Sex differences in the risk of cataract associated with type 2 diabetes: a Mendelian randomization study

Type 2 diabetes (T2D) is a recognized risk factor for developing cataract. However, it is unclear if the shared genetic variance and potential genetic causal relationship between T2D and cataract are different for males and females. We evaluated sex-specific genetic correlation (rg) and putative genetic causality between the two diseases by using linkage disequilibrium score regression (LDSC) and six Mendelian randomization (MR) approaches after lever-aging large-scale population-based genome-wide association studies (GWAS) summary of T2D and cataract. Application of LDSC found a significant genetic correlation between T2D and cataract in East Asian males (rg=0.68, 95% confident interval [CI]=0.17 to 1, p-value=8.60e-3) but a non-significant genetic correlation in East Asian females (rg=0.25, CI= -0.02 to 0.52, p-value=8.38e-2). MR analyses indicated a consistently stronger (paired t-test |t|=5.87, p-value=2.04e-3) causal effect of T2D on cataract in East Asian males (liability OR=1.20 to 1.41, p-value=5.86e-27 to 6.60e-6) than in females (liability OR=1.12 to 1.21, p-value=2.02e-14 to 1.82e-2). In Europeans, the LDSC analysis suggested a close significant genetic correlation between the two diseases in males (rg=0.20, 95% confident interval [CI]=0.08 to 0.32, p-value=7.00e-4) and females (rg=0.17, CI= 0.05 to 0.29, p-value=4.90e-3); but the MR analyses provided weak evidences on a causal relationship between the two diseases in both sexes. These results presented the first evidence on sex difference of the casual relationship between cataract and T2D in East Asians, and supported a potential genetic heterogeneity of the shared genetics underlying T2D and cataract between East Asians and Europeans in both sexes.

Determination of Hemoglobin Level Among 9-Month-Old Infants Visiting Well Child Clinic

Screening for anemia is recommended among infants aged 9 to 12 months. This study was conducted to determine the prevalence of anemia among 9-month-old infants at Well Child Clinic, and associated factors with anemia. Well Child record of all visits during January to December 2018 were reviewed. Hemoglobin (Hb) was determined by complete blood count (CBC) or point-of-care Hb (POC-Hb). Anemia was found in 99 from 145 infants (68.3%). The prevalence of anemia was 33.3% and 72.8% when tested by CBC and POC-Hb, respectively. Breastfed Infants had significantly lower mean Hb than formula-fed infants. The odd ratio [95% confident interval] of having anemia among infants who were fed with infant formula were 0.37 [0.14-0.94]; P = .038 when compared to breastfed infants. There was a high proportion of anemia among 9-month-old infants in Rama-WCC and breastfeeding was associated with anemia in infants. The use of POC-Hb may overestimate the prevalence of anemia.

STUDI TINGKAT KEPATUHAN MASYARAKAT PROVINSI KEPULAUAN RIAU UNTUK MELAKSANAKAN SOCIAL/PHYSICAL DISTANCING DALAM UPAYA MENCEGAH PENYEBARAN VIRUS COVID-19

