Low serum lipase levels in mothers of children with stunted growth indicate the possibility of low calcium absorption during pregnancy: A cross-sectional study in North Sumatra, Indonesia.

Stunting is caused by various factors, including low nutritional intake in the first two years of life. This study aimed to investigate the differences in sociodemographic factors and mineral, vitamin, and enzyme parameters in mothers associated with the occurrence of stunting in children. We conducted a cross-sectional study from September to November 2020 on North Sumatra Island, Indonesia. The data collected included sociodemographic characteristics, pregnancy history, birth history, food intake, and laboratory examinations, including measurements of calcium, iron, zinc, vitamin D, pancreatic amylase, and serum lipase levels. This study included 50 healthy mothers aged 18-50 years old with children aged 2 to 60 months. There was a significant difference in serum calcium levels between the groups of mothers of children with normal and stunted growth (p = 0.03, mean difference±standard error (SE) = 0.23±0.12, 95% CI: 0.19-0.45). All of the study subjects were categorized as vitamin D deficient. The mean lipase level in the group of mothers of children with stunted growth was significantly lower than that in the group of mothers of children with normal growth (p = 0.02, mean difference±SE = 4.34±1.83, 95% CI: 0.62-8.06). The conclusion was that serum lipase levels were significantly lower in mothers of children with stunted growth compared to mothers of children with normal growth. Serum lipase levels this low are likely to indicate that a mother is unable to meet her child's calcium needs during pregnancy, increasing the child's risk of stunted growth.

Comprehension of Calcitriol Levels in Pregnant Women With Latent Tuberculosis and Immune Function in their Newborns.

Background: Pregnant women with latent tuberculosis infection (LTBI) may develop active tuberculosis infection and could infect their neonates, which could impair the child's immune system due to infection-mediated immunological responses. In order to develop a preventative TB program in this study, we desired to understand the impact of calcitriol in LTBI pregnant women and immunological responses in neonates. Patients and Methods: In three hospitals in Medan, North Sumatra, we implemented a case-control design with 84 pregnant women in their third trimester and their newborns. We determined the levels of calcitriol, cathelicidin, and interferon gamma (IFN-γ) in women between December 2021 and July 2022. These measurements were then compared to the newborns' levels of calcitriol, cathelicidin, IFN-γ, and Toll-Like Receptor (TLR) 2. Analyses were performed using the Chi-squared and Fisher's tests, while Spearman correlations were employed to assess for correlations. Results: 42 pregnant women with LTBI (interferon gamma release assay (IGRA) positive) and 42 pregnant women without LTBI (IGRA negative) participated in the study. The findings demonstrated that pregnant women with LTBI were at increased risk for calcitriol deficiency (Odds Ratio (OR) = 3.667, p = 0.006), which had an impact on the calcitriol levels of their unborn children (p = 0.038). TLR2 levels and calcitriol levels were substantially associated with LTBI pregnant women and their healthy neonates (p = 0.048; p = 0.005). Cathelicidin levels in the newborns of non-LTBI pregnant women were influenced by their higher calcitriol levels (p = 0.043). Pregnant women with LTBI had higher levels of cathelicidin and IFN-γ than those without it (p = 0.03; p = 0.001). Conclusion: Pregnant LTBI women's calcitriol levels had an impact on the calcitriol levels of their newborns. Mother's immunological responses and babies' calcitriol levels affected the levels of cathelicidin, IFN-γ, and TLR2 in newborns.

The Addition of Atezolizumab to Chemotherapy in Non-Small Cell Lung Cancer: A Trial-Based Review and Meta-Analysis.

