudas audiovisuales) y B (escenario simulado). El desenlace primario fue el desempeño en la evaluación global. Se realizó prueba de Mann-Withney Wilcoxon para comparación entre grupos y Mann-Withney Wilcoxon pareada para análisis intragrupo (antes y después de la intervención). Resultados. Mediante prueba de Mann-Withney Wilcoxon pareada intragrupo pre y postintervención, el grupo A mostró mejor un desarrollo de competencias en el desenlace primario (p = 0,02) y en la evaluación global del escenario simulado (p = 0,04). El grupo B logró cambios significativos en el desenlace primario (p = 0,00), la anamnesis (p = 0,00) y la evaluación global del escenario simulado (p = 0,00). En la evaluación postintervención no se encontraron diferencias significativas en el desenlace primario ni secundario. Conclusiones. La comparación postintervención entre los grupos A y B no mostró diferencias significativas en ninguna de las variables estudiadas entre ambos grupos.Artículo original269-274Paciente pediátricoIntroduction. The acute respiratory infection is a public health problem in children under 5 years of age. The early detection and identification of its signs reduces the mortality rates in these age groups and is an objective in medical education. Aim. To compare the traditional teaching method with the simulated-scenario teaching method in the acquisition of skills necessary to recognize respiratory distress in children between 2 months and 5 years of age by medical students. Subjects and methods. A clinical trial was done for medical students and they were divided into two randomized groups: group A which used the traditional teaching method and group B, which used the simulated-scenario method. The primary outcomes were seen in the global evaluation performances. A Mann-Withney Wilcoxon test was used for the comparison among groups and a paired Mann-Withney Wilcoxon test was used for the intra-group analysis (before and after the intervention). Results. When using the paired Mann-Withney Wilcoxon intragroup test pre and post intervention, group A showed a better skill development in the primary outcome (p = 0.02) and the global evaluation in simulated scenario (p = 0.04). On the other hand, group B reached significant changes on the primary outcomes (p = 0.00), anamnesis (p = 0.00) and global evaluation with the simulated-scenario method (p = 0.00). It was observed that in the post-intervention evaluation there weren’t any significant differences between the primary and secondary outcomes. Conclusions. The post-intervention comparison between groups A and B didn’t show significant differences in the studied variables between both groups

Ampullary cancers harbor ELF3 tumor suppressor gene mutations and exhibit frequent WNT dysregulation

The ampulla of Vater is a complex cellular environment from which adenocarcinomas arise to form a group of histopathologically heterogenous tumors. To evaluate the molecular features of these tumors, 98 ampullary adenocarcinomas were evaluated and compared to 44 distal bile duct and 18 duodenal adenocarcinomas. Genomic analyses revealed mutations in the WNT signaling pathway among half of the patients and in all three adenocarcinomas irrespective of their origin and histological morphology. These tumors were characterized by a high frequency of inactivating mutations of ELF3, a high rate of microsatellite instability, and common focal deletions and amplifications, suggesting common attributes in the molecular pathogenesis are at play in these tumors. The high frequency of WNT pathway activating mutation, coupled with small-molecule inhibitors of β-catenin in clinical trials, suggests future treatment decisions for these patients may be guided by genomic analysis

Added Value of Molecular Biological Analysis in Diagnosis and Clinical Management of Liposarcoma: A 30-Year Single-Institution Experience

Biological, physical and clinical aspects of cancer treatment with ionising radiatio

The 894G>T variant in the endothelial nitric oxide synthase gene and spina bifida risk

The 894G>T single nucleotide polymorphism (SNP) in the endothelial NOS (NOS3) gene, has recently been associated with embryonic spina bifida risk. In this study, a possible association between the NOS3 894G>T SNP and spina bifida risk in both mothers and children in a Dutch population was examined using both a case-control design and a transmission disequilibrium test (TDT). Possible interactions between the NOS3 894G>T SNP and the MTHFR 677C>T SNP, elevated plasma homocysteine, and decreased plasma folate concentrations were also studied. The NOS3 894TT genotype did not increase spina bifida risk in mothers or children (OR 1.50, 95%CI 0.71–3.19 and OR 1.78, 95%CI 0.75–4.25, respectively). The TDT demonstrated no preferential transmission of the NOS3 894T allele (Χ2 = 0.06, P = 0.81). In combination with the MTHFR 677TT genotype or elevated plasma homocysteine concentrations, the NOS3 894GT/TT genotype increased maternal spina bifida risk (OR 4.52, 95%CI 1.55–13.22 and OR 3.38, 95%CI 1.46–7.84, respectively). In our study population, the NOS3 894GT/TT genotype might be a risk factor for having a spina bifida affected child in mothers who already have an impaired homocysteine metabolism

