scholarly journals LAMA MENDERITA DAN KONTROL GLIKEMIK BERHUBUNGAN DENGAN PENURUNAN FUNGSI KOGNITIF PADA PASIEN DIABETES MELITUS TIPE 2

2021 ◽  
Vol 7 (3) ◽  
pp. 495-501
Author(s):  
Syalfa Luthfira Nugroho ◽  
Wirawan Anggorotomo ◽  
Rakhmi Rafie
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cognitive Function ◽  
Glycemic Control ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Diabetes Melitus

Background : Diabetes Mellitus can cause the  risk of decline in cognitive function. Long suffering and ncontrolled glycemic control associated with chronic hyperglycemia that can change the function and microvascular structure of the central nervous system so that it can lead to decline of cognitive function.  Objective : This study aims to determine the relationship between the long-suffering and glycemic control with the decline of cognitive function in patients with type 2 Diabetes Mellitus in the health center Sriwijaya Mataram Central Lampung  in 2021. Methods: This study used an analytical research design with cross sectional approach. The population used was all patients diagnosed with type 2 Diabetes Mellitus in the health center Sriwijaya Mataram Central Lampung. The sample in this study amounted to 71 people who were taken with total sampling technique. Measuring instruments used were the Mini Mental State Examination (MMSE). The statistical test used was Chi Square test. Results : There is a relationship between the long-suffering (p value 0.000) and glycemic control (p value 0.000) with a decrease in cognitive function in patients with type 2 Diabetes Mellitus. Conclusion : There is a relationship between the long-suffering and glycemic control with the decline of cognitive function in patients with type 2 Diabetes Mellitus. Suggestion can detect a decline in cognitive function so as to improve the quality of life in patients with type 2 diabetes mellitus and education related to complications of type 2 diabetes mellitus is necessary. Keywords : Long-Suffering, Glycemic Control, Cognitive Function.          ABSTRAK Latar Belakang : Diabetes Melitus dapat menyebabkan resiko penurunan fungsi kognitif. Lama menderita dan kontrol glikemik tidak terkontrol berkaitan dengan keadaan hiperglikemia kronik yang dapat mengubah fungsi serta struktur mikrovaskular pada sistem saraf pusat sehingga dapat menyebabkan penurunan fungsi kognitif. Tujuan : Penelitian ini bertujuan untuk mengetahui hubungan antara lama menderita dan kontrol glikemik dengan penurunan fungsi kognitif pada pasien Diabetes Melitus tipe 2 di Puskesmas Sriwijaya Mataram Lampung Tengah tahun 2021.Metode  : Penelitian ini menggunakan desain penelitian analitik dengan pendekatan cross sectional. Populasi yang digunakan adalah semua pasien yang didiagnosis Diabetes Melitus tipe 2 di Puskesmas Sriwijaya Mataram Lampung Tengah. Sampel dalam penelitian ini berjumlah 71 orang yang diambil dengan teknik total sampling. Alat ukur yang digunakan adalah Mini Mental State Examination (MMSE). Uji statistik yang digunakan adalah uji Chi Square. Hasil: Terdapat hubungan antara lama menderita (p value 0.000) dan kontrol glikemik (p value 0.000) dengan penurunan fungsi kognitif pada pasien Diabetes Melitus tipe 2.Kesimpulan : Terdapat hubungan antara lama menderita dan kontrol glikemik dengan penurunan fungsi kognitif pada pasien Diabetes Melitus tipe 2.Saran dapat mendeteksi penurunan fungsi kognitif sehingga dapat meningkatkan kualitas hidup pada pasien Diabetes Melitus tipe 2 serta perlu dilakukan edukasi terkait dengan komplikasi Diabetes Melitus tipe 2. Kata Kunci : Lama Menderita, Kontrol Glikemik, Fungsi Kognitif. 

scholarly journals HUBUNGAN POLA MAKAN TERHADAP STATUS GIZI PASIEN RAWAT JALAN DIABETES MELITUS TIPE 2 DI WILAYAH KERJA RUMAH SAKIT GRANDMED LUBUK PAKAM