Background: Non-small cell lung cancer (NSCLC) stands as one of the most prevalent types of cancer worldwide, driving extensive research in oncologic therapeutic approaches. Atezolizumab, among the treatments under scrutiny, is undergoing evaluation as a potential first-line therapy for NSCLC. This review aims to assess the efficacy of atezolizumab in treating patients with NSCLC and to shed light on the ongoing quest for the most effective treatment. Methods: Multiple scientific databases, including PubMed, Cochrane, and ScienceDirect, were consulted. The literature identification utilized the strategic Boolean term method of keywords relating to "non-small cell lung cancer" and "atezolizumab" to suggest the analyzed population in our review without restricting the potential outcomes. The primary inclusion criterion is clinical studies that attempted to determine the efficacy of atezolizumab in NSCLC patients. Results: We included four trials to be analyzed in the final analysis, which we stratified into the programmed cell death-ligand 1 (PD-L1) expressivity status aside from the pooled intention-to-treat (ITT) population. We found the addition of atezolizumab may significantly improve the overall survival (OS) in the respective arm, remarkably among the high PD-L1 expression group (TC3 or IC3). The result of our meta-analysis presented the pooled OS of 0.79 (0.72, 0.87) in 95% confidence interval (CI) with a P value of < 0.05. Sub-analysis of the PD-L1's expression revealed TC3 population benefits the most (hazard ratio (HR): 0.55, 95% CI (0.42, 0.73)), compared to low (HR: 0.80, 95% CI (0.68, 0.93)) and negative expression (HR: 0.79, 95% CI (0.68, 0.93)); which is statistically meaningful (P < 0.05). Similar result was also observed in progression-free survival (PFS) analysis with the HR value of 0.63 (0.55, 0.72), with P value of < 0.05, favoring atezolizumab arm. Conclusions: Upon examination, the study reveals that the addition of atezolizumab demonstrates notable improvements in both OS and PFS among NSCLC patients. These findings present promising attributes for atezolizumab as a viable treatment for NSCLC. However, it is important to acknowledge that the future holds further revelations in this realm, and more insights are yet to be uncovered.

Need Action for No Relationship Between Emotional Intelligence on Physical Activity Among Undergraduates in Colombo District.

Purpose: Participation in regular physical activity is influenced by a variety of factors, including psychological dimensions. Emotional intelligence (EI), an emerging term, has not yet been extensively researched in relation to Physical Activity (PA). Thus, the aim of the present study was to examine the relationship between EI on the PA of university undergraduates. Methods: Cross sectional design was used to conduct the study. A total of 400 Colombo district state university undergraduates were included in the sample. The participants filled out two standard questionnaires. Wong and Low questionnaire to measure EI and the International Physical Activity Questionnaire (IPAQ- Long Form) to measure physical activity. Convenience sampling has been used in order to collect the data. SPSS 25.0 software was used to process and analyze the data with Spearman's test and Mann-Whitney U-test. Results: The rate of significance is 0.061 and as it is greater than 0.05 and the test results are not significant, the null hypothesis was accepted, and the hypothesis was rejected. At the same time, there was a weak negative correlation between EI and PA, which was statistically not significant - rs = - 0.094, p = 0.061. Conclusion: It is crucial to emphasize and put into practice the need for undergraduates to engage in more PA. The findings provide a basis for research aimed at determining the relationship between EI and PA.

Anti Inflammatory Action of Allium Sativum Ethanol Extract to Prevent Lung Damage in Smoker Rat Model.

Background: Smoking is the leading cause of death in worldwide and is known as one of the risk factors in the development and pathogenesis of several diseases and most are respiratory and cardiovascular diseases. Secondhand smoke (SHS) exposure is associated with negative health consequences including respiratory tract infection, asthma, and cancer. One of the pathogenesis that has known to cause these diseases is inflammation. Garlic (Allium sativum) is a medicinal herb that contains Allicin and other active constituents that are known to have anti-inflammatory ability by suppressing the expression and production of proinflammatory cytokines that will cause inflammation. Objective: The aim of this study is; to analyze the anti-inflammatory action of Allium sativum ethanol extract to prevent lung damage in the smoker rat model. Methods: This is a case-control study with five groups of rats each group contains of three rats. The five groups were negative control (KN), 10 days (10d) smoker (K1), 20 days (20d) smoker (K2), 20d smoker treated with Allium sativum for 10 days (K3) and 20d smoker treated with Allium sativum for 20 days (K4). After 20 days all animals were sacrificed and histological preparation of lung organs was observed under a microscope with 100 dan 400 times magnification and then captured by photomicrograph for analyzed. Results: There were improvements in lung structure both in group K3 and K4 . there was a decrease of leucocytes and inflammatory cells infiltration that covered almost all alveolar surface to 10-20% surface area and the dilated alveoli decrease from more than 50% to less than 30% area. The bronchus was clean in both two groups compared to the groups that were not treated with Allium sativum. Conclusion: This study shows that Allium sativum ethanol extract has the ability to prevent lung damage in the smoker rat model.

