Randomized control trial outcomes of tranexamic acid combination serum as a depigmenting agent for the use in healthy individuals.

To compare the effectiveness of tranexamic acid (TA) combination serum with hydroquinone, the gold standard in whitening agents for healthy populations. This was a three-arm randomized controlled trial. The subjects were divided into three groups: the first group received 3% TA combination serum (3% TA, 4% galactomyces ferment filtrate, 2% niacinamide, and 4% alpha arbutin), the second group received 2% TA combination serum, and the third group received 4% hydroquinone. One milliliter of each serum was applied on three holes: Hole A, which was located 4 cm from the left cubital fossa, Hole B, which was located 4 cm from the first hole, and Hole C, which was located 4 cm from the right cubital fossa. The skin brightness and pigmentation intensity were evaluated each week for 4 weeks using a chromameter. A total of 44 subjects were recruited for this study. All groups showed a significant improvement in skin brightness and pigmentation intensity after 4 weeks (p < .001). There were no differences between the treatment groups and hydroquinone (p > .05). TA serum (2 and 3%) combined with 4% galactomyces ferment filtrate, niacinamide, and alpha arbutin is an effective depigmenting agent.

The effect of health education in improving the knowledge and attitudes of integrated service post cadres about early detection of high-risk pregnancies in the working area of the Mamajang health center, Makassar city, Indonesia.

Maternal mortality can be reduced by strengthening the process of early detection of high-risk pregnancies. However, the lack of knowledge related to high-risk pregnancy is still an obstacle. This study aims to analyze the effect of health education on the knowledge and attitudes of cadres about early detection of high-risk pregnancy in the working area of Health Centre Mamajang Makassar City. Experimental research with a pretest protest design with a control group, involving 80 cadres spread across 20 Integrated Service Posts who were divided into four treatment groups. There was an increase in mean knowledge between the intervention group (P=0.000) and the control group (P=0.002). There was also an increase in attitude between the intervention group (P=0.000). However, there was no improvement in attitude (P=0.475) in the control group. The intervention group through combined video+booklet had the highest mean knowledge score (6.65-13.90) than the groups that received intervention through video (6.60-12.69) or booklet alone (6.75-12.07), respectively. On attitude, the highest average attitude score in the intervention group was the combined video+booklet group (22.0-35.8), video (21.22-34.65) and booklet alone (22.25-34.55). While the average score of the control group on knowledge (6.00-6.95) and attitude (22.60-23.05). The role of health education by involving a combination of both video and booklet media is appropriate as an effort to influence Integrated Service Post cadres in increasing knowledge and attitudes about the early detection of high-risk pregnancies.

The Relationship Between Admission Insulin Resistance Index (AIRI) and In-Hospital Outcome in Non-Diabetic Acute Coronary Syndrome.

Background: Acute coronary syndrome (ACS) is a major cardiovascular problem due to its high hospitalization and mortality rates. One of the risk factors for atherosclerosis that leads to ACS is insulin resistance (IR) which plays a role in the pathogenesis and development of cardiovascular events. This study aims to determine the relationship between IR and in-hospital outcomes in non-diabetic patients with ACS. Methodology: This was a cohort study conducted from January-June 2021. Insulin resistance was assessed using the Admission insulin resistance index (AIRI). This measurement was performed once during the patient's admission, and then the outcome was observed during hospitalization. The observed in-hospital outcomes were composite outcomes; namely, heart failure, arrhythmia, cardiogenic shock, and death. The statistical tests used were ANOVA, independent T and Chi-Square tests. Statistical test results were considered significant if p<0.05. Results: This study included 60 subjects (51 males and 9 females). Analysis revealed that AIRI was higher in patients with composite outcomes (mean 9.97 ± 4.08) than in patients without composite outcomes (mean 7.71 ± 4.06) (p<0.05); AIRI was higher in patients with heart failure (mean 10.72 ± 3.83) than in patients without heart failure (mean 7.25 ± 3.84) (p<0.001). Patients with IR had a higher rate of heart failure complications [OR 5.5 95% CI (1.56-19.38) (p=0.005)]. Conclusion: There is an association between AIRI and composite outcomes. Patients with IR have 5.5 times the risk of developing heart failure.