Pemerintah Indonesia sudah melakukan intervensi untuk menekan penyebaran virus Covid-19 yang semakin masif. Namun, bila setengah dari masyarakat tidak melakukan social/physical distancing maka jumlah kasus dan kematian akan terus bertambah. Propinsi Kepulauan Riau terdiri atas 7 kabupaten/kota kepulauan yang berbatasan langsung dengan negara tetangga Singapura, Malaysia dan Vietnam. Berdasarkan hal tersebut perlu dilakukan studi tentang kepatuhan masyarakat Propinsi Kepulauan Riau untuk melaksanakan social/physical distancing dalam upaya mencegah penyebaran virus Covid-19 sebagai Pintu Gerbang Negara Republik Indonesia. Jenis penelitian yang dilakukan adalah penelitian kuantitatif dengan metode survei. Instrumen dalam penelitian ini adalah kuesioner online dengan menggunakan google form. Perhitungan besar sampel dilakukan menggunakan rumus survei Lemeshow dengan jumlah populasi 970.132 jiwa sesuai dengan data jumlah usia produktif, anticipated population proportion 50% dan confident interval 95%. Besar sampel yang diperlukan adalah sebanyak 384 jiwa. Perhitungan besar sampel untuk masing-masing kabupaten/kota dihitung dengan proportional to size (PPS). Hasil penelitian menunjukkan bahwa ada 60% masyarakat yang tidak patuh dan 40% masyarakat yang patuh untuk melaksanakan social/physical distancing di Propinsi Kepulauan Riau. Responden didominasi oleh masyarakat yang tinggal di Kota Tanjungpinang (40,9%) dan Kota Batam (26,7%). Pendidikan responden paling banyak berasal dari perguruan tinggi (51,7%). Adapun akses informasi tentang covid-19 diperoleh paling banyak berasal dari media sosial (93,5%). Masih banyak masyarakat yang tidak patuh terhadap himbauan pemerintah untuk melaksanakan social/physical distancing. Dibutuhkan langkah tegas dari pemerintah khususnya pemerintah Propinsi Kepulauan Riau. Hal ini dimaknai bukan himbauan lagi tapi perintah yang harus dilaksanakan oleh segenap masyarakat Propinsi kepulauan Riau.

Hubungan Karakteristik Ibu Dengan Kejadian Stunting Baduta (7-24 Bulan) Di Karubaga

Stunting adalah perawakan pendek dengan nilai Z-score PB/U < -2SD yang terjadi akibat akumulasi masalah gizi kronis. Pada tahun 2017, stunting merupakan masalah gizi yang paling banyak ditemukan di Kabupaten Tolikara dibanding masalah gizi lainnya (underweight, wasting, overweight) dengan prevalensi stunting sebesar 41,0% yang dapat memberikan dampak buruk bagi sumber daya manusia (SMD) di masa yang akan datang. Penelitian ini bertujuan untuk mengetahui hubungan karakteristik ibu dengan kejadian stunting baduta usia 7-24 bulan. Penelitian ini menggunakan observational analytic dengan pendekatan cross sectional. Total sampel dalam penelitian ini adalah 81 ibu yang memiliki baduta usia 7-24 bulan dan merupakan peserta aktif program 1000 Hari Pertama Kehidupan (HPK). Pengambilan sampel dilakukan dengan simple random sampling. Sumber data penelitian ini adalah data sekunder yang diambil pada bulan Mei sampai Juni 2019. Data menggunakan uji chi-square dengan nilai p=0,05 dan confident interval (CI)=95%. Hasil analisis penelitian ini menunjukkan adanya hubungan yang signifikan antara kejadian stunting baduta usia 7-24 bulan dengan usia ibu (p= 0,003; CI=95%). Tidak ada hubungan antara kejadian stunting baduta usia 7-24 bulan dengan tinggi badan ibu (p=0,303; CI=95%), tingkat pendidikan ibu (p=0,203; CI=95%) dan pekerjaan ibu (p=0,961; CI=95%). Dapat disimpulkan bahwa memiliki anak di usia yang sangat muda (remaja) berhubungan erat dengan kejadian stunting baduta usia 7-24 bulan, sementara tinggi badan ibu, pendidikan dan pekerjaan ibu tidak memiliki hubungan yang signifikan dengan kejadian stunting. Kata kunci : Baduta, Stunting, Karakteristik Ibu, 1000 HPK

Knowledge and attitude towards adverse drug reactions reporting and pharmacovigilance: a survey among pharmacy, medicine and dentistry undergraduates in a public university