Effect of Garlic Ethanol Extract Administration on Gluthatione Levels to Prevent Oxidative Stress in Smoker Rat Model.

Background: Sickle Garlic (Allium sativum L.) is known as a spice native to western Asia has a strong antioxidant effect and revealed it functions as an antioxidant by increasing ROS-capture activity, cellular antioxidants, SOD, CAT, and GSH levels in cells. Cigarette smoke is very dangerous because it can cause serious illness and death. Cigarette smoke is a major source of exogenous ROS because its particles are high in free radicals. Smoking is also related to a decrease in the body's natural antioxidant levels. Glutathione (GSH) synthesis and expression were found to increase initially and then decrease after being exposed to cigarette smoke. Objective: The aim of this study is; to analyze effect of garlic ethanol extract administration on gluthatione levels to prevent oxidative stress in smoker rat model. Methods: This was a case-control study with a control group design, with 15 healthy rats (Rattus norvegicus, sp.) divided into three groups, KN untreated animals (control), K1 animals exposed to cigarette smoke for 40 days (smoker), and K2 animals exposed to cigarette smoke for 40 days and treated with Allium sativum 0.1 g per day for 40 days (smoker and Allium sativum L.). After 40 days of treatment, all animals, including the control, were sacrificed with 30 mg/IP ketamine injections, and the blood plasma were taken for examination. Results: there were significant difference in glutathione levels between the treatment groups (K2) with the control group (KN) and the smokers group (K1) (p <0.05). Conclusion: garlic ethanol extract administration can increase gluthatione levels and prevent oxidative stress in smoker rat model.

The anti-obesity properties of Anredera cordifolia leaf extract in rats fed a high-fat diet through inhibition of adipogenesis.

Objective: Various disease complications are a risk of overweight or obesity, so losing weight can reduce the risk of diseases caused by obesity. Binahong leaf ethanol extract (Anredera cordifolia) is a weight-loss herbal preparation. Aim: This study aims to analyze whether A. cordifolia extract is effective in losing weight by affecting the mechanism of adipogenesis in an animal obesity model. Materials and Methods: Animals were grouped into six groups as follows: the normal diet (K1), the negative control group (K2), the positive control group with Orlistat at a dose of 20 mg/kg BW (K3), an ethanol extract of A. cordifolia leaves at doses of 50 mg/kg BW (P1), 100 mg/kg BW group (P2), and 150 mg/kg BW (P3). All rats were fed a diet that consisted of high fat for eight weeks, except K1. Afterward, the treatments were given based on group distribution. Then, the rats were treated based on their groups for 4 weeks, and the high-fat diet was still given during the treatment for the control groups (K2). Anthropometric examinations such as body weight, length, and the circumference of the abdomen were measured. Metabolic parameters, including blood glucose, cholesterol levels, triglyceride levels, and abdominal fat weight, were measured using molecular parameters that measured PI3K levels and Extracellular signal-regulated kinase (ERK) in abdominal fat tissue samples using the ELISA method. Results: ERK levels of abdominal fat were lowered in the treatment group using the extract of A. cordifolia (50 mg/kg BW (P1) and 100 mg/kg BW (P2)) compared to the control group that was given a high-fat diet without treatment. The control group, which was fed a high-fat diet without treatment, had an average ERK level of 10.17 ± 2.98 ng/ml, P1 (50 mg/kg BW). Furthermore, when ethanol extracts were used as opposed to the control group, which received a high-fat diet without treatment, there was an increase in phosphoinositide three-kinase (PI3K) levels (K2). The control group received 9.35 ± 2.87 ng/ml, the treatment group received 100 mg/kg BW (P2) 9.48 ± 1.54 ng/ml, and the treatment group received 150 mg/kg BW (P3) 7.87 ± 1.79 ng/ml. The weight of fat in the abdomen differed between the groups that received a high-fat diet without treatment (K2) and those that received a high-fat diet with treatment (P1, P2, P3; p < 0.05). Conclusion: Anredera cordifolia extract possesses anti-obesity activities by decreasing ERK and increasing PI3K levels, as well as reducing abdominal fat weight.

