MELAKSANAKAN PEMBERDAYAAN PARA KADER TENTANG TEKHNIK MENCEGAH POST PARTUM BULES PADA IBU PASCA PERSALINAN

Pasca melahirkan ialah periode dimana seorang ibu akan menjalani hari- hari yang tak kalah melelahkannya dibandingkan dengan masa kehamilan. Keadaan tersebut sangat terkait dengan kondisi fisik maupun psikis yang lebih lanjut akan menimbulkan perasaan stres (tertekan). Penelitian menunjukkan  bahwa  ada sekitar  50-80%   wanita  pasca  melahirkan  yang   mengalami baby  blues  syndrome  atau  sering disebut juga dengan postpartum distress syndrome ini. Postpartum blues dapat dipicu oleh perasaan belum siap menghadapi lahirnya bayi atau timbulnya kesadaran akan    meningkatkan tanggungjawab sebagai ibu. Ibu primipara kebanyakan mengalami postpartum blues berat pada periode immediate postpartum yang akan meningkatkan kejadian depresi postpartum. Tujuan penelitian ini adalah untuk melaksanakan pemberdayaan para kader tentang tekhnik mencegah Postpartum Blues pada ibu pasca persalinan. Metode yang digunakan dalam kegiatan melalui serangkaian tahap antara lain dengan penyuluhan/edukasi, pelatihan, dan pendampingan. Komunitas dibentuk melalui beberapa kegiatan yaitu: koordinasi dengan pengurus RT pedukuhan, dan tokoh masyarakat memberikan pelayanan kesehatan tentang post partum blues, memberikan pendidikan kesehatan tentang post partum blues, memberikan reward bagi para ibu, memberikan door prize usai kegiatan pelayanan kesehatan ibu, memberian reward bagi  para kader. &nbsp

Circadian Rhythms in Adipose Tissue.

Purpose: Circadian rhythms are important in adipose physiology as adipokine plasma concentration, and approximately 20% of the murine adipose transcriptome, undergo diurnal variation. Additionally, overweight and diabetic mice exhibit suppressed amplitude clock and adipokine mRNA rhythms. However, the cellular basis of adipose rhythms is unclear, and clock gene rhythms have not been compared between lean versus overweight or diabetic human subjects. I tested the hypotheses that an endogenous adipocyte oscillator drives rhythmic synthesis and secretion of adipokines, and that rhythms of gene expression are suppressed in overweight or type 2 diabetic patients. Methods: Murine 3T3-L1 pre-adipocyte and adipocyte cultures were characterised. These cells were then ‘pulsed’ with 50% horse serum for 2 hours, and sampled every 4-hours over a 48-hour period. Additionally, lean, overweight, and type 2 diabetic subjects had 4 subcutaneous adipose biopsies taken, one every 6 hours. mRNA expression of clock genes and other genes key to adipose physiology were analysed by quantitative real-time PCR. Secretion of the adipokines leptin and adiponectin were also measured in culture medium from 3T3-L1 adipocytes. Results: Following a serum pulse of characterised 3T3-L1 cultures, circadian rhythms of clock genes Per2, NR1D1 (Rev-erba) and Dbp, but not Perl, Cryl and Arntl (Bmall), were observed in both pre- and postdifferentiated adipocytes. Ppara, Ppary, and Srebfl (Srebpl) also failed to exhibit temporal mRNA changes. Moreover, in the absence of Lep (Leptin) or AdipoQ (Adiponectin) mRNA rhythms in adipocytes, leptin accumulated in the culture medium in a circadian manner. In human adipose samples, PERI-3, CRY2, BMAL1, REV-ERBa and DBP showed diurnal oscillations, but CRY1 did not. In contrast, transription factors NRIP1 (RIP 140) and PPARGC1A (PGCla) exhibited temporal variation of expression, but this was not rhythmic over the timecourse. Interestingly, BMAL1 expression was lower in the overweight group, and PER2 showed lower mRNA levels in medicated versus non-medicated type 2 diabetic patients. Conclusion: 3T3-L1 pre- and post differentiated adipocytes possess an endogenous oscillator, which may control adipocyte leptin secretion, but only drives detectable rhythms of some genes. Additionally, there is only minimal effect of obesity and type 2 diabetes on circadian rhythms in human subcutaneous adipose tissue, although drug regimens may affect clock gene rhythms in type 2 diabetic patients. Together, these data increase understanding of circadian rhythms in adipose biology, and suggest avenues for future research

Circadian Rhythms in Adipose Tissue.