Prevalence of the HLA-Cw6 genotype and zinc deficiency in psoriasis vulgaris patients in Indonesia.

INTRODUCTION: Psoriasis vulgaris is an immune-mediated inflammatory disease influenced by genetic and immunologic factors, including micronutrient deficiencies. The HLA-Cw6 gene and zinc level have been separately studied in psoriasis patients, yielding inconsistent findings. A descriptive study regarding HLA-Cw6 allele expression, zinc levels, and their direct correlation in Indonesia is lacking. METHODS: This prospective case-control study involved 33 psoriasis patients and 33 age- and sex-matched control patients at the dermatology clinic affiliated with Hasanuddin University in South Sulawesi in 2021. Cases were classified into mild, moderate, and severe psoriasis according to Psoriasis Area and Severity Index (PASI) score. An EDTA tube was used to take a 5 ml blood sample, followed by analysis for PCR of the HLA-Cw6 allele and a colorimetric assay to measure zinc level. Statistical analysis was performed to determine the association between HLA-Cw6 and zinc level and psoriasis disease severity. RESULTS: Among the 33 psoriatic patients enrolled in this study, three (9.1%) of the cases were classified as mild psoriasis, 10 (30.3%) were classified as moderate psoriasis, and 20 (60.6%) were classified as severe psoriasis. The HLA-Cw6 allele was detected in 93.9% of psoriasis cases and in 3% of control patients (p < 0.001). The HLA-Cw6 allele was detected consecutively in 66.7%, 90.0%, and 100% of mild, moderate, and severe psoriasis patients, respectively. Zinc levels were lower in psoriasis patients compared to controls (16.85 ± 3.55 vs. 13.74 ± 3.78 µmol/l). Severe psoriasis patients exhibited the lowest average zinc level (14.76 ± 1.40 µmol/l, 15.48 ± 4.20 µmol/l, and 12.72 ± 3.56 µmol/l in mild, moderate, and severe patients, respectively). The mean zinc level in HLA-Cw6-positive patients was 13.68 µmol/l, and 14.6 µmol/l in HLA-Cw6-negative patients (p = 0.495). CONCLUSIONS: The study revealed the presence of HLA-Cw6 allele expression and decreased serum zinc levels in psoriasis patients compared to controls. Both factors demonstrated associations with psoriasis disease severity.

Effect of age and gender on high - Sensitivity C - Reactive protein levels serum on health worker with latent tuberculosis and healthy control.

BACKGROUND: Latent tuberculosis is defined as a state of persistent immune response stimulated by Mycobacterium tuberculosis antigens with no evidence and signs of active TB . Health workers have a high risk of developing latent TB disease due to occupational exposure from patients. High sensitivity CRP (hs-CRP) assays have been developed for special values that may indicate low-grade inflammatory lesions as is true in measurement of latent tuberculosis infection. Factors that affect CRP levels are gender and age. Our study is conducted to asses effect of age and gender on Hs- CReactive protein leves serum on health worker with latent tuberculosis and healthy control. METHOD: This research is a cross sectional study using primary data. The research was conducted at Wahidin Sudirohusodo Makassa Hospital and Community Center For Lung Health In South Sulawesi. Studied subject were recruited by consecutivesampling, in which the patient who met the inclusion criteria and then the serum HsCRP test was measured. Data analysis was performed using SPSS version 25. RESULT: During the study period , 80 subjects met the inclusion criteria. At age ≤ 32 years, the mean HsCRP was found to be lower in latent TB than in healthy controls, but not statistically significant (p>0.370). At age >32 years, the mean HsCRP was found to be higher in latent TB than in healthy controls, but not statistically significant (p>2.49). In males, the mean HsCRP was found to be higher in latent TB than in healthy controls, but not statistically significant (P =0.584). In women, the mean HsCRP was found to be lower in latent TB than in healthy controls, but not statistically significant (P =0.712). CONCLUSION: Serum HsCRP levels were found to be higher in latent TB subjects with increasing age and male gender but not statistically significant.