Assessment of water consumption during Ramadan intermittent fasting: Result from Indonesian cross-sectional study.

During Ramadan fasting, people are likely to consume water and beverages lower than recommended intake due to the limited time. However, it is necessary to achieve the recommended daily water intake to maintain the hydration status, as well as productivity during fasting. Unfortunately, there is a lack of data on drinking patterns during Ramadan. This study aims to investigate water and beverage intake and drinking patterns to help achieve water requirements during Ramadan among Indonesian adults. This is a cross-sectional study conducted during the Ramadan period from April to May 2021 (Ramadan 1442 Hijri). We used a self-administered questionnaire on drinking habits during Ramadan and utilized a 7-day fluid record (Liq.In 7) to assess water and beverage intake among participants who were managed through online procedure. There were 380 participants from five universities across Indonesia who completed the questionnaire accordingly and then analyzed it. The result shows that total water and beverage intake during Ramadan among participants was below the recommendation [1,670 (1,326-2,034) ml/day]. Among the type of beverages, water is the highest level of consumption [1,262 (983-1,666) ml/day] then followed by sugar-sweetened beverages [200 (91-350) ml/day]. We found a significant difference in water and beverages consumption between time of iftar [474 (375-590) ml/day], nighttime [574 (414-810) ml/day], and suhoor [560 (423-711) ml/day]. From this study, we found that during Ramadan the most common drinking pattern is 2-4-2, but a drinking pattern of 4-2-2 glasses (sequence of four glasses at iftar, two glasses at nighttime, two glasses at suhoor) had a significantly higher chance to adhere with the recommendation of fluid intake compared to other patterns. Therefore, based on this research on water and beverage intake, it is necessary and important to make improvements among Indonesian adults during Ramadan, and the drinking pattern of 4-2-2 glasses may help to achieve the recommended daily water consumption.

Is It Important to Increase Physical Activity Among University Students During the Second-Wave COVID-19 Pandemic in Asian Countries? A Cross-Sectional Study of the Knowledge, Attitudes, and Practices in Asian Countries.

Background: Difficulties in exercising have occurred for the entire world's population during this COVID-19 pandemic, especially in the second wave at the end of 2021. Most worrying is the lack of physical activity in young adults, as lack of exercise will increase the risk of noncommunicable diseases in the future. The youth such as university student can be agents of change, to increase physical activity, from sedentary to sport life. This study aimed to determine the relationship between knowledge, attitudes, and actions of university students and the correlation between the related variables. Methods: This study is a cross-sectional observational study involving 458 Asian university students based on Asian and African nationalities. This research was conducted from December 2021 to January 2022, during the second wave of the COVID-19 pandemic in Asia. The variables studied were the knowledge, attitudes, and actions of university students with regard to sports, and the statistical test used was the Chi-squared test. Results: The results showed that the research subjects were mainly from Indonesia and India (95.8%), there were more women than men (69.9% vs 30.1%), the most common age range was 18-20 years (61.4%), and 45.4% had a normal body mass index. In total, 48.3% had high knowledge, 93.4% had a positive attitude, and 34.7% had good practice. There was a significant relationship between knowledge and attitude (p=0.002) but not with action. Conclusion: This study found that good knowledge was associated with a good attitude, but due to the COVID-19 pandemic with activity restrictions on university students, there was no relationship with action.

Malondialdehyde value as radical oxidative marker and endogenous antioxidant value analysis in brain tumor.

Introduction: Oxidative stress has been considered as one of many contributor in developing risk of cancer. Oxidative stress may also promote the increasing number of free radical. Malondialdehyde (MDA) is one of radical oxidative marker, while Superoxide Dismutase (SOD) play role as endogenous antioxidant. It has been postulated that in cancer cells there is an increase of oxidative stress compared to normal cell. Method: This study is a case controlled analytical study to find the relationship between levels of MDA and SOD in patients with brain tumours. The sample obtained was 35 people who met the inclusion and exclusion criteria. Based on this analysis, it will be determined whether there is a significant relationship between levels of MDA and SOD in each type of brain tumours. Result: There is no significant relationship from all groups brain tumour and all tumours have a low correlation (r = 0.187) in the value of superoxide dismutase level. There is also no significant relationship from all groups (p = 0.302) and a low correlation (r = 0.187) to the value of Malondialdehyde level. Discussion: There was no relationship between superoxide dismutase in any type of intracranial tumour in this study. These concluded that superoxide values could not be a risk factor for primary intracranial tumours. Levels of MDA which is an indicator of lipid peroxidation, were significantly higher in patients consisting of meningiomas and gliomas. In high grade gliomas, the MDA increases due to the progressive progression of glioma tumours due to an increase in Reactive oxygen species levels. Conclusion: This study shows no correlation between SOD as an endogenous antioxidant and MDA as radical oxidative marker in primary brain tumour.