Purpose: Circadian rhythms are important in adipose physiology as adipokine plasma concentration, and approximately 20% of the murine adipose transcriptome, undergo diurnal variation. Additionally, overweight and diabetic mice exhibit suppressed amplitude clock and adipokine mRNA rhythms. However, the cellular basis of adipose rhythms is unclear, and clock gene rhythms have not been compared between lean versus overweight or diabetic human subjects. I tested the hypotheses that an endogenous adipocyte oscillator drives rhythmic synthesis and secretion of adipokines, and that rhythms of gene expression are suppressed in overweight or type 2 diabetic patients. Methods: Murine 3T3-L1 pre-adipocyte and adipocyte cultures were characterised. These cells were then ‘pulsed’ with 50% horse serum for 2 hours, and sampled every 4-hours over a 48-hour period. Additionally, lean, overweight, and type 2 diabetic subjects had 4 subcutaneous adipose biopsies taken, one every 6 hours. mRNA expression of clock genes and other genes key to adipose physiology were analysed by quantitative real-time PCR. Secretion of the adipokines leptin and adiponectin were also measured in culture medium from 3T3-L1 adipocytes. Results: Following a serum pulse of characterised 3T3-L1 cultures, circadian rhythms of clock genes Per2, NR1D1 (Rev-erba) and Dbp, but not Perl, Cryl and Arntl (Bmall), were observed in both pre- and postdifferentiated adipocytes. Ppara, Ppary, and Srebfl (Srebpl) also failed to exhibit temporal mRNA changes. Moreover, in the absence of Lep (Leptin) or AdipoQ (Adiponectin) mRNA rhythms in adipocytes, leptin accumulated in the culture medium in a circadian manner. In human adipose samples, PERI-3, CRY2, BMAL1, REV-ERBa and DBP showed diurnal oscillations, but CRY1 did not. In contrast, transription factors NRIP1 (RIP 140) and PPARGC1A (PGCla) exhibited temporal variation of expression, but this was not rhythmic over the timecourse. Interestingly, BMAL1 expression was lower in the overweight group, and PER2 showed lower mRNA levels in medicated versus non-medicated type 2 diabetic patients. Conclusion: 3T3-L1 pre- and post differentiated adipocytes possess an endogenous oscillator, which may control adipocyte leptin secretion, but only drives detectable rhythms of some genes. Additionally, there is only minimal effect of obesity and type 2 diabetes on circadian rhythms in human subcutaneous adipose tissue, although drug regimens may affect clock gene rhythms in type 2 diabetic patients. Together, these data increase understanding of circadian rhythms in adipose biology, and suggest avenues for future research

Hubungan Pendekatan Mother-Baby Care (M-Bc) sebagai Inovasi dalam Upaya Memandirikan Ibu Postpartum di Klinik Pratama Mandiri Berastagi