2021 ◽  
Vol 3 (2) ◽  
pp. 168-171
Author(s):  
Raini Panjaitan ◽  
Reno Irwanto ◽  
Andreais Boffil Cholilullah ◽  
Salmi Angraini
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Nutrient Status ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
Cross Sectional Design

Diabetes mellitus is a chronic disease characterized by hyperlycemia. Risk factors for type 2 diabetes mellitus due to intake of carbohydrates, fats and protein. This study aims to see the relationship between diet in the nutrient status of type 2 diabetes mellitus in out patient in Grandmed Hospital Lubuk Pakam. This research method is an observational description with cross-sectional design. The sample is patients type 2 diabetes mellitus in out patient in Grandmed Hospital Lubuk Pakam. The sample is 30 people. The instruments are Food Recall 24 Hours and analyzed by nutrition app Nutri Survey. The data analysis used in this study was the Chi-Square test (95% CI) From the result of this research showed that 44,6% of patients with excess carbohydrate intake with a p value of 0.000 ≤ α (0,05). this research showed that 49,0% of patients with excess fat intake with a p value of 0.000 ≤ α (0,05). this research showed that 38,0% of patients with excess protein intake with a p value of 0.000 ≤ α (0,05). The conclusion are that there is significant relationship between diet in the nutrient status of type 2 diabetes mellitus in out patient in Grandmed Hospital Lubuk Pakam and type 2 diabetes mellitus in out patient nutrient status characteristics categorized as obesity.  

scholarly journals Hubungan Antara Tingkat Stres Dan Kadar Glukosa Darah Puasa Penderita Diabetes Melitus Tipe 2 Di Kecamatan Maos

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Esti Oktaviani Purwasih
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Stress Level ◽  
Fasting Blood Glucose ◽  
P Value ◽  
Cross Sectional ◽  
Diabetes Melitus

ABSTRAKDiabetes melitus (DM) tipe 2 yaitu penyakit gangguan metabolik ditandai kenaikan gula darah karena penurunan sekresi insulin oleh sel beta pankreas dan atau ganguan resistensi insulin.Penelitian ini bertujuan untuk mengidentifikasi hubungan antara kadar glukosa darah puasa dengan tingkat stres pada penderita diabetes melitus (DM) tipe 2. Jenis penelitian adalah deskriptif korelasi dengan pendekatan cross sectional. Variabel independen dalam penelitian ini yaitu tingkat stres. Sedangkan variabel dependen dalam penelitian ini yaitu kadar glukosa darah puasa. Penelitian dilakukan di Puskesmas Maos dan Klinik Graha Amanah Maos bulan Maret 2017. Sampel diambil dengan total sampling, berjumlah  60 responden yang menderita DM tipe 2 minimal 1 tahun, memiliki kadar GDP 130 mg/dl, dan tidak memiliki penyakit komplikasi seperti gagal ginjal kronis, dan kanker.Hasil analisis data menggunakan spearman rho didapatkan tidak terdapat hubungan antara kadar glukosa darah puasa dan tingkat stres (p value = 0,137). Kata Kunci: Diabetes Mellitus Tipe 2, Glukosa Darah Puasa, Tingkat Stres. ABSTRACTType 2 diabetes mellitus (DM ) is a metabolic disease that characterized by an increasing of  blood  glucose because of decreasing insulin secretion by pancreatic beta cells and or insulin resistance disorders.This research aimed to identify the relationship between fasting blood glucose (FBG) level and stress level in patients with  type 2 diabetes mellitus (DM). The research design was descriptive correlation with cross sectional approach. The independent variable in this study was stress level. The dependent variable in this study was fasting blood glucose level. The study was at Maos Community Health Center and Graha Amanah Clinic in March 2017.The sample was total sampling. These were 60 respondents who diagnosed  type 2 diabetes mellitus at least 1 year, had FBG level 130 mg / dl, and did not have complications such as chronic kidney failure , and cancer.The results of data analysis by using spearman rho found that there was no correlation between fasting blood glucose level and stress level (p value = 0.137). Keywords: Type 2 Diabetes Mellitus, Fasting Blood Glucose, Stress Level.

