EMERGENCY TREATMENT FOR CENTRAL RETINAL ARTERY OCCLUSION ( CRAO )

Central retinal artery occlusion (CRAO) is a blinding event but not considered as a common emergency problem. Since awareness of the case is low, patients usually come to the ophthalmologist later than the golden period and havingthe worst prognosis. We report the case of patient with a central retinal artery occlusion that had visual improvement after emergency treatment.A 47-year-old woman with no comorbidities presented with symptoms of a sudden blurred vision, no pain or redness in the right eye (RE). Best-corrected visual acuity in the RE was 1/60. A relative afferent pupillary defect was observed in the RE. Ocular fundus examination of RE was suggestive of CRAO. Emergency treatment were performed, including rebreathing of expired CO2, ocular massage and ocular chamber paracentesis. One week later, the visual acuity was improved.This case highlights that fast and accurate response in acute management of CRAO should be conducted, especially within the golden hours which is less than 6 hours after the accident, to prevent permanent visual loss of thepatient.

THE EFFECT OF AVASIN THERAPY ON COGNITIVE, EXECUTIVE, AND ATTENTION FUNCTIONS IN ADHD CHILDREN: A CASE SERIES

Attention Deficit Hyperactivity Disorder (ADHD) is a neurobehavioral disorder that most commonly occurs in children. The number of ADHD events is getting more increase. Its handling takes a long time so that the use of Complementary Alternative Medicine (CAM) is increasingly in demand. CAM is used by 60-65% of parents with ADHD children to improve symptoms and reduce side effect of conventional medication. Avasin therapy is one the complementary treatments that we used to treat ADHD children.We conducted avasin therapy to 3 children with ADHD. Before and after avasin therapy, the three children were examined by Children's Color Trail Test to access cognitive nd function, BRIEF 2 to access executive function, as well asTOVA and QEEG Brain Mapping to assess attention function.The changes in values on Children's Color Trail Test, nd BRIEF 2 , TOVA, and QEEG Brain Mapping were obtained after a series of avasin therapy.

“Halal” Abortion in Perspective Common Law system,Civil Law System and Ius Constituendum : Towards Legality and Safety

Background: To safe services in hygienic conditions must be made widely available and affordable, so that the stigma associated with providing and obtaining abortions can lessen and safe services can become normal and accepted, abortion is broadly legal, widely available and safe in Indonesia.Objective: The purpose of this article to discuss ius constituendum on abortion in Indonesia from criminal law perspective between Common Law System and Civil Law System.In Indonesia Ius Contituendum on abortion is not directed to legalization of abortion as carried out both in Netherland and USA but tends to be harmonized with therapeutic abortion concept both medical and psychiatric fields.Material and Method: Systematic review of studies evaluating the prevalence of unsafe abortion in Indonesia.Results: The public health tragedy caused by unsafe abortion is all the more so because it is largely preventable, by improving the quality and availability of post abortion care, by making abortion legal and increasing access to safe services, and—because almost every abortion is preceded by an unintended pregnancy—by expanding access to contraceptive information and services. Restrictive laws have much less impact on stopping women from ending an unwanted pregnancy than on forcing those who are determined to do so to seek out clandestine means. Ironically, the abortion laws governing of Indonesia is holdovers from the colonial era.Conclutions: “Halal” abortion is making a significant contribution toward reducing the need for abortion altogether and the likelihood of unsafe abortion by bringing down the rates of unintended pregnancy. This is also helping to reduce complications of unsafe abortion through its support for programs to increase access to and improve post abortion care. This includes not only treatment for septic or incomplete abortion, but also essential post abortion.Keywords: “Halal” abortion, the public health tragedy, unintended pregnancy Common law system,Civil law system and Ius Constituendum.

Green Nail Syndrome, A Rare Infection of Pseudomonas aeruginosa in The Nail

ObjectiveA nail infection is a common case caused by fungal infection, thus can make any bacterial correlated infection in the nail can be under-diagnosed. However, Pseudomonas aeruginosa can cause nail infection known as green nail syndrome (chromonychia). Method A 3 years old girl presented with greenish discoloration on the nail plate of the right toenail since previous a month. She came from well-educated family, but the water resource at their home was not good enough. The specimen of nail scraping was sent to the microbiology laboratory. The Gram from nail scraping didn’t show any significant result. After 24 hours, a greenish colony, non-lactose fermenter on the Mac Conkey and a dominant blue-green color colony on the blood sheep agar had grown. The colonies are beta hemolytic, flat and spreading. They were also positive to oxidase and catalase. Result The Gram result from the colony was showed as basil negative Gram. Identification from Vitex 2® concluded as Pseudomonas aeruginosa that resistant to all penicillin derivate and 2nd generation of cephalosporin. However the isolate was still sensitive to ceftazidime, carbapenems, quinolones and amino-glycosides. The treatment was decided using topical fluoroquinolone nadifloxacin, and gave a significant result in a month Conclusion Green nail syndrome that is caused by P. aeruginosa infection could be treated by topical fluoroquinolone for 1-2 months

