Geriatric Medicine, Sarkopenia, Frailty, dan Kualitas Hidup Pasien Usia Lanjut: Tantangan Masa Depan Pendidikan, Penelitian dan Pelayanan Kedokteran di Indonesia

Geriatri adalah cabang ilmu kedokteran dengan fokus pada penuaan dini dan tatalaksana penyakit terkaitusia lanjut. Proses menua mengakibatkan penurunan fungsi sistem organ seperti sistem sensorik, sarafpusat, pencernaan, kardiovaskular, dan sistem respirasi. Selain itu terjadi pula Perubahan komposisitubuh, yaitu penurunan massa otot, peningkatan massa dan sentralisasi lemak, serta peningkatanlemak intramuscular. Masalah yang sering dijumpai pada pasien geriatri adalah sindrom geriatri yangmeliputi: imobilisasi, instabilitas, inkontinensia, insomnia, depresi, infeksi, defisiensi imun, gangguanpendengaran dan penglihatan, gangguan intelektual, kolon irritable, impecunity, dan impotensi. Dimasa yang akan datang diperlukan tempat rawat jalan terpadu dan perawatan kasus akut geriatri dirumah sakit di seluruh Indonesia. Program lainnya adalah nutrisi usia lanjut, tempat istirahat sementara,layanan psiko-geriatri dan dementia care, dukungan care giver, pencegahan penyakit kronis dankonseling, serta menyiapkan moda transportasi yang sesuai

COVID-19 and Indonesia

Coronavirus disease 2019 (COVID-19) pandemic is an ongoing problem in more than 200 countries in the world. Indonesia has been greatly affected by COVID-19 with case fatality rate (CFR) being 8.9% in the end of March 2020. We have some room for improvement related to the unreadingess of healthcare facility and the major steps taken by the government. It is suggested that the country should have stricter Stay-at-Home notice, suppress the spread by imposing lockdown on a large scale, improve healthcare service, and increase the availability of personal protective equipments (PPE). It is important to avoid an epidemic peak that potentially overwhelms healthcare service by quarantining the case contacts. Lockdown may prolong the epidemic doubling time significantly. Demand of health system is likely to grow since the number of COVID-19 case is likely to rise. Effective procedures for protecting medical staff from infection are essential. Scientific research in Indonesia is also crucial to provide suggestion and recommendation pertinent to COVID-19

IMPLEMENTASI SUPERVISI AKADEMIK BERBASIS TEKNOLOGI PADA MASA PANDEMI COVID-19 DI SMA NEGERI 36 JAKARTA

Penelitian ini bertujuan untuk mengetahui implementasi supervisi akademik berbasis teknologi pada masa pandemi covid-19 di SMA Negeri 36 Jakarta. Dalam penelitian ini, peneliti menggunakan pendekatan kualitatif dengan metode deskriptif. Penelitian ini dilakukan pada bulan Desember 2020 – Juli 2021. Teknik pengumpulan data dalam penelitian ini menggunakan wawancara, observasi, dan studi dokumentasi. Hasil penelitian menunjukkan bahwa: (1) perencanaan supervisi akademik berbasis teknologi dimulai dengan kepala sekolah bersama wakil kepala sekolah, tim pengembang, dan guru senior menyusun Rencana Pelaksanaan Supervisi Akademik (RPSA) melalui Google Meet dan instrumen supervisi akademik Pembelajaran Jarak Jauh, lalu mensosialisasikannya pada saat rapat kerja dan whatsapp group. (2) langkah-langkah kepala sekolah dalam pengimplementasian supervisi akademik berbasis teknologi terbagi menjadi tiga tahap yaitu pra-observasi (melakukan pertemuan awal untuk memeriksa RPP dan memastikan media yang digunakan oleh guru), observasi (melakukan pengamatan dengan teknik kunjungan dan observasi kelas menggunakan Zoom Meeting dan Google Meet), dan pasca-observasi (memberikan umpan balik kepada guru yang sudah disupervisi). (3) kendala dalam pengimplementasian supervisi akademik berbasis teknologi adalah jaringan yang kurang stabil. Selain itu, kepala sekolah mengalami kesulitan dalam merefleksikan guru agar mau memperbaiki kekurangannya pada saat mengajar di dalam kelas online, maka dari itu kepala sekolah selalu memberikan masukan, arahan, dan berdiskusi dengan guru yang bersangkutan. This study aims to determine the implementation of technology-based academic supervision during the COVID-19 pandemic at SMA Negeri 36 Jakarta. In this study, the researcher used a qualitative approach with a descriptive method. This research was conducted in December 2020 – July 2021. The data collection techniques in this study were interviews, observations, and study documentation. The results show that: (1) technology-based academic supervision planning begins with the principal together with the vice principal, development team, and senior teachers preparing an Academic Supervision Implementation Plan through Google Meet and Distance Learning academic supervision, then socializing it at the time of work meetings and whatsapp groups. (2) the principal's steps in implementing technology-based academic supervision are divided into three stages, namely pre-observation (conducting an initial meeting to check the lesson plans and ensuring the media used by teachers), observation (performing observations with visitation techniques and observation using Zoom Meetings and Google Meet), and post-observation (providing feedback to supervised teachers). (3) the obstacle in implementing technology-based academic supervision is an unstable network. In addition, school principals have difficulty in assessing teachers to want to improve their shortcomings when teaching in online classes, therefore the principal always provides input, direction, and learning with the teacher concerned