Hallazgos hematológicos en perros y gatos en Lima, Perú

The aim of this study was to conduct a haematological evaluation of dogs and cats in Lima, Peru. A total of 460 blood samples (410 dogs and 50 cats) were collected between December 2017 and May 2018. The smears were stained with Wright and the reticulocytes were stained with Brilliant cresyl blue. Descriptive statistics were performed for quantitative variables in the erythroid, myeloid and lymphoid series, as well as the frequency analysis of qualitative variables between species indicator of type of anaemia and leukaemia, ability of medullary regeneration, abnormal morphological changes, out of physiological range and presence of extra and intracellular microorganisms. The most frequent alterations were normochromic normocytic anaemia (23.2% dog, 10% cat), megaloblastic anaemia (5.1% dog), severe hypochromic microcytic anaemia (4% cat), neutrophilic chronic myeloid leukaemia (7.1% dog, 8% cat), monocytosis with cytoplasmic vacuolization in monocytes (4.9% dog), severe thrombocytosis with platelet aggregates (6% cat), polychromatophilia (6.3% dog), dacrocytes (54.4% dog, 64% cat), acanthocytes (11.7% dog, 40% cat) , macrocytes (14.6% dog, 6% cat), small leukocytes (10% dog, 6% cat), Cytauxzoon felis (20% cat), Anaplasma spp (0.2% dog) and Mycoplasma spp (2% dog, 20% cat). Only significant differences were observed between sexes in total platelets (p=0.0087) and eosinophils (p=0.0260) being greater in male dogs. It is concluded that the prevalence of C. felis in the cats studied is relatively low and there is a risk of zoonosis of Anaplasma spp and Mycoplasma spp in the owners of affected animals in Lima, Perú.El objetivo del estudio fue realizar una evaluación hematológica a perros y gatos en Lima, Perú. Se colectaron 460 muestras de sangre (410 perros y 50 gatos) entre diciembre de 2017 y mayo de 2018. Los frotis se colorearon con Wright y las láminas de reticulocitos con Azul de cresil brillante. Se realizó estadística descriptiva para variables cuantitativas en las series eritroide, mieloide y linfoide, así como el análisis de frecuencias de variables cualitativas entre especies indicadoras de tipo de anemia y leucemia, capacidad de regeneración medular, cambios morfológicos anormales, salida de rango fisiológico y presencia de microorganismos extra e intracelular. Predominaron la anemia normocítica normocrómica (23.2% perro, 10% gato), anemia megaloblástica (5.1% perro), anemia severa microcítica hipocrómica (4% gato), leucemia mieloide crónica de neutrófilos (7.1% perro, 8% gato), monocitosis con vacuolización citoplasmática en monocitos (4.9% perro), trombocitosis severa con agregados plaquetarios (6% gato), policromatofilia (6.3% perro), los dacriocitos (54.4% perro, 64% gato), acantocitos (11.7% perro, 40% gato), macrocitos (14.6% perro, 6% gato), leucocitos pequeños (10% perro, 6% gato), Cytauxzoon felis (20% gato), Anaplasma spp (0.2% perro) y Mycoplasma spp (2% perro, 20% gato). Solo se evidenciaron diferencias significativas entre sexos en las plaquetas totales (p=0.0087) y los eosinófilos (p=0.0260) siendo mayor en perros machos. Se concluye que la prevalencia de C. felis en los gatos estudiados es relativamente baja y existe un riesgo de zoonosis de Anaplasma spp y Mycoplasma spp en los propietarios de animales afectados en Lima, Perú. &nbsp

Deep Molecular Characterization of Milder Spinal Muscular Atrophy Patients Carrying the c.859G>C Variant in SMN2

Spinal muscular atrophy (SMA) is a severe neuromuscular disorder caused by biallelic loss or pathogenic variants in the SMN1 gene. Copy number and modifier intragenic variants in SMN2, an almost identical paralog gene of SMN1, are known to influence the amount of complete SMN proteins. Therefore, SMN2 is considered the main phenotypic modifier of SMA, although genotype-phenotype correlation is not absolute. We present eleven unrelated SMA patients with milder phenotypes carrying the c.859G>C-positive modifier variant in SMN2. All were studied by a specific NGS method to allow a deep characterization of the entire SMN region. Analysis of two homozygous cases for the variant allowed us to identify a specific haplotype, Smn2-859C.1, in association with c.859G>C. Two other cases with the c.859G>C variant in their two SMN2 copies showed a second haplotype, Smn2-859C.2, in cis with Smn2-859C.1, assembling a more complex allele. We also identified a previously unreported variant in intron 2a exclusively linked to the Smn2-859C.1 haplotype (c.154-1141G>A), further suggesting that this region has been ancestrally conserved. The deep molecular characterization of SMN2 in our cohort highlights the importance of testing c.859G>C, as well as accurately assessing the SMN2 region in SMA patients to gain insight into the complex genotype-phenotype correlations and improve prognostic outcomes

Intravenous versus oral iron for anaemia among pregnant women in Nigeria (IVON): an open-label, randomised controlled trial.

