PERAN PEMERIKSAAN MRI DTI DAN MT DALAM MENDETEKSI SKLEROSIS HIPOKAMPUS PADA EPILEPSI LOBUS TEMPORALIS MESIAL INTRAKTABEL DENGAN MRI NORMAL

Latar belakang : Etiologi Epilepsi Lobus Temporal Mesial (ELTM) intraktabel tersering adalah sklerosis hipokampus. Sekitar 20-30% pasien epilepsi fokal intraktabel menunjukkan MRI standar normal.MRI DTI dan MT, mempunyai kemampuan menunjukkan substrat epileptogenik. Tujuan : Membuktikan pemeriksaan MRI DTI (MD dan FA) serta rasio MT mempunyai kemampuan yang baik dalam mendeteksi sklerosis hipokampus pada ELTM intraktabel dengan MRI normal yang diukur dari derajat neuronal loss, gliosis dan axonal sprouting. Metode : Penelitian menggunakan desain uji diagnostik. Diagnosis ELTM berdasarkan semiology dan EEG ictal, diagnosis sklerosis hipokampus ditentukan dari pemeriksaan MRI standar, dilanjutkan pemeriksaan MRI DTI, dan MT. Pemeriksaan histopatologi sediaan operasi hipokampus dengan pengecatan NeuN, GFAP dan NPY untuk menilai neuronal loss, gliosis dan axonal sprouting. Hasil : Didapatkan 23 subyek ELTM yang dilakukan operasi dan 10 subyek sehat dengan MRI normal. Dari 23 subyek, pemeriksaan histopatologi menunjukkan 11 sklerosis hipokampus, 12 FCD.Sepuluh subyek ELTM dengan MRI normal, 4 dengan sklerosis hipokampus dan 6 dengan FCD. Nilai MD meningkat secara bermakna, nilai FA dan rasio MT dan MT matlab lebih rendah bermakna dibandingkan subyek sehat. FA (0,17) mempunyai nilai diagnostik tertinggi dengan sensitivitas 81,8%, spesifisitas 72,3%, nilai duga positif 64,3%, nilai duga negatif 89,5%, dan kesesuaian lateralisasi dengan EEG 7/10. FA menunjukkan korelasi sedang bermakna dengan derajat neuronal loss, dan gliosis. MD (1,2637x10-3) dan rasio MT (17,85%) mempunyai sensitivitas 81,2%, spesifisitas 68,2%, nilai duga positif 56,2%, nilai duga negatif 88,2%. AUC FA, MD dan rasio MT adalah 0,89; 0,79; 0,74. Kesesuaian MD dan MTR dengan EEG masing-masing 7/10 dan 6/10 pasien.Tidak didapatkan korelasi antara nilai MD, dan rasio MT dengan derajat neuronal loss, gliosis dan axonal sprouting. Kesimpulan: FA (0,17) mempunyai nilai diagnostik terbaik dalam mendeteksi sklerosis hipokampus. FA mempunyai korelasi sedang bermakna dengan derajat neuronal loss, dan gliosis secara bermakna serta kesesuaian dengan EEG 7 dari 10 pasien. Kata kunci: ELTM intraktabel, MRI normal, MRI DTI, fractional anisotropy, mean diffusivity, rasio Magnetization Transfer, sklerosis hipokampus Introduction: Hippocampal sclerosis is the most common pathology found in intractable MTLE. Standardized T2 and FLAIR MR showed normal MR in 20-30% of these cases. The application DTI and MT sequences may show the epileptogenic zone of MTLE Objectives: The main objective of this research is to prove that DTI (MD and FA) quantitative MRI examination as well as MT ratio are reliable in detecting hippocampal sclerosis on intractable MTLE with normal MRI as measured from the degree of neuronal loss, gliosis and axonal sprouting. Method : The research design was diagnostic test. The MTLE diagnosis was based on semiology and ictal EEG, while hippocampal sclerosis was diagnosed using standardized MRI, followed by MRI DTI and MRI MT examinations. Histopathological analysis of hippocampus with NeuN, GFAP and NPY staining were to measure neuronal loss, gliosis and axonal sprouting. Results: Twenty-three MTLE subjects underwent surgery and 10 non MTLE (healthy subjects) were involved. Histopathological analysis of the 23 respondents were as follows: 11 were hippocampal sclerosis, 12 were FCD. Normal MRI was showed in 10 subjects with MTLE, 4 were hippocampal sclerosis and 6 were FCD. MD value significantly increased, whereas the values of FA, MT ratio and matlab MT ratio significantly lower than healthy subjects. FA (0.17) has the highest diagnostic value, showed by 81.8% sensitivity, 72.3% specificity, 64.3% positive predictive value, 89.5% negative predictive value, and lateralization concurring with EEG 7/10. Moreover, FA showed a significant moderate correlation with neuronal loss, and gliosis degrees. MD (1.2637x10- 3) and MTR (17.85%) had 81.2% sensitivity, 68.2% specificity, 56.2% positive predictive value, and 88.2% negative predictive value. AUC of FA, MD and MTR are 0,89; 0,79 and 0,74. The concurrence between MD and MTR, with EEG were 7/10 and 6/10 patients respectively. There was no correlation between MD and MTR values with the degree of neuronal loss, gliosis, and axonal sprouting. Conclusion: FA (0.17) has the best diagnostic value in detecting hippocampal sclerosis. In addition, it shows a moderate correlation with the degrees of neuronal loss, and gliosis, as well as suitability with EEG of 7 out of 10 patients. Keywords: intractable MTLE, normal MRI, MRI DTI, fractional anisotropy, mean diffusivity, magnetization transfer ratio, hippocampal sclerosis