The Incidence of Adult Obesity is Associated with Parental and Adolescent Histories of Obesity in North Sumatra, Indonesia: A Cross-Sectional Study.

PURPOSE: Obesity that occurs in adulthood is influenced by various factors, not only energy balance, especially concerning the amount of energy consumed, but also heredity. The hereditary factors of obese parents on childhood obesity have been studied, but what about adulthood? This study examines the relationship between a history of obesity in adolescence, and maternal and paternal incidences of adult obesity. PATIENTS AND METHODS: This study was a cross-sectional study that included adult men and women aged 20-60 years old. The subjects had no chronic or metabolic disease. This research was conducted from April to November, 2020, in North Sumatra Province, Indonesia. The parameters studied were demographics, daily food intake, anthropometry and a history of obesity in adolescence, and for the participants' fathers and mothers. The statistical test used was the chi-squared test/Fisher test. RESULTS: This study included 136 research subjects, 60 male and 76 female; based on the results of the study, 47.8% were found to be obese, but food intake showed a low intake (96.2%). There was a significant relationship between a history of obesity in adolescence and incidences of obesity (≥30 kg/m2) in the mother and father, with significance values of p=0.01, p=0.004, and p=0.001, respectively. CONCLUSION: This study found that there was a significant relationship between a history of obesity in adolescence and incidences of adult obesity (≥ 30kg/m2) in parents, but not with the level of food intake per day. The risk of obesity will increase further with a history of obesity in parents and obesity in adolescence, and this can be used to understand and prevent obesity.

Role and value of inflammatory markers in brain tumors: A case controlled study.

INTRODUCTION: Brain tumor is one of the most devastating diseases in the world. The Pathogenesis is vary in multiple aspect of mechanism. The tumor microenvironment contains many different noncancerous cell types in addition to cancer cells. Inflammation is thought to be one of the factors that influence the oncogenesis process in brain tumors. METHODS: This study is a case controlled analytical study that analyzes the relationship between levels of inflammatory markers with the type of brain tumor. Samples of 35 people were then categorized according to the variables above and analyzing to measure its significance. RESULTS: Based on demografic study, most sample was male with age was 41-50 years It was found that high levels of procalcitonin were found in the case of glioma brain tumors. Procalcitonin level was considered a significant marker in predicting the severity of a brain tumor (p < 0.005). There was no significant value between the C-Reactive Protein and Neutrophyl-Lymphocyte ratio values for brain tumors. DISCUSSION: Abnormal inflammation is a characteristic of malignant cancers and malignant transformation of low-grade gliomas and other brain tumor. Inflammation-induced activation of transcription factors contributes to the survival and rapid growth of glioma cells. CONCLUSION: As in other malignant cancers, inflammation may contribute to tumor progression. Biomarkers based on inflammation, such as the classical example of Procalcitonin and C-reactive protein, have been used to assess prognosis of glioma patients. These results should be validated and extended in larger clinical studies.

The Moderate Correlation Between 25(OH)D Serum and Saliva in Healthy People with Low Vitamin D Intake.