BACKGROUND: Oral iron for anaemia in pregnancy is often not well tolerated, with poor adherence. Iron administered intravenously might address these tolerance and adherence issues. We investigated the effectiveness and safety of intravenous ferric carboxymaltose versus oral ferrous sulphate on anaemia and iron deficiency among pregnant women in Nigeria. METHODS: We did a multicentre, open-label, parallel, randomised controlled trial of pregnant women (aged 15-49 years) with haemoglobin (Hb) concentrations of less than 10 g/dL at 20-32 weeks' gestation from 11 primary, secondary, or tertiary health facilities in Nigeria (five in Lagos and six in Kano). Exclusion criteria included vaginal bleeding, blood transfusion or major surgery within the past 3 months, symptomatic anaemia, anaemia known to be unrelated to iron deficiency, clinically confirmed malabsorption syndrome, previous hypersensitivity to any form of iron, pre-existing maternal depression or other major psychiatric illness, immune-related diseases, such as systemic lupus erythematosus or rheumatoid arthritis, or severe allergic reactions. Participants were randomly assigned (1:1) by nurses and doctors using a web-based randomisation service to either receive a single dose of intravenous ferric carboxymaltose (20 mg/kg to a maximum of 1000 mg) or oral ferrous sulphate (200 mg; 65 mg elemental iron) three times daily until 6 weeks postpartum. The study was primarily unmasked. Primary outcomes were maternal anaemia (Hb <11 g/dL) at 36 weeks' gestation and preterm birth at before 37 weeks' gestation, with analysis by intention to treat in participants with available data. This study was registered at the ISRCTN registry on Dec 10, 2020 (ISRCTN63484804) and on ClinicalTrials.gov (NCT04976179) on April 7, 2021. FINDINGS: Between Aug 10, 2021, and Dec 15, 2022, 13 724 pregnant women were screened for eligibility. 12 668 were excluded due to ineligibility for inclusion, and 1056 provided consent to participate and were randomly assigned to either the intravenous or oral administration groups. 527 were assigned to the intravenous ferric carboxymaltose group and 529 were assigned to the oral ferrous sulphate group. 518 in the intravenous group were assessed at 36 weeks' gestational age and after 518 deliveries, and 511 completed the 6 weeks postpartum visit. 513 in the oral ferrous sulphate group were assessed at 36 weeks' gestational age and after 512 deliveries, and 501 completed the 6 weeks postpartum visit. No significant difference was found in anaemia at 36 weeks (299 [58%] of 517 in the intravenous group vs 305 [61%] of 503 in the oral group; risk ratio 0·95, 95% CI 0·85-1·06; p=0·36), nor in preterm birth (73 [14%] of 518 vs 77 [15%] of 513; 0·94, 0·70-1·26; p=0·66). There were no significant differences in adverse events. The most common adverse events were diarrhoea (in six participants) and vomiting (in three participants) in the oral group and fatigue (in two participants) and headache (in two participants) in the intravenous group. INTERPRETATION: Although the effect on overall anaemia did not differ, intravenous iron reduced the prevalence of iron deficiency to a greater extent than oral iron and was considered to be safe. We recommend that intravenous iron be considered for anaemic pregnant women in Nigeria and similar settings. FUNDING: Bill & Melinda Gates Foundation

Pancreatic cancer genomes reveal aberrations in axon guidance pathway genes.

Pancreatic cancer is a highly lethal malignancy with few effective therapies. We performed exome sequencing and copy number analysis to define genomic aberrations in a prospectively accrued clinical cohort (n = 142) of early (stage I and II) sporadic pancreatic ductal adenocarcinoma. Detailed analysis of 99 informative tumours identified substantial heterogeneity with 2,016 non-silent mutations and 1,628 copy-number variations. We define 16 significantly mutated genes, reaffirming known mutations (KRAS, TP53, CDKN2A, SMAD4, MLL3, TGFBR2, ARID1A and SF3B1), and uncover novel mutated genes including additional genes involved in chromatin modification (EPC1 and ARID2), DNA damage repair (ATM) and other mechanisms (ZIM2, MAP2K4, NALCN, SLC16A4 and MAGEA6). Integrative analysis with in vitro functional data and animal models provided supportive evidence for potential roles for these genetic aberrations in carcinogenesis. Pathway-based analysis of recurrently mutated genes recapitulated clustering in core signalling pathways in pancreatic ductal adenocarcinoma, and identified new mutated genes in each pathway. We also identified frequent and diverse somatic aberrations in genes described traditionally as embryonic regulators of axon guidance, particularly SLIT/ROBO signalling, which was also evident in murine Sleeping Beauty transposon-mediated somatic mutagenesis models of pancreatic cancer, providing further supportive evidence for the potential involvement of axon guidance genes in pancreatic carcinogenesis