Hematology profile analysis in coronavirus disease 2019 (COVID-19) patients.

Objectives: Some hematological parameters were reported as markers to assess severity of COVID-19 patients. Comorbidities were risk factors for severe COVID-19. Differences in hematology profile based on severity and comorbidity, and correlation between hematology profile and Ct value were never studied at Makassar, Indonesia. The aim of this study were to know the differences of hematology profile based on severity and comorbidity, and the correlation between hematology profile and Ct value in COVID-19 patients. Methods: This study was retrospective, cross-sectional of confirmed COVID-19 patients who had been hospitalized at Dr. Wahidin Sudirohusodo hospital, Makassar, since June to August 2020. Hematology profile, Ct value, comorbidity, and severity of COVID-19 patients were obtained from Hospital Information System Data. Results: From 217 patients, subjects were 102 (47%) male dan 115 (53%) female, 127 mild-moderate patients (58.5%) and 90 severe patients (41.5%), 143 patients (65%) without comorbidity, 74 patients (35%) with comorbidity. White blood cells (WBC), red cell distribution width (RDW), neutrophil and monocyte count, and neutrophil lymphocyte ratio (NLR) were significantly higher in severe patients than mild-moderate patients (p<0.05), besides RBC, hemoglobin, hematocrit, lymphocyte and thrombocyte count were significantly lower in severe patients than mild-moderate patients (p<0.05). Hematology profile was not different significantly based on comorbidity and was not correlated significantly with Ct value, except eosinophil count (r=0.161; p=0.018). Conclusions: We suggest that hematology profile could predict the severity of COVID-19 patients. Moreover, eosinophil count could be considered to predict the infectivity of patient with COVID-19.

Sexual behavior influence against HIV/AIDS in homosexuals at Palu City in 2020.

OBJECTIVE: The purpose of this study is to examine the sexual behavior relationship with HIV/AIDS on homosexuals in Palu City and its risk factors. METHOD: The study was held using a case-control with a retrospective study. The number of samples on the case-control group is 90 respondents with 1:1 comparison. Sampling techniques and data collection based on the medical record of VCT in Anutapura Hospital by using the questionnaire. The data is processed using the univariate analysis, bivariate analysis by using chi-square, and multivariate analysis by using logistic regression analysis. RESULTS: Based on bivariate analysis gained that there is a significant relationship of sexual behavior in homosexuals with HIV/AIDS in Palu City. Dependent variable is HIV/AIDS while the independent variable are the number of pairs p=0.004 (OR=12.6); Anal sex p=0.003 (OR=3.6); Oral ejaculation p=0.002 (OR=14.2); Oral sex-licking/rimming p=0.035 (OR=2.5); Fingering p=0.019 (OR=2.8); and interfemoral coitus p=0.011 (OR=3.0). Based on the modeling of multivariate logistic regression analysis obtained, dominant variables are the number of pairs, anal sex, and interfemoral coitus, so the most dominant variables are the number of pairs with OR=20.8. Homosexuals that have more than one couple do bareback sex, and interfemoral coitus have an estimated probability of HIV/AIDS in Palu City is 83.7%. CONCLUSION: There is a significant influence between sexual behavior against HIV/AIDS in homosexuals at Palu City in 2020.

The relationship between socioeconomic status and nutritional status of pregnant women in temporary shelter, Talise, Palu.