PURPOSE: The routine examination of vitamin D levels is carried out by checking serum 25(OH)D levels, while serum 1.25(OH)D levels are less frequently utilized. The proposition that testing for salivary vitamin D can show a correlation with serum levels in healthy people is questionable, especially with low vitamin D intake. This study aimed to find the correlation between vitamin D levels, which were assessed as 25(OH)D and 1.25(OH)D in saliva, and serum 25(OH)D and 1.25(OH)D levels in people with low vitamin D intake. PATIENTS AND METHODS: This study is a cross-sectional study involving healthy men and women, aged 18-60 years, carried out from August to November, 2020, in North Sumatra Province, Indonesia. The parameters studied were the 25(OH)D and 1.25(OH)D levels in saliva and serum, and vitamin D intake. The statistical analysis used was the Spearman correlation test, performed to determine the correlation between each parameter. RESULTS: This study involved 56 study subjects, who were rural adults (male or female) with a 78.6% deficiency in 25(OH)D found by examining saliva, and a 76.8% deficiency found by examining the serum. All of the subjects were categorized as having low vitamin D intake (less than 15 micrograms per day). The analysis showed a moderate correlation between levels of saliva 25(OH)D and serum 25(OH)D (p = 0.424), and a weak correlation between levels of saliva 1.25(OH)D and serum 25(OH)D (p = 0.339). CONCLUSION: In people with low vitamin D intake, there was a moderate correlation between serum 25(OH)D and saliva, but a weak correlation was found in the 1.25(OH)D assay. The use of saliva 25(OH)D levels to detect 25(OH)D in the circulation is a possible non-invasive alternative to serum testing.

Positive Correlation Between General Public Knowledge and Attitudes Regarding COVID-19 Outbreak 1 Month After First Cases Reported in Indonesia.

The increasing number cases of coronavirus disease (COVID-19) infections in the general population in Indonesia raises questions concerning the public's knowledge and attitudes regarding this pandemic. To determine the correlation between the general public's knowledge and attitudes regarding the COVID-19 outbreak 1 month after the first cases were reported in Indonesia. This cross-sectional study was conducted between early March and the end of April 2020 in the general population of Indonesia, beginning with the North Sumatra region, where the spread of COVID-19 in Indonesia began. Questionnaires were randomly distributed online in the red zone in Indonesia. Data were collected by collecting people's responses to the questionnaire, which were distributed via WhatsApp (WA) application and were competed independently by the participants. A descriptive analysis was conducted to describe the demographic characteristics, knowledge, and attitudes of the general population. A total of 201 people had good knowledge (98%) and a positive attitude (96%) regarding the COVID-19 pandemic. The respondents had a negative attitude in relation to two aspects of the COVID-19 outbreak: having to always maintain a distance of 1.5 m when in crowds, and not being able to regularly exercise or eat nutritious food (78.6% and 79.1%, respectively). Most people in Indonesia have good knowledge and a positive attitude regarding the COVID-19 pandemic. However, negative attitudes were still found in this study, and as a result, transmission prevention measures cannot reach their maximum effectiveness by simply publicizing the increase in day-to-day cases to the general public.

Association Between Family Support, Coping Strategies and Anxiety in Cancer Patients Undergoing Chemotherapy at General Hospital in Medan, North Sumatera, Indonesia.

OBJECTIVE: This study aims to test the association between family support and coping strategies and anxiety at Dr. Pirngadi General Hospital Medan. METHODS: The study was a correlational descriptive study with a cross-sectional approach. The samples were 102 cancer patients undergoing chemotherapy, who were selected through purposive sampling technique. Data was collected using a family support questionnaire instrument developed based on the concept of the House and Friedman theory, a coping strategy questionnaire modified from the Revised Ways of Coping questionnaire by Folkman and Lazarus, and an anxiety questionnaire modified from the Hamilton Anxiety Rating Scale (HAM-A). Bivariate analysis was conducted using the Product Moment correlation coefficient to test the association between family support, coping strategies, and anxiety. Multivariate analysis was conducted using the logistic regression test to investigate dominant variables associated with coping strategies and anxiety. RESULTS: The results of the bivariate analysis showed a significant positive association (p=0.001) and strong correlation (r=0.612) between family support and Problem Focused Coping (PFC) strategy, while there was a significant negative association (p=0.001) and moderate correlation (r=-0.462) with the Emotion Focused Coping (EFC) strategy. A significant negative association (p=0.001) and strong correlation (r=-0.646) was found between family support and anxiety. The multivariate analysis showed a dominant association (p = 0.001) between family support with PFC strategy (OR = 12.2), EFC (OR = 0.142), and anxiety (OR = 0.039). CONCLUSION: Based on the results, it can be concluded that there was an association between good family support and effective coping strategies and lower anxiety levels in cancer patients undergoing chemotherapy. These results can be an input for health services to increase family support for cancer patients undergoing chemotherapy in combination with effective coping strategies to decrease anxiety levels.