This research was conducted to determine the current level of knowledge and attitude on ADR reporting and pharmacovigilance system among undergraduate healthcare professional students in one of the public universities in Malaysia. An adapted and validated questionnaires was used. Volunteers were recruited using convenience sampling. The questionnaire consisted of two sections A (demographic) and B (Knowledge, Attitude, and Perception on ADR reporting and Pharmacovigilance). Data collected were analyzed using SPSS version 23. A total of 113 undergraduate healthcare professional students participated, which consist of 80% female and 20% male (n=34 dentistry; n=30 medical and n=49 pharmacy). Overall mean level of knowledge on ADR reporting and pharmacovigilance system among undergraduate healthcare professional students (mean= 3.79; SD = 0.61) was moderately knowledgeable. There was no significant mean difference between healthcare professional students except for dentistry with p-value 0.97 at 95% confident interval. The overall mean level of attitude and perception on ADR reporting and pharmacovigilance (mean = 3.90; SD = 0.44) was moderately positive. Least Significant Difference showed no significant different mean among healthcare professionals except dentistry with p-value 0.02 at 95% confident interval. All undergraduate professional students showed a moderately knowledgeable and positive attitude toward ADR reporting and pharmacovigilance system in Malaysia. This study showed a positive development among undergraduate professionals as compared to the previous study. A high knowledge and positive attitude are required to ensure Malaysia do not experience under-reporting of ADR; thus do not jeopardize Malaysian safety.

Meta-analysis reveals severe pollination limitation for the flowering plants growing in East Himalaya-Hengduan Mountains region.

Pollination limitation widely occurs and has an important effect on flowering plants. East Himalaya-Hengduan Mountains region is one of the 24 biodiversity hot spots around the world. However, no study as we known has synthetically assessed the degree of pollination limitation in this area. The present study aims to reveal the degree of pollination limitation for the flowering plants growing on East Himalaya-Hengduan mountains, and test if the reproductive features, the floral traits or the elevation are closely correlated with the degree of pollination limitation. We complied data from 76 studies, with 96 species and 108 independent data records included. We found that flowering plants in this area undergo severe pollination limitation (overall hedges’d=2.004, with the 95% confident interval [1.3264, 2.6743]), which is much higher than the flowering plants growing in many other regions around the world. The degree of pollination limitation was tested to be related to the capacity of autonomous self-reproduction and the pollination pattern (generalized vs. specialized pollinated) of plants. In addition, we found a clear relationship between elevation and the degree of pollination limitation, which indicates that plants might undergo severe pollination limitation in higher places.

P4586Bilateral internal thoracic artery grafting neutralizes detrimental effect of diabetes on survival in patients with ischemic cardiomyopathy

Background In ischemic cardiomyopathy patients requiring coronary artery bypass grafting (CABG), the association of diabetic status with outcomes after surgery as well as survival benefit with bilateral internal thoracic artery (ITA) grafting remain largely unknown. Purpose We evaluated the associations of diabetic status with postoperative LV reverse remodeling, change in renal function, and late outcome following surgical revascularization, with focus on cases with severely impaired LV function. We also attempted to determine the survival benefit of bilateral ITA grafting over single ITA grafting according to diabetic status. Methods We classified 188 patients (mean age 67±9 years) with left ventricular (LV) ejection fraction ≤40% who underwent isolated initial CABG into non-diabetic (n=64), non-insulin-dependent DM (NIDM, n=74), and insulin-dependent DM (IDM, n=50) groups. Results At baseline, there were no differences between the diabetic and non-diabetic patients in terms of age, LV function parameters and degree of coronary artery disease, while the diabetic patients were more likely to present chronic kidney disease and peripheral vascular disease. During follow-up (68±47 months), the 5-year survival rate was 84% and 65% in the non-diabetic and diabetic patients respectively (p=0.034). After adjusting for all covariates, both NIDM and IDM were independently associated with increased mortality (NIDM: adjusted hazard ratio 1.9, 95% confident interval 1.0–3.7, p=0.049; IDM: adjusted hazard ratio 2.4, 95% confident interval 1.2–4.8, p=0.016) and composite adverse events defined as mortality and/or heart failure readmission (NIDM: hazard ratio 1.7, 95% confident interval 1.0–2.8, p=0.038; IDM: hazard ratio 3.0, 95% confident interval 1.7–5.1, p<0.001). Diabetic patients showed less improvements in LV dimensions and ejection fraction (interaction effect p<0.05 for all), and steady decrease in the estimated glomerular filtration rate over time after surgery (group effect p<0.05). Among non-diabetic patients, there was no difference in survival rate between single ITA and bilateral ITA grafting (5-year: 86% vs. 80%, p=0.95), whereas among diabetic patients, survival of those who received the latter was better (57% vs. 81%, p=0.004). Multivariate analysis revealed that use of bilateral ITA was significantly associated with decreased risk of mortality (hazard ratio 0.3, 95% confident interval 0.1–0.8, p=0.024). Conclusion Non-insulin- and insulin-dependent diabetes was significantly associated with worse long-term clinical outcome after CABG for ischemic cardiomyopathy. Bilateral ITA grafting has potential to improve survival in diabetic patients with ischemic cardiomyopathy.