OBJECTIVE: One of the indicators in measuring the nutritional status of a particular community is the nutritional status of pregnant women. A nutritional deficiency occurs if nutritional input for pregnant women from food is not balanced with their body's needs. Several determinants are related to nutritional status. This study aimed to determine the relationship between socioeconomic and nutritional status of pregnant women in temporary shelter, Talise, Palu. METHODS: This research was a quantitative observational study with a cross-sectional study approach. Sampling was done by random sampling technique, which obtained 85 pregnant women. Data collection was carried out using a questionnaire. RESULTS: Based on the Chi-Square test, p-value=0.001, which means that difference between socioeconomic status and nutritional status in pregnant women was significant (p<0.05). Variable of parity factor that was at risk and no risk in pregnant women showed p-value=0.030 and p-value=0.048. Additionally, the variable of pregnancy gap factor that was at risk and no risk in pregnant women showed p=0.070 and p=0.159. In addition, infectious disease factor that was at risk and no risk in pregnant women showed p-value=0.017 and p-value=0.027. Last but not least, implementation of ANC variable that was in line with standards and not in line with standards in pregnant women showed p-value=0.019 and p=0.043. CONCLUSION: Based on the Chi-Square test calculation, p-value=0.001, which indicates a significant value between socioeconomic status and nutritional status in pregnant women (p<0.05).

Association between molecular subtype of local advanced breast cancer with Ca 15-3 level.

BACKGROUND: Neoplasm is an abnormal mass of tissue that grows excessively and not coordinated with normal tissue growth and continues to do so even though the stimulation that triggered the change has stopped. Breast cancer can be known by using tumor marker, which has been used is mucin-like glycoprotein Carcinoma Antigen (CA 15-3) which is a tumor marker that is specific to breast cancer. METHOD: This study is a cross-sectional study to determine the association between molecular subtypes of locally advanced breast cancer with CA 15-3 level at Abdul Wahab Sjahranie Samarinda Hospital. The population in this study were all breast cancer patients that were confirmed by histopathological examination. RESULTS: A total of 75 patients were included for this study, 29 patients (38.7%) known as Overexpression HER2, 18 patients (24.0%) were Luminal B with HER2 (+), 11 patients (14.7%) were Luminal B with HER2 (-), 11 patients (14.7%) were Basal-like/TNBC, and 6 patients (8,0%) were Luminal A. From the ANOVA test, the value of p = 0.045 (p < 0.05) means there was an association between Ca 15-3 level and molecular subtypes in patients with locally advanced breast cancer at the Abdul Wahab Sjahranie Hospital in Samarinda 2017. In this study Ca 15-3 levels were obtained on average for Luminal A 16.98 U/mL, Luminal B with HER2 (-) 42.41 U/mL, Luminal B with HER2 (+) 73.75 U/mL, Overexpression HER2 47.73 U/mL, and Basal Like /TNBC 63.50 U/mL. CONCLUSION: Statistically, it was found that there was an association between Ca 15-3 levels and molecular subtypes in patients with locally advanced breast cancer at the Abdul Wahab Sjahranie Hospital in Samarinda 2017.

Effect of varash oil to decrease menstrual pain in primary dysmenorrhea of senior high school student at Palu City.

OBJECTIVE: menstrual pain is a common gynecological symptom at women on or near their menstrual period. Two third of them experienced moderate to severe pain. However, just several seek for medical help. This research aims to know the effect of ginger oil used on decreasing menstrual pain scale. MATERIALS AND METHODS: this cross over experimental study was held from February until May 2020 on 64 grade XI high school students at Palu city. Participants were grouping cluster randomly into group A which applied 5ml ginger oil five days before until the second day of the first menstrual period, and group B that given the same treatment in the next period. A visual pain scale measured the pain scale on the second day of the menstrual period. RESULT: most participants were in the age of 17 years old. The study found a lowering of pain scale significantly at both groups after treatment. The main menstrual pain scale were 6.87 ± 1.817 and 6.46±1.362 decreased to 3.48±1.928 and 4.24±2.010 after treatment (p=0.0001). Differences between the two groups were significant in the first period (p=0.0001) but not significant in the second period (p=0.410). CONCLUSION: the use of ginger oil several days before menstruation can reduce menstrual pain scale on students with primary dysmenorrhea; therefore, its use can be recommended to prevent the pain.