Historical Overview: The Parliamentary Library from Past to Present

Parliamentary libraries (also known under various terminologies such as federal libraries, legislative libraries, information resource centers, documentation centers, or reference services) enhance the research and information capacity of parliaments. As their histories show, however, some also came to consider their constituencies as lying beyond the confines of their parent legislature.published or submitted for publicatio

Keragaan Pengetahuan Gizi Dan Pengetahuan Praktek Pemberian Makanan Bayi Dan Anak Dari Ibu Dengan Balita Gizi Buruk Di Daerah Bogor Dan Sekitarnya

Dalam upaya menurunkan prevalensi gizi kurang dan gizi buruk telah banyak dilakukan berbagai USAha misalnya melalui kegiatan Usaha Perbaikan Gizi Keluarga (UPGK). Namun demikian sampai saat ini masih banyak ditemukan anak Balita yang menderita gizi kurang dan gizi buruk serta masih tetap merupakan masalah utama dalam bidang gizi dan kesehatan. Temuan dari telaahan terdahulu menunjukkan bahwa pengetahuan gizi ibu merupakan salah satu faktor yang dapat mempengaruhi konsumsi pangan dan status gizi anak Balita. Tujuan penelitian ini: menggali keragaman di lapangan berkenaan dengan pengetahuan gizi dan pengetahuan praktik pemberian makanan bayi dan anak dari ibu Balita gizi buruk guna meningkatkan program KIE gizi dalam penyusunan model penyuluhan terarah untuk mencegah terjadinya gizi kurang dan gizi buruk pada usia dini. Penelitian dilakukan di daerah Bogor dan sekitarnya. Responden penelitian adalah ibu-ibu dari anak Balita penderita gizi buruk (n=32) yang berobat di Klinik Gizi Puslitbang Gizi, Bogor. Sebagai kontrol diambil 30 responden yang mempunyai anak Balita gizi baik dan menjadi tetangga dari anak Balita gizi buruk dengan dasar pelayanan kesehatan yang sama yaitu Puskesmas dan Posyandu. Hasil penelitian menunjukkan bahwa pengetahuan gizi ibu dengan Balita gizi buruk berbeda dan lebih rendah dibandingkan dengan ibu Balita gizi baik, sementara pengetahuan praktik cara pemberian makanan bayi dan anak dari ibu Balita gizi buruk juga berbeda dan lebih rendah dibandingkan dengan ibu Balita gizi baik. Pengetahuan gizi yang kurang dan pengetahuan praktik pemberian makanan bayi dan anak dari ibu-ibu Balita yang cenderung kurang tepat cukup berperan dan menentukan keadaan gizi yang kurang dan kemungkinan akan bertambah buruk jika hal-hal tersebut tidak segera mendapat pelayanan kesehatan yang tepat guna baik di Puskesmas maupun di Posyandu