Effect of Nigella sativa Seed Extract for Hypertension in Elderly: a Double-blind, Randomized Controlled Trial

Background: Nigella sativa (NS) seed extract shows diuretic activity, inhibits sympathetic nervous system overactivity and increases the production of Nitric Oxide in in vivo studies, thus it has a potential use as an adjuvant antihypertensive for elderly population. This study aimed to determine the effect of Nigella sativa seed extract to systolic blood pressure (SBP) and diastolic blood pressure (DBP) of elderly patients with hypertension.Methods: a double-blind, randomized controlled trial was conducted on elderly subjects with hypertension in three outpatient clinics in Cipto Mangunkusumo National Hospital Jakarta Indonesia from June to September 2011. Subjects were divided into intervention group given 300 mg Nigella sativa seed extract twice daily for 28 days and into another group which was given placebo. Blood pressure were measured on day 1 and 28. Intention to treat analysis using unpaired t-test to compare blood pressure after intervention between the two groups was performed.Results: of a total of 85 patients, 76 subjects fulfilled the study criteria and were randomized into 2 groups, with 38 subjects in each group. Both groups were comparable in all important prognostic factors. The mean systolic blood pressure of the NS group was decreased from 160.4 (SD 15.7) mmHg to 145.8 (SD 19.8) mmHg, and from 160.9 (16.3) mmHg to 147.53 (SD 22.0) mmHg in the placebo group (p=0.36). The mean diastolic blood pressure in the NS group was decreased from 78.3 (SD 11.9) to 74.4 (SD 8.2) mmHg, and from 79.0 (SD 12.4) to 78.2 (SD 8.9) in the placebo group (p=0.35). Reported adverse events include dyspepsia in 6 subjects (15.7%), nausea in 3 subjects (7.8%), and constipation in 2 subjects (5.2%). No electrolyte abnormalities, liver and renal toxicities, or orthostatic hypotension were observed.Conclusion: although a trend towards a slight decrease in blood pressure was observed, Nigella sativa has not been proven to be effective in reducing blood pressure in elderly patients with hypertension

Inducing and Aggravating Factors of Gastroesophageal Reflux Symptoms

Gastroesophageal reflux disease (subsequently abbreviated as GERD) is a  disease commonly found in the community. Several factors have been recognized as inducing and aggravating factors of GERD symptoms such as older age, female gender, obesity, smoking habit, alcohol consumption, certain diet and poor eating habit like eating fatty, spicy, and acid food

Validity and Reliability of the Indonesian Version of SF-36 Quality of Life Questionnaire on Patients with Permanent Pacemakers

Aim: to construct and validate Indonesian version of SF-36. Methods: this is a cross-sectional study, which consist of 2 stages process: 1) language and cultural adaption; and 2) validity and reliability evaluation. We evaluated 32 pacemaker patients during language and cultural adaptation stage and 20 pacemaker patients during validity and reliability evaluation stages from September 2014 to August 2015. We followed cross-cultural adaptation guideline to produce Indonesian version of the questionnaire. The final translated questionnaire was checked by assessing the correlation of SF-36 and 6-minutes walking test (6MWT) and NT pro-BNP result. Results: Indonesian version of SF-36 showed positive correlation between 6MWT result and physical functioning (PF) (r=0.363; p=0.001) and negative correlation between NT pro-BNP score with general health (GH) (r=-0.269; p=0.020) and mental health (MH) (r=-0.271; p=0.019). The internal consistency of Indonesian version of SF-36 questionnaire, which measured by Cronbach’s alpha, was good with value of >0.70. Repeatability between day 1 and day 8 was good, with strong positive correlation (r=0.626; p=0.003). Conclusion: the Indonesian version of SF-36 could be used as a general questionnaire to assess quality of life in patients with permanent pacemaker