The Effectiveness of Galactomyces Ferment Filtrate, Dexpanthenol, and Centella Asiatica Combination Serum in the Treatment of Post-Acne Hyperpigmentation in Subjects with Skin of Color.

Post-acne hyperpigmentation (PAH) occurs secondary to acne vulgaris and may cause significant adverse effects. Although may occur in any skin types, PAH has been found to be more common and severe in people with colored skin. This study aimed to assess the effectiveness of combination serum containing galactomyces ferment filtrate (GFF), dexpanthenol, and Centella asiatica for treating PAH. This randomized controlled clinical trial involved Fitzpatrick skin type (FST) IV and V patients with PAH. Subjects were equally divided into treatment group, who received three drops of combination serum twice daily for 8 weeks, and placebo group. The melanin index (MI) and Lightness (L*) score were assessed every 2 weeks. Out of 51 subjects, the L* score of the treatment group in subjects with FST V was significantly higher on the 4th and 6th week compared to the placebo group (P ˂ 0.05). The MI of subjects with FST IV was significantly lower compared to the placebo group after 8 weeks (P ˂ 0.05). The treatment group showed consistent increasing and decreasing trend in L* score and MI, respectively (r ˃ 0.9, P ˂ 0.05). Combination serum containing GFF, dexpanthenol, and C. asiatica may be effective in treating PAH in subjects with colored skin by accelerating lessening of PAH.

Hemostatic parameters in pulmonary tuberculosis patients after intensive phase treatment.

BACKGROUND: Tuberculosis (TB) is an infectious disease caused by mycobacterium tuberculosis (Mtb). This infection causes the release of proinflammatory cytokines that affect hemostasis. Pulmonary TB infection causes an increased activation of procoagulant factors, decreased anticoagulant factors and suppresses fibrinolysis which causes hypercoagulable. Our study is conducted to assess the association between pulmonary TB infection (PTB) with hemostatic parameters before and after intensive phase treatment. METHODS: This was an analytic observational prospective cohort design. The study was conducted at the Community Center for Lung Health in South Sulawesi. Studied subjects were recruited by consecutive sampling, in which the patients who met the inclusion criteria received intensive phase of ATD treatment. PT, aPTT, fibrinogen, and D-dimer were measured before treatment and after the intensive phase of ATD. These data were analyzed using the SPSS Version 22. RESULTS: In this study, 30 subjects are new cases of PTB. Prothrombin time, aPTT and D-dimer levels were higher in far advanced lesions and smear-positive sputum group (p<0.001). There was a significant level decrease in PT, aPTT, fibrinogen, D-dimer after intensive phase treatment (p<0.001). CONCLUSION: Pulmonary tuberculosis infection is associated with hypercoagulability which is characterized by an increase in hemostatic parameters and has significant improvement after intensive phase of ATD treatment.

High uric acid level increases the risk of acute kidney injury in acute coronary syndrome patients.

BACKGROUND: Both clinical and experimental evidence have been published over the past few decades supporting the existence of a close relationship between the elevated levels of serum uric acid with cardiovascular events and acute kidney injury (AKI). This study aimed to determine the effect of serum uric acid levels on the incidence of AKI in acute coronary syndrome (ACS) patients. METHODS: A retrospective cohort study with a cross sectional design was performed. The research was conducted at Dr. Wahidin Sudirohusodo Hospital from October 2019 to December 2019. Nonrandom sampling was employed in the medical records. All patients who met the inclusion criteria were at > 18 years old and diagnosed with ACS with AKI. The demographic data of age, sex and serum uric acid levels were recorded. The data obtained were analyzed using the SPSS (Statistical Package for Social Sciences). RESULTS: There were 158 subjects of ACS patients with AKI and 135 without AKI. There was a significant correlation between high uric acid levels with the incidence of AKI in ACS (p<0.001). Patients with high serum uric acid levels were 9.5 times at risk of developing AKI compared to those with normal serum uric acid levels. CONCLUSION: High uric acid level is one of the risk factors for AKI in ACS and indicates 9.5 times at risk of developing AKI compared to normal serum uric acid level. Therefore, it is necessary to monitor serum uric acid level and kidney function in ACS patients.