Pengembangan Media Poster sebagai Alat Bantu Edukasi Gizi pada Remaja Terkait Keluarga Sadar Gizi (Kadarzi) (Poster Media Development AS Nutrition Education Tool For Adolescents Related On Family Nutritional Awareness)

Study on family nutritional awareness (Kadarzi) of phase I showed that the knowledge, attitudes and behavior of nutrition in the community were still low. Study on Kadarzi of phase II focused on the development of nutrition education materials. This study was to develop media and nutrition education strategies in order to achieve Kadarzi. The study design was cross-sectional, with qualitative methods. The study was conducted in three provinces: West Java, West Sumatra and East Kalimantan. Samples consisted of two groups, namely sample for media feasibility test (n=98) and sample for implementation of educational test (n=296). Educational channel used was formal education. Type of educational media developed was posters. This study had developed 5 posters with the materials: 1) fruits and vegetables, 2) breakfast, 3) ) weighing to adolescents 13-15 years old (SMP), 4) weighing to adolescents 16-18 years old (SMA) and 5) adolescent anemia. The result showed there was an increase on nutrition knowledge as much as 78,25 percents, after being given nutrition education and a desire to assess an adolescents own nutritional status by weighing and measuring her height. Media nutrition education which was developed was quite simple and easy to understand. The channel education selected was quite effective to improve nutrition knowledge

Gambaran Keragaman Makanan dan Sumbangannya terhadap Konsumsi Energi Protein pada Anak Balita Pendek (Stunting) di Indonesia

Conditions that potentially interfere with the fulfillment of nutrients, especially energy and protein in children aged 0-3 years will cause a problem of growth disorders in children under five (24-59 months). The aim is to assess proportion of food diversity and contribution to energy and protein consumption among children under five (24-59 months) stunted and not stunted. Data used in this analysis are secondary data base of health research (Riskesdas) in 2010. A total of 6796 children aged 24-59 months include the variable child's age, height, nutrient consumption and family characteristics (family head education, occupation and family income) were anlyzed for the purpose. Nutrient intake data were analyzed with the program nutrisoft while nutritional status processed by the program antro WHO, 2007. Data analysis using chi square test and anova. Food consumption was normal toddlers (24-59 months) is more diverse than the short toddlers. Food consumption was normal toddlers (24-59 months) is more diverse than the short toddlers. The diversity of these foods is approached with the hope offood pattern score (PPH), which is normal toddlers PPH score at 96.6, while among short toddlers at 88,4. Significantly more short toddler who suffered a deficit of energy and protein compared with normal toddlers (P = 0.000)

Profil Tinggi Badan Anak Usia Baru Masuk Sekolah (Tbabs) Di Beberapa Kabupaten/kota Di Indonesia: Analisis Data Riskesdas 2007

Background: One of nutrition indicator is determined by good quality of human resource reflected by anthropometry such as body height. Objectives: The aim of th1s analysis is to measure the height of pre-elementary school children in rural and urban Indonesia. Methods: Data source of this analysis is Riskesdas Data (2007). Analytic unit of this study was house hold who had new prelimenary school children. (6-7 years old). Variable which was anthropometry data, height for age and sex, was analysed using software anthropometry plus WHO 2007 as standard reference. Other variables were social economic, head of family's job, living place (rural or urban) and income expenditure per-capita (kuintil). Results: This result shows that prevalence of pre-elementary school children having stunted is 28.4%. Whereas having normal height standard (WHO 2007) is 90.4%. There is no significant difference between boys and girls' height. However, children's height in rural and urban are different signicantly. More short pre-elementary students are found in rural than urban area. No significant relationship is found beetwen house hold social economic status and children's height. Conclusions: Prevalence of pre-elementary school children having stunted is 28.4%. More short pre-elementary students are found in rural than urban area