scholarly journals Glycemic Control and Its Factor in Type 2 Diabetic Patients in Jakarta

2020 ◽  
Vol 9 (3) ◽  
pp. 198
Author(s):  
Maifitrianti Maifitrianti ◽  
Nora Wulandari ◽  
Muthoh Haro ◽  
Sifah F. Lestari ◽  
Anisa Fitriani
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Hba1c Level ◽  
Cross Sectional ◽  
Primary Health ◽  
Diabetes Melitus

Poor glycemic control is a primary risk factor for the progression of complications. This study aimed to determine the status of glycemic control and associated factors among type 2 Diabetes Mellitus (DM) patients at primary health care of Cakung District, Kebon Jeruk District and Rawa Bunga Village, Jakarta. This study was conducted from July to August 2019, and adopted a cross-sectional design. The respondents' data included sex, age, occupation, education, long suffered with diabetes, diagnosed chronic disease, antidiabetic and other regular drugs were obtained through a questionnaire. Measurement of glycated haemoglobin A1c level was carried out in a standardized laboratory in Jakarta. A total of 126 respondents met the inclusions and exclusion criteria, of which 70.6% were female. The mean age of patients was 61.46±9.086 years (35–85 years). HbA1c level was measured, and the results showed that 45.2% of respondents had good glycemic control (<7% of HbA1c level), while 54.8% had poor control (≥7% of HbA1c level). On the bivariate analysis, the number of antidiabetics was significantly associated with glycemic control (p<0.05). The poor glycemic control was significantly higher in patients with polytherapy (72.6%) antidiabetic compared to single antidiabetic (37.5%) (p=0.01). These findings highlighted the need for proper management of patients with polytherapy, in order to prevent the complication of type 2 DM.Keywords: Glycemic control, Jakarta, primary health care, type 2 diabetes mellitus Kontrol Gikemik dan Faktor yang Berhubungan pada Pasien dengan Diabetes Melitus Tipe 2 di JakartaAbstrakKontrol glikemik yang buruk merupakan faktor risiko utama terjadinya komplikasi pada pasien diabetes melitus (DM). Penelitian ini bertujuan untuk mengetahui kontrol glikemik dan faktor yang berhubungan pada pasien DM tipe 2 di Puskesmas Kecamatan Cakung, Kecamatan Kebon Jeruk dan Kelurahan Rawa Bunga, Jakarta. Penelitian dilakukan pada bulan Juli–Agustus 2019. Desain penelitian yang digunakan adalah cross-sectional. Data responden antara lain jenis kelamin, umur, pekerjaan, pendidikan, lama menderita penyakit DM, penyakit kronis lain yang diderita, obat DM dan obat rutin lain yang digunakan didapatkan melalui instrumen kuisioner. Pengukuran kadar HbA1c dilakukan di laboratorium yang terstandarisasi di Jakarta. Sebanyak 126 responden memenuhi kriteria inklusi dan eksklusi terlibat dalam penelitian ini, dan sebanyak 70,6% adalah berjenis kelamin perempuan. Usia rata-rata pasien adalah 61,46±9,086 tahun (35–85 tahun). Hasil penelitian menunjukkan bahwa 45,2% responden memiliki kontrol glikemik yang baik (<7 level HbA1c), sedangkan 54,8% responden memiliki kontrol glikemik yang buruk (≥7 level HbA1c). Hasil uji bivariat menunjukkan bahwa jumlah antidiabetes yang digunakan berhubungan dengan kontrol glikemik. Kontrol glikemik yang buruk secara signifikan lebih tinggi ditemukan pada pasien dengan politerapi (72,6%) dibandingkan pada pasien dengan terapi tunggal antidiabetes (37,5%) (p=0,01). Temuan ini menyoroti perlunya manajemen yang tepat pada pasien dengan politerapi untuk mencegah komplikasi DM tipe 2.Kata kunci: Diabetes melitus tipe 2, Jakarta, kontrol glikemik, puskesmas

