scholarly journals Karakteristik Bayi Baru Lahir dari Ibu Terkait COVID-19 di RSUP Dr. Kariadi Semarang

2020 ◽  
Vol 7 (1A) ◽  
pp. 166-170
Author(s):  
Adhie Nur Radityo ◽  
Arsita Eka Rini ◽  
Moh Syarofil Anam ◽  
Gatot Irawan Sarosa

Latar belakang Kejadian kasus COVID-19 pada bayi belum banyak dilaporkan dan mekanisme penularan terhadap bayi baru lahir masih belum jelas. Tujuan Melaporkan perbedaan karakteristik bayi baru lahir dari ibu terkait COVID-19 di RSUP Dr. Kariadi Semarang Metode Penelitian retrospektif dengan data sekunder catatan medik bayi baru lahir dari ibu terkait COVID-19 di RSUP dr Kariadi Semarang pada periode April-Mei 2020 dengan kelompok pembanding bayi baru lahir dari ibu tidak terkait COVID-19. Kriteria inklusi semua bayi lahir dari ibu terkait COVID-19 dirawat di rumah sakit dan dilakukan pemeriksaan PCR dengan spesimen swab nasofaring. Data yang dikumpulkan adalah usia kehamilan, jenis kelamin, berat lahir, cara persalinan, usia ibu dan jenis minum yang diberikan pada bayi. Dilakukan uji beda menggunakan uji chi square dan shapiro wilk. Analisis data menggunakan program komputer SPSS. Hasil Dari 46 sampel penelitian terdiri dari 23 bayi lahir dari ibu terkait COVID-19 dan 23 bayi lahir dari ibu tidak terkait COVID-19 dilakukan analisis dengan hasil tidak terdapat perbedaan bermakna dari usia kehamilan, berat lahir, cara persalinan dan usia ibu. Pada kelompok bayi lahir terkait COVID-19 mayoritas lahir dengan jenis kelamin perempuan (74%) dan jenis minum yang diberikan sekitar 86% dengan susu formula. Tidak ada bayi yang mendapat ASI eksklusif pada bayi yang lahir dari ibu terkait COVID-19. Semua bayi yang lahir dari ibu terkait COVID-19 didapatkan hasil swab nasofaring negatif dan tidak menunjukkan gejala apapun sampai dengan pulang. Simpulan Tidak didapatkan perbedaan karakteristik usia kehamilan, berat lahir, cara persalinan dan usia ibu. Terdapat perbedaan karakteristik jenis kelamin dan jenis minum yang diberikan pada kedua kelompok penelitian. Keyword: bayi baru lahir, COVID-19   Background The incidence of COVID-19 cases in newborn has not been widely reported and the mechanism of transmission to the newborn is unclear. Objective To report the characteristics of newborns from mothers related to COVID-19 at Kariadi Hospital Semarang. Method Retrospective study with secondary data on medical records of newborns from mothers related to COVID-19 at Kariadi Hospital in the April-May 2020 period with a comparison group of newborns from mothers not related to COVID-19. Criteria for inclusion of all infants born to mothers associated with COVID-19 were hospitalized and PCR examination carried out with nasopharyngeal swab specimens. Data collected were gestational age, sex, birth weight, mode of delivery, maternal age and type of dietary given to the baby. Analysis tests were performed using chi square test and Shapiro Wilk. Data analysis using SPSS computer programs Result Of the 46 study samples consisting of 23 babies born to mothers related to COVID-19 and 23 babies born to mothers not related to COVID-19 were analyzed with the results that there were no significant differences in gestational age, birth weight, mode of delivery and maternal age. In the group of babies born with COVID-19 the majority were born with a female sex (74%) and the type of dietary given was around 86% with formula milk. No baby gets exclusive breastfeeding for babies born to mothers related to COVID-19. All babies born to mothers related to COVID-19 obtained negative nasopharyngeal swab results and did not show any symptoms until discharge. Conclusion There were no differences in the characteristics of gestational age, birth weight, mode of delivery and maternal age. There were differences in the characteristics of the sexes and types of dietary given in the two study groups. Keyword: newborn, COVID-19