Risk factors for asphyxia neonatorum in public health centres of nosarara and pantoloan, Palu City.

OBJECTIVE: This study aims to determine the risk factors of asphyxia neonatorum in two PONED Public Health Centers of Nosarara and Pantoloan, in Palu City, Central Sulawesi. METHODS: This study used a case-control study design. Sampling was conducted by a simple random sampling technique. The sample size in this study was 60 samples. The data collected was secondary data from medical records at Nosarara and Patoloan Public Health Centers, Palu City. Multivariate analysis used to determine the main risk of the incidence of neonatal asphyxia. RESULTS: The results showed the Prolong Parturition OR=5.714 (95% CI 1.724-18.944); Prematurity OR=4.333 (95% CI 1.203-15.605); LBW OR=7.000 (95% CI 1.381-35.487). CONCLUSION: risk factors for neonatal asphyxia were prolonged labour, prematurity, and LBW. The main factors causing neonatal asphyxia were LBW.

The influence of fluoride in drinking water on the incidence of fluorosis and intelligence of elementary school students in Palu City.

OBJECTIVE: This research aims to know the influence of fluoride in drinking water towards Fluorosis and the Intelligence Level of Elementary School Students in Palu City. METHOD: This cross-sectional study was performed through descriptive analysis on 100 students aged 6-12 years old selected by stratified random sampling from two different areas with different levels of fluoride in drinking water in Palu City. The samples were collected from two different elementary schools which were SDN 2 Talise and SDN Inpres 1 Birobuli. The examination was performed by a dentist using Dean's Fluorosis Index and philology, who measured students' IQ using Raven's Coloured Progressive Matrices. RESULTS: High level of F in drinking water affects the fluorosis status of students (p=0.001), in which among 40 students (40%) who experienced fluorosis, 38 (38%) of them are from the area whose F level is high. The high level of F also affected the children's IQ, obtaining a p-value of 0.001, showing that there were no students with low IQ found in the area with low F level. For the status of Fluorosis and IQ, p=0.001 was obtained. Among the 60 students who did not experience fluorosis, 96.6% of them had a high IQ level. CONCLUSION: The recent research found that fluorosis was found more often in the area of which F level was high, where the IQ level of the students was found to be lower compared to the students who loved in the area with low F level.

The relationship between knowledge and personal hygiene and the occurrence of sexually transmitted diseases at the Community Health Center Talise, Palu.

OBJECTIVE: This morbidity rate has increased compared to the results of a survey in 2012, which were 16,110 cases of STDs, and 11,141 cases in 2010. This study aimed at determining the relationship between knowledge and personal hygiene and the incidence of sexually transmitted diseases in adolescents at the Community Health Center Talise, Palu. METHODS: This study utilized a case-control study design to assess the relationship between knowledge and personal hygiene and the occurrence of sexually transmitted diseases. There were 84 samples in this study involving 42 cases and 42 controls. Data collection was carried out using a questionnaire. RESULT: The variable of personal hygiene showed that the Chi-Square test results provided a value of p=0.016, which means that the difference between individual hygiene and the incidence of sexually transmitted diseases (STDs) in adolescents was significant (p<0.05). CONCLUSION: This study concludes that the OR calculation has a value of 4.6, which means that adolescents who have insufficient knowledge have 4.6 times greater risk of suffering from STDs than adolescents who had sufficient knowledge.