Faktor Risiko Kejadian Hipertensi di Rumah Sakit Umum Daerah dr. Zainoel Abidin Provinsi Aceh

Hipertensi atau tekanan darah tinggi merupakan masalah yang ditemukan pada masyarakat baik di negara maju maupun berkembang termasuk Indonesia. Tujuan dari penelitian ini adalah menganalisis factor risiko yang berhubungan dengan kejadian hipertensi di RSUD dr. Zainoel abidin Provinsi Aceh. Penelitian ini bersifat deskriptif analitik dengan menggunakan desain Cross sectional.Analisis yang digunakan adalah analisis univariat dan analisis bivariat menggunakan uji chi square dengan CI (Confident Interval) 95%. Sampel pada penelitian ini berjumlah 80 orang. Hasil bivariat diperoleh hasil ada hubungan antara kejadian hipertensi dengan umur (P value=0.003, OR=5.113), Jenis Kelamin (P value= 0.743), pekerjaan (p value = 0.341), Stress (p value= 0.274), konsumsi kopi (p value= 0.400), obesitas (p value= 0.041, OR=3.361), Riwayat keluarga (P value=0.0001, OR=6.616). Berdasarkan analisis multivariat diperoleh variabel yang paling dominan adalah variabel riwayat keluarga (p value= 0.001, OR=7.321). Berdasarkan hasil penelitian dapat disimpulkan bahwa ada hubungan signifikan antara umur, obesitas dan riwayat keluarga dengan kejadian hipertensi di RSUD dr. Zainoel Abidin Provinsi Aceh. Diharapkan kepada masyarakat aceh agar lebih menjaga kesehatan dengan cara berolahraga, menjaga pola makan dan sering melakukan pemeriksaan darah jika memiliki riwayat keturunan hipertensi.

Determinan Pernikahan Usia Muda pada Wanita Desa Gampong Pukat Kecamatan Pidie Kabupaten Pidie

Pernikahan usia muda merupakan masalah di Indonesia. Batas usia pernikahan usia sehat adalah usia 25 tahun untuk laki-laki dan 20 tahun untuk perempuan. Dalam (SDKI) 2007, dari 6.341 perempuan usia 15-19 tahun, 12,8% dari mereka sudah menikah dan dari 6.681 perempuan usia 20-24 tahun, 59% diantaranya sudah menikah. Ini merupakan penelitian kuantitatif non-eksperimental dengan pengumpulan data secara cross sectional. Analisis univariat hanya melihat distribusi frekuensi dan persentase setiap variabel. Analisis bivariat menggunakan uji chi square dengan CI (Confident Interval) 95% dan analisis multivariat menggunakan regresi logistik. dilakukan di Desa Kampong Pukat Kecamatan Pidie Kabupaten Pidie pada bulan Desember Tahun 2015, dengan populasi seluruh pasangan yang sudah menikah yaitu sebanyak 50 istri. Dan semua anggota populasi dijadikan responden. Hasil penelitian diperoleh bahwa ada hubungan pengetahuan (p-Value = 0,012, OR = 0,159), variabel pekerjaan (p-Value = 0,010, OR = 5,667), variabel dorongan orang tua (p-Value =0,035, OR = 5,333) berhubungan dengan pernikahan di usia muda. Penelitian ini menemukan bahwa ada hubungan variable pengetahuan dan pekerjaan yang termasuk faktor predisposing berhubungan bermakna dengan pernikahan usia muda dan dorongan orang tua berhubungan bermakna dengan pernikahan di usia muda. Dari analisis multivariat diperoleh hasil bahwa pengetahuan merupakan variabel yang paling dominan terhadap pernikahan usia muda setelah di control oleh variable dorongan orang tua, pekerjaan dan pendidikan.