PREVALENCE OF HYPERTENSION AMID PATIENTS WITH TYPE-2 DIABETES MELLITUS- AT A TERTIARY LEVEL HOSPITAL IN CENTRAL INDIA

2021 ◽  
pp. 57-59
Author(s):  
Hakimuddin Malvi ◽  
Syed Maqsood Husain
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Central India ◽  
P Value ◽  
Tertiary Level ◽  
Cross Sectional ◽  
Study Results ◽  
Level Hospital

Background: India has been recognized as the diabetes capital of the world by the year of 2025 Hypertension is a signicant danger factor for cardiovascular infection, stroke and ischemic coronary illness. Objective: The aim of this paper is prevalence of hypertension amid patients with type 2 diabetes mellitus- at a tertiary level hospital in central India. Methods: Present work is hospital based cross-sectional study was conduct in Chirayu Medical College & Hospital, Bhopal. The study population consisted of total 300 subjects. Data obtained directly from patients and patients medical les, and the following data were included in the study . Results: The results showed that the after using chi-square test we found that hypertension was signicantly higher p value(<0.05) among female patients (69%),patients with long duration diabetes (77%)10 years and more, also it was signicantly higher among patients with current smokers (69%). Conclusion: In this study the prevalence of hypertension is increasing in patient with T2DM. Hypertension was the most danger factor for micro vascular and macro vascular confusion of T2DM.

scholarly journals HUBUNGAN KUALITAS TIDUR DENGAN KADAR GLUKOSA DARAH PUASA PADA PASIEN DIABETES MELLITUS TIPE II DI PUSKESMAS KASSI-KASSI KOTA MAKASSAR

2020 ◽  
Vol 15 (1) ◽  
pp. 46-50
Author(s):  
Muhammad Basri ◽  
Baharuddin K ◽  
Sitti Rahmatia
Keyword(s):  
Diabetes Mellitus ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Dm Type 2 ◽  
Diabetes Melitus

Diabetes Melitus (DM) merupakan salah satu kelompok penyakit metabolik dan kronis dengan karakteristik hiperglikemia yang terjadi karena kelainan sekresi insulin, kerja insulin atau keduaduanya yang membutuhkan perawatan medis dan pendidikan pengelolaan mandiri untuk mencegah komplikasi akut jangka panjang (Nian, 2017). Tujuan penelitian ini adalah Mendeskripsikan hubungan kualitas tidur dengan kadar glukosa darah Puasa pada pasien DM tipe II di PKM Kassi-Kassikota Makassar. Manfaat : Meningkatkan pengetahuan pada Penderita DM Tipe II yang mengalami gangguan Kwalitas dan Pola Tidur shari-hari Meningkatkan pengetahuan pada Penderita DM Tipe II yang mengalami gangguan Kwalitas dan Pola Tidur shari-hari Metode : Pada penelitian ini menggunakan desain cross sectional, jenis penelitian ini menggunakan metode analitik yaitu metode penelitian yang dilakukan dengan tujuan untuk mengetahui hubungan antara Kualitas tidur dengan kadar glukosa darah puasa pada pasien DM Tipe II. Sampel menggunakan purposive sampling dengan menggunakan rumus Slovin dengan jumlah sampel  55  orang  yaitu  seluruh pasien DM tipe 2 yang menjalani rawat jalan di PKM Kassi-Kassi Kota Makassar. Hasil Uji Statistik Chi Square diperoleh p value 0,000 < 0,05.sehingga peneliti berasumsi bahwa  ada hubungan antara kualitas tidur dengan kadar glukosa darah pada pasien DM Type 2 di Puskesmas Kassi-Kassi Makassar.  Kesimpulan yaitu terdapat hubungan kualitas tidur dengan kadar glukosa darah pada pasien diabetes melitus tipe 2 di Puskesmas Kassi-Kassi Makassar. Saran dapat dijadikan sebagai salah satu acuhan bagi pasien diabetes melitus tipe 2 untuk meningkatkan kualitas tidur dan menjaga kadar glukosa darah puasa

scholarly journals Efektivitas Mobile Health Intervention Terhadap Manajemen Diri Dan Kontrol Glikemik Pada Pasien Dengan Diabtes Melitus Tipe 2: A Systematic Review