Risk factors of anemia among pregnant women in community health center (Puskesmas) Singgani and Puskesmas Tipo Palu.

OBJECTIVE: The aim of this study is to describe the risk factors of anemia among pregnant women. METHOD: We used an observational analytic study with a matched case-control study design. The sampling method used in this study is a simple random sampling technique. The sample size in this study is 138 samples that consist of 46 cases and 92 controls. The data obtained from patient medical records and analyzed statistically using the chi-square test. RESULTS: Nutritional status is a risk factor of anemia among pregnant women in Community Health Center (Puskesmas) Singgani and Puskesmas Tipo. The risk of pregnant women with chronic energy deficiency (CED) developing anemia is higher in Puskesmas Singgani compared to in Puskesmas Tipo. CONCLUSION: Prevention can be done by counseling the bride and groom about pregnancy preparation and counseling the pregnant women to pay attention to the nutritional intake, particularly the consumption of folic acid supplements and iron.

The effect of balanced counseling strategy family planning against attitude, subjective norm, and intentions on the use of modern contraception behavior in the Singgani Public Health Center work area of Palu city.

OBJECTIVE: There is a declining trend in the use of modern contraception in the community. The stagnation of family planning services is due to the lack of optimal family planning counseling. Family Planning Balanced Counseling Strategy (FP-BCS) is a family planning counseling that is practical, interactive, and encourages client participation. This study aimed to analyze the influence of the FP-BCS on attitudes, subjective norms, and intentions on modern contraception in the working area of Singgani Health Center, Palu, Indonesia. METHOD: This research was a quasi-experimental with non-randomized pretest-posttest along to control group design. The sample of the study was third-trimester pregnant women who did antenatal care in the working area of the Singgani Community Health Center. The total sample was 17 respondents for each group; intervention group (treated by Maternal and Child Health (MCH) book and FP-BCS) and control group (treated by MCH Book without FP-BCS). The influence of FP-BCS toward attitudes, subjective norms, and intentions on modern contraception was statistically analyzed using the Wilcoxon Signed Rank Test, McNemar, Mann-Whitney, and Chi-Square. RESULT: The Wilcoxon Signed Rank Test and McNemar analysis on the intervention group showed an increase in attitude (p=0.000), subjective norms (p=0.000), and intention (p=0.000). The control group showed an increase in intention (0.031), subjective norms (p=0.005), but there was no increase in attitude (p=0.081). The Mann-Whitney and Chi-Square analysis showed differences in attitudes (p=0.000), subjective norms (p=0.021), and intentions (p=0.010) between groups, which were given an FP-BSC and those not given an FP-BCS. CONCLUSION: All in all, it is expected that Family Planning-Balanced Counseling Strategy will be an option in providing family planning counseling.

Albumin excretion rate among patients with diabetic retinopathy.

BACKGROUND: Chronic microvascular complications consist of diabetic nephropathy (DN), diabetic retinopathy (DR), and diabetic neuropathy. Diabetic nephropathy is assessed through albuminuria, and diabetic retinopathy is assessed through fundoscopy. Several studies have assessed the albuminuria in diabetic retinopathy but have found inconclusive results. This study aims to investigate the albumin excretion rate in patients with diabetic retinopathy. METHODS: A cross sectional design was applied in this study. The diagnosis of type 2 diabetes mellitus was determined based on the anamnesis and laboratory examinations. The study was conducted at Dr. Wahidin Sudirohusodo Hospital and Hasanuddin University Hospital in Makassar during November 2018 until April 2019. The stages of diabetic retinopathy were based on funduscopic examinations. In addition, the blood pressure, BMI, albumin excretion rate, lipid profile, and HbA1C were also examined. Chi Square and Kappa tests were performed in the statistical analysis. RESULTS: 120 subjects with type 2 diabetes mellitus were observed. Of the total subjects, the number of females within the age of 36-79 years made up the biggest fraction. There was a significant relation between hypertension comorbidity with the albumin excretion rate and grading diabetic retinopathy where the A3 and proliferative diabetic retinopathy (PDR) percentages were higher in the hypertension group at 68.8% and 54.5%. There was also a significant correlation between incidence of albuminuria with diabetic retinopathy. Particularly, proliferative diabetic retinopathy (PDR) remained associated with albuminuria, while non-proliferative diabetic retinopathy (NPDR) was related to non-albuminuria. CONCLUSION: Albuminuria incidence confirms association with diabetic retinopathy grading.