FAKTOR RISIKO KEJADIAN HIPERTENSI DI RUMAH SAKIT UMUM DAERAH DR. ZAINOEL ABIDIN PROVINSI ACEH

ABSTRAKDi Provinsi Aceh kejadian hipertensi banyak dijumpai baik wanita maupun pria. Jumlah kejadian hipertensi di provinsi Aceh tahun 2015 sebanyak10% rawat jalan dan rawat inap 87 orang,Tahun 2017 sebanyak rawat jalan 29%, rawat inap 90 0rang dan 2 diantaranya meninggal. Tujuan dari penelitian ini adalah menganalisis factor risiko yang berhubungan dengan kejadian hipertensi di RSUD dr. Zainoel abidin Provinsi Aceh. Desain penelitian ini adalah Cross sectional dengan jumlah populasi 774 orang dan jumlah sampel 80 orang. Pengumpulan data dengan cara observasi dan wawancara dan menggunakan kuesioner. Analisis yang digunakan adalah analisis univariat dan analisis bivariat menggunakan uji chi square dengan CI (Confident Interval) 95%.. Hasil bivariat diperoleh hasil ada hubungan antara kejadian hipertensi dengan umur (P value=0.003, OR=5.113), Jenis Kelamin (p value = 0.743), pekerjaan (p value = 0.341), Stress (p value = 0.274), konsumsi kopi (p value= 0.400), obesitas (p value = 0.041, OR=3.361), Riwayat keluarga (p value =0.0001, OR=6.616). Berdasarkan analisis multivariat diperoleh variabel yang paling dominan adalah variabel riwayat keluarga (p value = 0.001, OR=7.321). Berdasarkan hasil penelitian dapat disimpulkan bahwa ada hubungan signifikan antara umur, obesitas dan riwayat keluarga dengan kejadian hipertensi di RSUD dr. Zainoel Abidin Provinsi Aceh.Kata-kata kunci : Hipertensi, faktor risiko ABSTRACTIn the Province of Aceh the incidence of hypertension is found in both women and men. The number of hypertension events in Aceh province in 2015 was 10% outpatient and 87 inpatient care, 2017 as many as 29% outpatient care, 90 inpatient hospitalizations and 2 of them died. The purpose of this study was to analyze the risk factors associated with the incidence of hypertension in RSUD dr. Zainoel abidin the Province of Aceh. The design of this study was cross sectional with a population of 774 people and a total sample of 80 people. Data collection by means of observation and interviews and using questionnaires. The analysis used was univariate analysis and bivariate analysis using the chi square test with CI (Confident Interval) 95%. Bivariate results were obtained. There was a relationship between the incidence of hypertension and age (P value = 0.003, OR = 5.113), Gender (P value = 0.743), employment (p value = 0.341), stress (p value = 0.274), coffee consumption (p value = 0.400), obesity (p value = 0.041, OR = 3,361), family history (P value = 0.0001, OR = 6.616). Based on multivariate analysis, the most dominant variable was obtained from the family history variable (p value = 0.001, OR = 7.321). Based on the results of the study it can be concluded that there is a significant relationship between age, obesity and family history with the incidence of hypertension in RSUD dr. Zainoel Abidin Aceh Province.Keyword: Hipertention, risk factor