Author(s):  
Maria Septiana Maria Septiana

Komplikasi yang menjadi penyebab kematian bayi baru lahir yang terbanyak yaitu asfiksia. penyebab terjadinya asfiksia ada 3 yaitu, faktor ibu (preeklamsi dan eklamsia, perdarahan abnormal yang disebabkan karena plasenta previa atau solusio plasenta, partus lama, demam selama persalinan, infeksi berat, kehamilan post matur, usia ibu kurang dari 20 tahun atau lebih dari 35 tahun), faktor bayi (bayi prematur, persalinan sulit, kelainan konginetal, air ketuban bercampur mekonium), faktor tali pusat (lilitan tali pusat, tali pusat pendek, simpul tali pusat dan prolapsus tali pusat) Metode penelitian : Pengambilan data dalam penelitian ini menggunakan data sekunder dengan pendekatan retrospektif. Hasil Penelitian : Faktor penyebab kejadian asfiksia pada bayi baru lahir berdasarkan faktor ibu yaitu mayoritas terjadi pada usia ibu 20-35 tahun sebanyak 16 (51,6%), , paritas10 (32,3%), umur kehamilan 18 (58,1%) dan berdasarkan faktor dari bayi yaitu mayoritas terjadi pada berat lahir bayi >2500 gram sebanyak 12 (38,7%), dan jenis persalinan yang mengalami asfiksia pada persalinan normal sebanyak 10 (32,3%). Kesimpulan : Faktor penyebab kejadian asfiksia pada bayi baru lahir di RS Fadhilah Kota Prabumulih yaitu dari faktor ibu yaitu mayoritas terjadi pada usia ibu 20-35 tahun, paritas multipara, umur kehamilan 37-42 minggu dan dari faktor bayi yaitu bayi dengan berat lahir >2500 gram dan jenis persalinan normal.     ABSTRACT Asphyxia is one of the complications that become the largest cause of death. Therevare three cause of asphyxia, namely, maternal factors (preeclampsia and eclampsia, abnormal bleeding caused by placenta previa or placental abruption, prolonged labor, fever during labor, severe infections, pregnancy post mature, maternal age less than 20 years old or over 35 years ), factor infants (premature babies, difficult delivery, konginetal disorders, meconium-stained amniotic fluid mixes), factor umbilical cord (umbilical cord loops, short umbilical cord, knot the cord and umbilical cord prolapse). Athere are 31 cose of asphyxia in Fadhilah Hospital. Objective : Knowing the factors that cause asphyxia in newborns at RS Fadhilah Prabumulih City. Methods : Collecting data in this study using secondary data with retrospective approach Result: Factors that cause asphyxia in newborns by maternal factors that occur in the majority of maternal age 20-35 years as many as 16 (51.6%), parity 10 (32.3%), gestational age 18 (58.1%) and by factors of which the majority occur in infants birth weight> 2500 g were 12 (38.7%), and the type of delivery that asphyxiated the normal labor as much as 10 (32.3%). Conclusion : Factors that cause asphyxia in newborns at PKU Muhammadiyah Hospital in Bantul 2016 ie from the maternal factors that occur in the majority of maternal age 20-35 years, multiparas parity, gestational age of 37-42 weeks and infant factors that infants with birth weight> 2500 gram and type of normal deliveries.


2017 ◽  
Vol 38 (3-4) ◽  
pp. 68
Author(s):  
Suartawan Suartawan ◽  
Hamid HA

The rate of morbidity due to infection including nosocomial infection during neonatal period is higher than that due to other causes. The purpose of this study was to know the incidence and risk factors of nosocomial infection. This study was conducted on all babies treated at the neonatal unit, Sanglah General Hospital, Denpasar during the period of April-June 1995. Chi square test was used to compare nosocomial infection between birth weight groups and mode of deliveries. The incidence of nosocomial infections in this study was 6%, with male to female ratio of 1.6:1. Skin infections were found most frequently. This occurrence of nosocomial infection was significantly related to the birth weight and mode of delivery, in which the risk of nosocomial infection was greater in babies with low birth weight and delivered by cesarean section or other obstetric procedures.