2020 ◽  
Vol 11 (4) ◽  
pp. 342
Author(s):  
Wahyu Sukma Samudera ◽  
Novita Fajriyah ◽  
Ida Trisnawati
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Mobile Health ◽  
Controlled Trial ◽  
Health Intervention ◽  
Self Management ◽  
Diabetes Melitus

Background: Type 2 diabetes mellitus was one of non-communicable diseases that increased of prevalence in word wide, included in Indonesia. Utilization of technology as an effort of increase of diabetes treatment is important for achieving of optimum glycemic control and to prevent of complication of diabetes mellitus. However, intervention for self management in patients with diabetes mellitus at this time still not using technology based mobile health intervention. Purpose: This study aims to verify of effectiveness of mobile health intervention on self management and glycemic control in patient with type 2 diabetes mellitus. Method: Design of this studies was used systematic review of randomized controlled trial with PRISMA approach. Article search was carried out through databases: Scopus, Science Direct, and ProQuest with randomized controlled trial design within last 10 years. Results: The finding showed 407 articles have been obtained. Articles selection process were through few steps: topic selection, full text selection, design of studies and obtained 10 articles have been as appropriate of inclusion criteria. Based on results of finding of 10 articles were showed that mobile health intervention was effective in improving of glycemic control by decreasing hbA1c, fasting blood glucose, 2 hours post pandrial. Furthermore, mobile health intervention was effective in increasing of self management in patient with type 2 diabetes mellitus and increased adherence of diabetes medication. Moreover, mobile health intervention can also improve of insulin level and lipid profile in patient with type 2 diabetes mellitus. Conclusion: Mobile health intervention was effective in improving of glycemic control and self management, and giving of facilitate communication between patient and health providers Keywords: mobile health application; self management; glycemic control; diabetes mellitus ABSTRAK Latar belakang: diabetes melitus (DM) tipe 2 merupakan salah satu penyakit tidak menular yang mengalami peningkatan angka kejadian di dunia, termasuk di Indonesia. Penggunaan teknologi sebagai upaya meningkatkan manajemen diabetes melitus sangatlah penting untuk dilakukan guna mencapai kontrol glikemik optimal dan mencegah komplikasi dari Diabetes Melitus. Namun, manajemen diri pada sebagian besar pasien Diabetes Melitus saat ini masih belum menggunakan bantuan teknologi berbasis mobile health. Tujuan: Penelitian ini bertujuan untuk memverifikasi efektivitas dari penggunaan mobile health intervention terhadap manajemen diri dan kontrol glikemik pasien dengan diabetes melitus tipe 2. Metode: desain dalam penelitian ini adalah systematic review dengan menggunakan pendekatan PRISMA. Pencarian artikel dilakukan pada beberapa database yang meliputi: Scopus, Science Direct dan ProQuest dengan desain Randomized controlled trial dalam 10 tahun terakhir. Hasil: hasil temuan didapatkan sejumlah 407 artikel penelitian. Proses seleksi artikel dilakukan beberapa tahap meliputi: seleksi topik, fullteks, desain artikel penelitian dan didapatkan 10 artikel penelitian yang sesuai dengan kriteria inklusi. Berdasarkan hasil temuan dari 10 artikel penelitian yang digunakan, menunjukkan bahwa mobile health intervention efektif dalam memperbaiki kontrol glikemik pasien diabetes melalui penurunan kadar hbA1c, gula darah puasa, 2 jam post pandrial. Selanjutnya, mobile health intervention efektif dalam meningkatkan manajemen diri pasien diabetes dan meningkatkan kepatuhan pengobatan. Selain itu, mobile health intervention juga dapat memperbaiki level insulin dan profil lipid pasien diabetes melitus tipe 2. Kesimpulan: Mobile health intervention efektif dalam memperbaiki kontrol glikemik dan meningkatkan manajemen diri pasien diabetes melitus serta memudahkan komunikasi antara pasien dengan tenaga kesehatan Kata kunci: mobile health application; manajemen diri; kontrol glikemik; diabetes melitus

scholarly journals Correlation Analysis Study between Hearing Loss Occurence and Duration of Type 2 Diabetes Mellitus in Sultan Agung Islamic Hospital Semarang