Relationship between Vitamin D Level and Serum TNF-α Concentration on the Severity of Chronic Obstructive Pulmonary Disease.

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory disease and disturbed bacterial clearance. Vitamin D deficiency is sometimes observed in COPD patients and as significant roles in increasing inflammation of airway obstruction and systemic obstruction, increasing pro-inflammatory cytokine including TNF-α, reduction of bacterial clearance and increase exacerbation risk due to infection. Also, vitamin D plays significant roles in the metabolism of calcium and mineralisation of bones and regulation system of immune. TNF-α also has essential roles in pathogenesis and inflammation of COPD. Several studies that investigate the relationship between vitamin D level and serum TNF-α concentration in COPD patients are relatively uncommon, including in Indonesia. AIM: This study aimed to assess the relationship between vitamin D level and TNF-α concentration in patients on the severity of the chronic obstructive pulmonary disease. METHODS: This study was a hospital-based descriptive cross-sectional study. Total samples were 50 COPD patients with the average age of older than 60 years during their enrollments at the Department of Pulmonology and Respiratory Medicine of the Dr Wahidin Sudirohusodo General Hospital Makassar in September 2018-January 2019. All procedures of the present study were reviewed and approved by the Research Ethics Committee of Medicine Faculty of Hasanuddin University. The severity of COPD was assessed according to the combination of COPD assessment stages that referred to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guideline 2015 that consisted of the combination of scoring COPD Assessment Test (CAT), the modified Medical Research Council (mMRC) questionnaire and results of the spirometry measurement. Assessment of airway obstruction levels referred to the GOLD spirometry criteria. Determination of thoracic photographs was conducted to verify the COPD diagnosis of the severity of COPD. Determination of serum TNF-α concentration and vitamin D3 [1,25(OH)2D3] level used the ELISA method. RESULTS: The majority of COPD patients were observed in the category of older than 60 years old accounted for 34 COPD patients (68%), and the majority of COPD patients were males accounted for 47 males with COPD (94%). The majority of COPD patients were observed in the group of D (38%). All the study subjects observed in this study were smokers, and 82% of them were in the category of heavy smokers. 21 study subjects had higher concentration of serum TNF-α (tertile 3 = 0.21-1.83 pg/dl), 20 study subjects and lower level of vitamin D (tertile 1 = 182.1-364.5 pg/dl). The majority of the study subjects (38%) were in the category of severe COPD (category D of the severity of COPD at the tertile 3) according to the GOLD Combine Assessment. Given the relationship between vitamin D level and serum TNF-α concentration on the airway obstruction, there were significant positive correlations between the increase of vitamin D levels and the increase of serum TNF-α concentrations on airway obstruction. Given the relationship between vitamin D level and serum TNF-α concentration on the severity of COPD, there were significant positive correlations between the increase of vitamin D levels (tertiles 1, 2 and 3) and the increase of serum TNF-α concentrations on the severity of COPD at p-value < 0.05. Overall, there were non-linear relationships between vitamin D level and serum TNF-α concentration on the severity of COPD. CONCLUSIONS: Serum TNF-α concentration was positively associated with airway obstruction level and severity of COPD. Low level of vitamin D was negatively associated with airway obstruction level and severity of COPD. Vitamin D3 level (1,25(OH)2D) was negatively associated with serum TNF-α concentration and airway obstruction level and severity of COPD.