ABSTRACT Caring for mothers and newborns after passing through a critical period is a very important stage. At this stage, the mother can develop a deeper loving relationship with her baby, recover after giving birth and learn to understand how to care for her baby. In fact, quite a lot of mothers are still confused about caring for their babies. Research was conducted to support mothers in terms of independently caring for their newborns with the mother-baby care method and also to attract the participation of the mother's family and husband in newborn care. The purpose of this study was to find out whether there is a relationship between the M-BC approach in efforts to make post partum mothers independent. The research was carried out using a quantitative research design and using a cross sectional approach and taking a sample of 28 mothers at the Berastagi Mandiri Pratama Clinic. The test results using the Rank Spearman method show that the p value is smaller than the significance value (α). The correlation coefficient (r) between mother's knowledge about newborn care using the mother-baby care model and mother's independence motivation is 0.917 or 91.7% which indicates a very strong relationship. This research resulted in a strong correlation between the variables of mother's knowledge about the Mother-Baby Care method for newborns and the mother's independence variable so that it is suggested to health workers and institutes to use this model in the care of mothers and newborns. Keywords: Mother-Baby Care, Post-Partum Mother's Independence, Newborn Care. ABSTRAK Perawatan terhadap ibu dan bayi baru lahir setelah melewati masa kritis adalah tahap yang sangat penting. Di tahap ini ibu dapat mengembangkan hubungan kasih sayang yang lebih dalam dengan bayinya, memulihkan diri sehabis persalinan sekaligus belajar memahami cara merawat bayinya. Faktanya, cukup banyak ibu yang masih kebingungan merawat bayinya. Dilakukan penelitian untuk mendukung ibu dalam hal mandiri merawat bayi baru lahirnya dengan metode Mother-baby care dan juga menarik partisipasi keluarga dan suami ibu dalam perawatan bayi baru lahir. Tujuan penelitian ini untuk mengetahui apakah terdapat hubungan pendekatan M-BC dalam upaya memandirikan ibu post partum. Penelitan yang dilakukan yaitu memakai desain penelitian kuantitatif dan menggunakan metode pendekatan cross sectional dan mengambil sampel sebanyak 28 orang ibu di Klinik Pratama Mandiri Berastagi. Hasil uji menggunakan metode Rank Spearman yang menunjukkan nilai p value yang lebih kecil dari nilai signifikansi (α). Nilai koefisien korelasi (r) antara pengetahuan ibu tentang perawatan bayi baru lahir menggunakan model Mother-baby care dengan motivasi kemandirian ibu adalah sebesar 0,917 atau 91,7% yang menunjukkan adanya hubungan yang sangat kuat. Penelitian tersebut menghasilkan adanya korelasi yang kuat antara variabel pengetahuan ibu tentang metode Mother-Baby Care untuk bayi baru lahir dengan variabel kemandirian ibu sehingga disarankan kepada petugas dan institut kesehatan untuk menggunakan model ini dalam perawatan ibu dan bayi yang baru lahir. Kata Kunci: Mother-Baby Care,  Kemandirian Ibu Post-Partum, Perawatan Bayi Baru Lahir

Perbandingan Lama Rawat Inap Pasien COVID-19 Derajat Berat dan Kritis dengan Komorbid Diabetes Melitus dan Hipertensi dan Komorbid Lain

Latar belakang: Coronavirus Disease-19 (Covid-19) merupakan penyakit yang disebabkan oleh virus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2). Penyakit ini ditetapkan sebagai pandemi dunia pada tahun 2020. Per 2 Oktober 2021 terdapat 4.218.142 kasus konfirmasi Covid-19 di Indonesia. Penyebaran penyakit ini dapat terjadi melaui udara maupun kontak mukosa tubuh. Dampak penyakit ini cukup beragam pada masing-masing individu. Tujuan: Penelitian ini bertujuan untuk mengetahui lama masa rawat inap pasien Covid-19 derajat berat dan kritis dengan komorbid diabetes melitus dan/atau hipertensid dan/atau komorbid lainnya di Ruang Perawatan Intensif Incovit RSUD Dr. Saiful Anwar, Malang. Metode: Penelitian ini menggunakan metode deskriptif analisis dengan mengambil data sekunder dari rekam medis dan data keluar rumah sakit pasien yang dirawat di Ruang Perawatan Intensif Incovit. Data yang sudah dikumpulkan dilakukan uji normalitas menggunakan tes Saphiro-Wilk kemudian dilakukan uji Kruskal-Wallis dan uji Dunn sebagai uji lanjutan. Hasil: Penelitian ini didominasi oleh subyek dengan usia kurang dari 60 tahun, laku-laku, dan sebagian besar memiliki komorbid. Lama rawat inap yang memiliki nilai signifikansi p<0,05 adalah pasien dengan outcome meninggal. Lama rawat inap paling panjang didapatkan pada pasien tanpa komorbid dan pasien dengan komorbid diabetes melitus saja (Median: 7,5 hari). Sedangkan lama rawat inap paling pendek didapatkan pada pasien dengan komorbid selain diabetes melitus dan hipertensi (Median: 3,5 hari). Kesimpulan: Semakin banyak komorbid pasien, semakin berat pula keadaan pasien, sehingga lama rawat pada kelompok keluar rumah sakit akan semakin panjang, namun pada kelompok dengan outcome meninggal akan semakin pendek