2018 ◽  
Vol 25 (2) ◽  
pp. 86-92
Author(s):  
Wayterlis Apriani ◽  
Awal Isgiyanto ◽  
Yuliana Yuliana

Asphyxia can lead to complications in babies born including death in newborns. This study aimed to determine the relationship between maternal age and gestational age with the incidence of Neonatal Asphyxia in Kaur Hospital. This type of research was Analytical Survey with Case Control design. The population in this study were all mothers and babies born in 2016 as many as 270 people and who experienced asphyxia as many as 68 people. Data collection in this study used secondary data. Data analysis used Chi-Square, Contingency Coefficient and OR analysis. The results showed that there were 68 people (50%) asphyxia with 79 people (58.1%) aged 20-35 years, (3) 84 people (61.8%) mature, there was a significant relationship between the age of mothers with asphyxia in Kaur Hospital was in a close relationship category, and there was a significant relationship between the gestational age of asphyxial mothers in  Kaur  Hospital with the moderate relationship category. It was expected that health workers, especially midwives, can approach every pregnant woman and provide counseling about the importance of regulating maternal age and gestational age before                  the process of pregnancy and childbirth so as to reduce the risk of asphyxia. Keywords: asphyxia, maternal age, gestational age


2020 ◽  
Vol 1 ◽  
pp. 78-81
Author(s):  
Yuni Arisandi ◽  
Sodikin Sodikin

Hyperbilirubinemia is a problem that often occurs in newborns characterized by icterus, yellowish pigmentation of the skin, sclera, and nails. Many factors cause hyperbilirubinemia in infants such as the type of labor, birth weight, gestational age, gender, and asphyxia.This research aimed to discover the factors associated with the occurrence of hyperbilirubinemia in infants.This was a quantitative research with a retrospective cohort design. There were 83 respondents as the research sample taken using a random sampling technique. The research data were analyzed using the chi-square test and multivariate logistic regression. The majority of respondents underwent labor with actions (59 respondents / 71.1%), delivered male babies (51 respondents / 61.4%), delivered babies with normal birth weight (56 respondents / 67.5%), had a full-term pregnancy (54 respondents / 65.1%), and did not experience asphyxia (65 respondents / 78.3%). In addition, most respondents gave birth to babies with hyperbilirubinemia (43 respondents / 51.8%). Chi-square test results indicated a correlation between the type of labor (p = 0.008), birth weight (p = 0.019), gestational age (p = 0.000), and asphyxia (p = 0.013) with the incidence of hyperbilirubinemia. While the variable of gender (p = 0.106) had no correlation. The most influential factor was gestational age (p = 0.027) with an odds ratio of 4.011. In conclusion: The types of labor, birth weight, gestational age, and asphyxia have a correlation with the occurrence of hyperbilirubinemia.


2021 ◽  
Vol 5 (1) ◽  
pp. 139-145
Author(s):  
Mika Oktarina ◽  
Tria Nopi Herdiani ◽  
Ida Rahmawati ◽  
Ratna Susanti

Preeclampsia and eclampsia is a complication in the labor process whose incidence is always high. The purpose of this study was to study the relationship between Birth Weight and the incidence of preeclampsia in RSUD dr. M. Yunus, Bengkulu city in 2017. The type of research used in this study is Survey Analytic using the Cross Sectional method. The population in this study was overall in the hospital of Dr. M. Yunus City of Bengkulu in January to December in 2017 which is 362 babies. The sampling technique in this study was 78 proportional sampling. The data used is secondary data obtained from the patient register at Dr. M Yunus Hospital in Bengkulu. Data were analyzed using univariate and bivariate analysis with Chi-Square test (2) and Contingency Coefficient (C) test. The results obtained: Of the 78 newborns sampled there were 60 infants (76.9%) normal birth weight, 55 people (70.5%) did not experience preeclampsia, there was a significant relationship between preeclampsia and low infant weight in RSUD dr. M. Yunus Bengkulu in the tight category. It is expected that health workers can maintain and improve the quality of their abilities and skills to deal with babies with low birth weight born by preeclampsia patients or other patients.