Nutrition Status Related to Clinical Improvement in AFB-Positive Pulmonary Tuberculosis Patients in Primary Health Centres in Medan, Indonesia.

BACKGROUND: Tuberculosis (TB) remains a major public issue in Indonesia, including in North Sumatra province. Despite reported good efficacy of TB treatment in the region, the success of treatment depends on many factors, including nutritional status. AIM: To determine the relationship between Body Mass Index and Albumin level with sputum conversion in AFB-positive pulmonary TB patients. METHODS: The study was done in two primary health centres in Medan between October and November 2018. A total of 39 newly diagnosed TB patients with confirmed AFB-positive were included in the study. Participants received TB treatment according to the national guidelines. RESULTS: The proportion of participants with below normal, normal and above normal BMI status were 13 (33.3%), 21 (53.9%) and 5 (12.8%), respectively. Level of albumin was determined as normal in 25 participants (64.1%), and the remaining as low. Normal BMI status was significantly associated with increased albumin level (p < 0.05). At 2 months follow-up, the sputum conversion was observed in 24 individuals (61.5%), and the conversion was significantly associated with normal BMI and/or normal albumin level (p < 0.05). CONCLUSION: We concluded that nutritional status is an important factor in the success of TB treatment.

Vitamin A Supplementation in Pulmonary Tuberculosis Patients on Acceleration of Sputum Conversion in Medan City.

BACKGROUND: Indonesia is in the second rank for the most TB (Tuberculosis) cases in the world after India. It is estimated that there are 1 million cases per year in Indonesia. AIM: To find out the influence of Vitamin A supplementation in the medication of pulmonary TB on the acceleration of sputum conversion time at an intensive phase in the Working Area of Puskesmas in Medan Kota Subdistrict. METHODS: This research was Quasi Experiment method. With two groups. The samples were 30 newly diagnosed pulmonary TB patients consisting of of15 patients in the treatment group and 15 patients in the control group. The statistical data were analysed with t independent test, significance 95% (p < 0.05). RESULTS: The treatment group discovered that they were mostly 18-27 years old 40.0%, male 73.3%, mostly university students 26.7%, had BTA conversion in the second week 80.0%; and the sputum conversion time was 2.4 weeks in average. The results of the research on the control group demonstrated that they were mostly 18-27 years old 33.3%, male 80.0%, mostly university students and entrepreneurs 20.0%, had BTA conversion in the second week 80%; and the sputum conversion time was 4.1 weeks in average. Vitamin A supplementation in the medication of pulmonary TB patients had some influence on the acceleration of sputum conversion at the intensive phase (p ≤ 0.001). CONCLUSION: We concluded that Vitamin A in the medication of pulmonary TB patients had some influence on the acceleration of sputum conversion at the intensive phase in the Medan Kota.

A Comparison of the Quality of Sleep between Pre and Post-Surgery Cervical Herniated Nucleus Pulposus Patients Utilizing the Anterior Discectomy Method.

BACKGROUND: Herniated Nucleus Pulposus (HNP) is the prolapse of the intervertebral disk through a tear in the annulus fibrosus. This causes nerve root compression with clinical pain manifestation and affects the quality of sleep. AIM: The aim of this study was find out the comparison in the quality of sleep between before (pre) and after (post) surgery cervical HNP patients. METHODS: This study was a retrospective cohort study. Ninety patients were asked to complete the Pittsburgh Sleep Quality Index (PSQI) questionnaire. All data which has been computed were analysed with the McNemar test. RESULT: The outcome reveals that from 90 patient`s cervical HNP, 81 (90%) were 40 years old age group and 66 (73.3%) of them were women. The result showed that 66 (73.3%) patients have a bad sleep quality before surgery. Surgery has increased the quality of sleep after surgery 66 (73.3%) patients had good sleep quality. There was a significant difference in the quality of sleep pre and post operation (p = 0.001). CONCLUSION: There was a significant difference in the quality of sleep between pre and post operation cervical HNP patient utilising anterior discectomy methods.