Sains Medika ◽  
2015 ◽  
Vol 6 (1) ◽  
pp. 12
Author(s):  
Citta Arunika Risyudhanti ◽  
Agung Sulistyanto ◽  
Suparmi Suparmi
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Hearing Impairment ◽  
Medical Records ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Chi Square ◽  
Cross Sectional

Introduction: Hearing impairment due to cochlear damage is one complication of Type 2 Diabetes Mellitus (DM2). Objective: This study aims to determine the relationship between duration of DM2 with hearing impairment.Method: The analytic observasional study with the cross sectional design using the medical record of DM2 outpatient in internal clinic of Islamic Sultan Agung Hospital Semarang and also pure tone audiometric examination’s record in Otorynolaryngology clinic of Islamic Sultan Agung Hospital Semarang.31 medical records of DM2 patients were meeting the inclusion and exclusion criteria. The data consist of 18 medical records of patients with less than6 years duration of DM2, and 13 medical records of patients with more than 6 years duration of DM2. The pure tone audiometry was used to classified the hearing impairment. The data analysis was conducted using SPSS 20.0. The correlation between the duration of DM2 and hearing impairment was analyzed using Chi Square test. The significance relation between the duration of DM type 2 and hearing impairment was analyzed using cooficient contigency, with significance of < 0.05. Result: hearing impairment’s distribution frequency on tested ears in Sultan agung Islamic Hospital Semarang were 27 ears having SNHL type (43,5%), 19 ears having CHL (30,6%) and 16 ears were normal (25,8%), p = 0,02 (p < 0,05). Conclusion: There is a weak correlation between the DM 2 duration and the incidence of hearing impairment in Sultan Agung Islamic Hospital Semarang.

scholarly journals The Relationship Of The Level Of Family Knowledge And Efforts To Prevent Complications Of Diabetes Mellitus Tipe 2 In The Working Area Of Babakan Public Health Center District Of Cirebon

2021 ◽  
Vol 8 (1) ◽  
pp. 14-19
Author(s):  
Lukatul Khoiriyah ◽  
Ramli Effendi ◽  
Thia Oktiany
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Health Center ◽  
P Value ◽  
Chi Square ◽  
Work Area ◽  
Chi Square Test ◽  
The Relationship

The level of family knowledge is a very important factor in the actions of families of people with Diabetes Mellitus, behavior based on knowledge will be easier to carry out than those not based on knowledge. Diabetes Mellitus is a disease that requires proper and immediate treatment efforts because it can cause complications such as heart disease, kidney failure, and damage to the nervous system. One way to overcome the effects of Type 2 Diabetes Mellitus is by applying a diet. This study aims to determine the relationship between the level of family knowledge with efforts to prevent complications of type 2 diabetes mellitus in the work area of Babakan Puskesmas, Cirebon Regency. This research method uses descriptive correlational, this research uses cross section research. The population is all families with type 2 Diabetes Mellitus in the work area of Babakan Puskesmas in Cirebon Regency as many as 144 respondents and sampling using Purposive Sampling obtained 60 respondents. The instruments used were questionnaire sheets, and data analysis using chi-square test that is the significance value α = 0.1. The results of the above study indicate between the level of family knowledge and prevention of complications of type 2 diabetes mellitus in getting p-value = 0.04, because the p-value of 0.04 <0.1 then Ho is rejected and Ha is accepted which means there is a relationship between the level of family knowledge and prevention of complications of type 2 diabetes mellitus in the work area of Babakan Health Center, Cirebon Regency.

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