2016 ◽  
Vol 12 (1) ◽  
pp. 33
Author(s):  
Novia Fajarwati ◽  
Pudji Andayani ◽  
Lena Rosida

Abstract:Neonatal asphyxia is a condition where the baby can not breathe spontaneously and regularly soon after birth or shortly after birth. Birth weight is a part of the factors that can cause neonatal asphyxia. Research conducted retrospective observational analytic approach to determine the relationship between birth weight and neonatal asphyxia which uses secondary data from medical records of patients. The study was conducted in August-October 2015 in the NICU and medical record room of RSUD Ulin Banjarmasin. The sampling technique used purposive sampling and obtained a sample of 334 cases. The statistical test used is chi-square test with 95% confidence level. The results showed that of 334 cases of birth weight data showed 17.4% risk birth weight and no-risk birth weight by 82,6%. Neonatal asphyxia 26.3% and 73.7% of no-neonatal asphyxia. Based on the statistical test showed p = 0.674 so that it can be concluded that there is no significant correlation between birth weight and neonatal asphyxia in RSUD Ulin Banjarmasin period June 2014-June 2015.Keywords: neonatal asphyxia, birth weight, risk factor Abstrak: Asfiksia neonatorum adalah suatu keadaan dimana bayi tidak dapat bernapas secara spontan dan teratur segera setelah lahir atau beberapa saat setelah lahir. Berat badan lahir merupakan bagian dari faktor neonatus yang dapat menyebabkan asfiksia neonatorum. Penelitian dilakukan secara observasional analitik dengan pendekatan retrospektif untuk mengetahui hubungan antara berat badan lahir dan kejadian asfiksia neonatorum yang menggunakan data sekunder dari rekam medis pasien. Penelitian dilakukan pada bulan Agustus-Oktober 2015  di ruang NICU dan ruang rekam medis RSUD Ulin Banjarmasin. Teknik pengambilan sampel menggunakan metode purposive sampling dan didapatkan sampel sebanyak 334 kasus. Uji statistik yang digunakan yaitu  uji chi-square dengan tingkat kepercayaan 95%. Hasil penelitian menunjukkan bahwa dari 334 kasus diperoleh data berat badan lahir berisiko sebesar 17,4% dan berat badan lahir tidak berisiko sebesar 82,6%. Kejadian asfiksia neonatorum sebesar 26,3% dan tidak asfiksia neonatorum sebesar 73,7%.  Berdasarkan hasil uji statistik didapatkan hasil p = 0,674 sehingga dapat disimpulkan bahwa tidak terdapat hubungan yang bermakna antara berat badan lahir dan kejadian asfiksia neonatorum di RSUD Ulin Banjarmasin periode Juni 2014-Juni 2015. Kata-kata kunci: asfiksia neonatorum, berat badan lahir, faktor risiko


2020 ◽  
Vol 8 (3) ◽  
Author(s):  
Wedi Iskandar ◽  
Yeni Andayani ◽  
Lia Marlia ◽  
Burhan Burhan ◽  
Aris Primadi

Prematurity and low birth weight are some of the causes of neonatal death and significant health problem. This study aimed to determine the influence of gestational age and birth weight on neonatal mortality at the Al Islam Hospital Bandung in 2015–2019. It was a case-control retrospective observational analysis using medical records of the Al Islam Bandung Hospital from January 1, 2015, to December 31, 2019. The inclusion criteria for infants were born alive. Exclusion criteria had severe congenital abnormalities and gestational age <26 weeks. The chi-square test evaluated the univariate comparison test of risk factors between 2 groups. Multiple logistic regression to assess neonatal mortality's predictive factors and the percentage contribution of the influence was calculated (Nagelkerke’s R2 analysis). The number of infants enrolled in 2015–2019 was 6,791 neonates, and who died was 56 neonates (0.82%). In premature infants and low birth weight there was a very significant relationship with neonatal mortality, respectively p=0.000 (p<0.05) OR=30.397 (CI=16.506–55.976), and p=0.000 (p<0.05) OR=41.206 (CI=18.611–91.233). In the multiple logistic regression test, p=0.000 (p<0.05), with a Nagelkerke’s R2 value of 0.344 or 34.4%. This presence that gestational age and birth weight significantly affects neonatal mortality, either partially or simultaneously. The percentage contribution of the influence of gestational age and birth weight to neonatal mortality was 34.4%. PENGARUH USIA GESTASI DAN BERAT BADAN LAHIR TERHADAP KEMATIAN NEONATUSPrematuritas dan berat badan lahir rendah merupakan beberapa penyebab kematian neonatus dan masalah kesehatan yang signifikan. Penelitian ini bertujuan mengetahui pengaruh usia gestasi dan berat badan lahir terhadap kematian neonatus di RS Al Islam Bandung tahun 2015–2019. Penelitian ini merupakan penelitian observasional retrospektif kasus kontrol menggunakan data rekam medis RS Al Islam Bandung periode 1 Januari 2015 hingga 31 Desember 2019. Kriteria inklusi bayi lahir hidup. Kriteria eksklusi bayi dengan kelainan kongenital berat dan usia gestasi <26 minggu. Uji chi-square mengevaluasi perbandingan univariat faktor risiko antara 2 grup. Regresi logistik multipel untuk mengevaluasi faktor prediktif kematian neonatus dan persentase kontribusi pengaruh dihitung (Analisis R2 Nagelkerke). Jumlah bayi yang dirawat tahun 2015–2019 sebanyak 6.791 dan yang meninggal sebanyak 56 (0,82%). Pada bayi lahir prematur dan berat badan lahir rendah terdapat hubungan sangat bermakna terhadap kematian neonatus, berturut-turut p=0,000 (p<0,05) OR=30,397 (CI=16,506–55,976) dan p=0,000 (p<0,05) OR=41,206 (CI=18,611–91,233). Pada uji regresi logistik multipel, p=0,000 (p<0,05) dengan nilai R2 Nagelkerke sebesar 0,344 atau 34,4%. Usia gestasi dan berat badan lahir berpengaruh bermakna terhadap kematian neonatus, baik secara parsial maupun simultan. Persentase sumbangan pengaruh usia gestasi dan berat badan lahir terhadap kematian neonatus sebesar 34,4%.


2018 ◽  
Vol 11 (1) ◽  
pp. 053-061
Author(s):  
Fitriyani Fitriyani

Every year the incidence of premature rupture of membranes ranges from 5-10% of all preterm preterm births and membranes occurring in 1% of all pregnancies.70% of cases of premature rupture of membranes occur in early pregnancy, prematurerupture of membranes is the cause of preterm birth as much as 30% (Manuaba, 2010). Atthe Derah Kepahiang General Hospital, the incidence of premature rupture of membranesis 219 cases in 2016.This research is analytical descriptive research with case controldesign. The sample in this study amounted to 138 people divided into two groups of 69cases and 69 controls. Statistical test using chi square test and binary logisticregression.Results of the study of 69 people with premature rupture of membranes atmaternal age <20 and> 35 years (46.4%), primiparity and grandemultipara parity(62.3%), fetal abnormalities (33.3%), gestational age aterm ( 63.8%) and those with ahistory of premature rupture (18.8%) in Kepahiang Hospital by 2016. Maternal age (pvalue0.013 OR = 2.646), parity (p-value 0.0,0 OR OR = 3.111) (p-value 0,0017 OR =2,950), gestational age (p-value 0,386) and history of premature rupture (p-value 0,167)at Kepahiang Hospital 2016. The most dominant factor causing premature rupture ofmembranes in RSUD Kepahiang year 2016 is parity (Exp (B) 2,806).It is expected thatthe hospital can use the research as input to suppress the incidence of premature ruptureof membranes, by counseling to explain the risk factors of premature rupture ofmembranes, especially maternal age, parity and fetal abnormalities.


2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Rizka Amelia ◽  
Ariadi Ariadi ◽  
Syaiful Azmi

AbstrakPreeklampsia dan eklampsia tidak hanya berdampak bagi ibu, tetapi juga terhadap janin yang dikandungnya, seperti hambatan pertumbuhan janin intrauterin yang dapat dilihat dari berat lahir bayi tersebut. Ibu dengan preeklampsia berat/ eklampsia early onset cenderung melahirkan bayi dengan berat lahir Kecil untuk Masa Kehamilan (KMK), sementara yang  late onset cenderung melahirkan bayi dengan berat lahir Sesuai untuk Masa Kehamilan (SMK) atau bahkan Besar untuk Masa Kehamilan (BMK). Tujuannya penelitian ini adalah menentukan perbedaan berat lahir bayi pasien preeklampsia berat/ eklampsia early dan late onset. Penelitian ini dilaksanakan dari Oktober 2012 sampai Juli 2013 di bagian Rekam Medik RSUP Dr. M. Djamil Padang. Jenis penelitian yang digunakan adalah observasional analitik dengan desain cross sectional. Hasil penelitian menunjukkan bahwa angka kejadian preeklampsia berat/ eklampsia early onset adalah 26,1% dan yang late onset sebanyak 73,9%. Bayi KMK lebih banyak dilahirkan oleh ibu preeklampsia berat/ eklampsia early onset (16,67%) dibandingkan dengan yang  late onset (7,35%). Setelah dilakukan analisis melalui uji chi-square, disimpulkan bahwa tidak ada perbedaan berat lahir bayi antara pasien preeklampsia berat/eklampsia early dan late onset secara signifikan (p>0,05).Kata kunci: preeklampsia berat/eklampsia early onset, preeklampsia berat/eklampsia late onset, berat lahir bayi AbstractPreeclampsia and eclampsia are not only effect to mother, but also influent to the fetus, such as intrauterine fetal growth retardation  which can be seen as baby's birth weight. Mothers with early onset severe preeclampsia / eclampsia tend to give birth small for gestational age  babies, while the late onset tend to give birth normal birth weight or large for gestational age babies. The objective of this study was to determine the differentiation between baby's birth weight of early and late onset severe preeclampsia/ eclampsia. The research was conducted from October 2012 to July 2013 at the medical records department of general hospital center Dr. M. Djamil Padang. The type of this research was observational analytic with cross sectional design. The results showed that the incidence of early onset severe preeclampsia/ eclampsia was 26.1% and late onset was 73.9%. Small for gestational age babies born from mothers with early onset severe preeclampsia/ eclampsia (16.67%) is more than the late onset (7.35%). After analyzed by chi square test, it was concluded that there was no differentiation between baby's birth weight of early and late onset severe preeclampsia/ eclampsia significantly (p> 0,05).Keywords: early onset severe preeclampsia/eclampsia, late onset severe preeclampsia/eclampsia, baby’s birth weight


2021 ◽  
Vol 3 (1) ◽  
pp. 42-50
Author(s):  
Asfarina Puspanagara ◽  
Yulia Nur Khayati

Low Birth Weight (LBW) is the first cause of infant mortality in West Java. Babies born with LBW need to get serious treatment, because in these conditions babies are easily distracted. Factors that influence the occurrence of LBW are age, nutritional status, pregnancy distance and maternal parity (Manuba, 2010). The purpose of this study was to determine the relationship between maternal nutritional status and the incidence of low birth weight (LBW). This study used a descriptive analytic using a cross sectional approach. The research was conducted in August 2020 - December 2020 at RSIA dr. Djoko Pramono. The sample of this study were all deliveries at RSIA dr. Djoko Pramono from August-16 October 2020, totaling 182. Data collection techniques with secondary data were arranged using a master table. The results of the study were analyzed bivariately using the chi Square test. Based on the results of statistical analysis with chi square, it was found that there was a significant relationship between nutritional status and the incidence of LBW, with a p value of 0.000 (<0.05), OR = 16.684. Women because they will conceive and give birth and so that there is no further deficiency of pregnancy status, so as to reduce the level of morbidity and mortality of infants. Abstrak Bayi dengan Berat Badan Lahir Rendah (BBLR) merupakan penyebab pertama kematian bayi di Jawa Barat. Bayi yang lahir dengan BBLR perlu mendapatkan penanganan yang serius, karena pada kondisi tersebut bayi mudah sekali mengalami gangguan. Faktor yang mempengaruhi terjadinya BBLR yaitu umur, status gizi, jarak kehamilan dan paritas ibu (Manuba, 2010). Tujuan penelitian ini untuk mengetahuiubungan status gizi ibu dengan kejadian Berat Badan Lahir Rendah (BBLR). Penelitian ini menggunakan desain diskriptif analitik dengan menggunakan pendekatan cross sectional. Populasi Penelitian ini adalah ibu bersalin pada Agustus 2020 – Desember 2020 di RSIA dr. Djoko Pramono. Sampel penelitian ini adalah seluruh ibu bersalin di RSIA dr. Djoko Pramono dari bulan Agustus-16 Oktober 2020 yang berjumlah 182. Teknik pengumpulan data dengan data sekunder yang disusun menggunakan master table dan dianalisis menggunakan chi square. Hasil Penelitian terdapat hubungan yang signifikan antara status gizi dengan kejadian BBLR, dengan hasil p value 0.000 (< 0,05) OR = 16,684.  Saran bagi pasien yaitu diharapkan untuk pasien agar lebih maksimal memperhatikan asupan makanan (status gizi) terutama .


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