THE RELATIONSHIP OF VITAMIN D 25(OH)D LEVELS WITH THE INCIDENCE OF HYPERTENSION ON THE ELDERLY AT PUBLIC HEALTH CLINIC

Introduction: Hypertension is a chronic disease which its presence is often not known until occurrence of other diseases. Several studies had previously investigated the relationship between vitamin D concentration and hypertension. However, no concluding result is obtained. This paper aimed to determine the relationship between vitamin D 25(OH)D concentration and hypertension onelderly at a public health clinic located at Reni Jaya, South Tangerang.Methods: This was cross-sectional study conducted in a public health clinic between January 2017 to January 2018. One hundred and fifty subjects were recruited by consecutive sampling after informed consent were obtained.Anamnesis, physical examination, and anthropometric measurement were performed by general practitioners. The following day serum vitamin D 25(OH)D examination were collected and examined at certied laboratory. The data werethen analyzed using Chi-Square test.Results : As many as 80 (53.4%) subjects had insufficient vitamin D 25(OH)D concentration (25-50 nmol/L). Stage I and II hypertension were found in 51 (34.0%) and 34 (22.7%) subjects, respectively. Age was significantly associated with hypertension (p=0.048). No significant association was observed between vitamin D 25 (OH)D and hypertension p=0.347.Conclusions: There was no significant association between serum vitamin D 25(OH)D and hypertension.

DESCRIPTION AND FACTORS RELATED OF RISK ASSESSMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN COMMUNITY SETTING

Background: Currently, Chronic Obstructive Pulmonary Disease (COPD) is one of degenerative disease with high morbidity and mortality, especially in low-income countries, including Indonesia. Increasing prevalence of COPD in Indonesia straightly correlates with increasing of tobacco smoking and air pollution level. Many studies had conducted to decrease COPD morbidity and mortality. Prevention is the best way to reduce the incidence of COPD. This study aimed to identify risk assessment of COPD in the community around Research, Teaching, and Clinical Unit (RTCU) Buaran, South Tangerang.Methods: This study was cross sectional design and involved 134 respondents (41 males and 93 females) who live around RTCU Buaran, using two stages cluster sampling. During April to June 2015, respondents were asked to fill the questionnaire that adapted from COPD Risk Screener that contains five questions.Results: The study showed that the risk assessment of COPD of community around RTCU Buaran was 5.2% at high risk and 94.8% at low risk respectively. Using Fisher's Exact Test, there was signicant correlation between the risk assessment of COPD and respondents' age, gender, the early symptoms of COPD, and tobacco smoking (p<0.05).Conclusion: This study showed the risk assessment of COPD of community around RTCU Buaran was dominantly at low risk (94.8%), it seemed due to females' respondents more dominant than males'. Factors that significantly related to risk of COPD were age, gender, the early symptoms of COPD, and tobacco smoking.

THE FOOD'S QUALITY ANALYSIS OF CANTEEN IN SYARIF HIDAYATULLAH STATE ISLAMIC UNIVERSITY JAKARTA

Background: Food is an important requi-rement supporting the human activities, including academic activities on campus. The composition and quality of nutrients, both macro, and micronutrients in a diet, plays an important role in ensuring the availability of energy sources for daily activities and long-term health. This study is a preliminary study to evaluate the nutritional value of food provided in the canteen of campus.Method: This research will use a cross-sectional design on food samples sold in the canteen of Syarif Hidayatullah State Islamic University Jakarta. The macronutrient composition analysis was calculated using a list of foodstuffscompositions.Results: Most of the packaged food menu do not meet the macronutrient composition in a manner of balanced nutrition. The dominant side dish is chicken, the fat composition is higher than the recommendation due to fried processing. The portion of rice is not standard on various packages, with an average of 1.6 servings of standard rice. The content of vegetables is minimal. A snack menu is predominantly carbohydrate foods with a moderate to high sugar content, with minimal ber content, and processed by frying.Conclusion: The nutritional quality of the food menu in the canteen has largely not yet fulfilled the recommended macronutrient composition.

COPING STRATEGIES AMONG MOTHERS OF CHILDREN WITH EATING DIFFICULTY

Background: The impact of eating difficulty in children can cause the intake of nutrients to be less, so the nutritional needs become unreachable. It is not easy for parents to face the fact that their children have eating difficulty. Coping becomes part of the adjustment. Coping is a special term used to indicate an individual's reaction when facing pressure or stress. Thus, the coping strategies of parents in dealing with children who have eating difficulty is requiredto deal with and control existing problems.Objective: The aim of this study was to explore the coping strategies of mothers who have children with eating difficulty.Methods: This research was a phenomenological qualitative research. Qualitative data collection techniques in this study was in-depth semi-structured interview techniques. Data analysis was performed by AtlasTi software. Content analysis was used to analyze raw data and identify overarching themes.Results: There four main themes and associated subthemes, were abstracted from the data, namely feeding problem manifestation (refusing to chew, throw out, prolonged mealtimes, inadequate food intake, food refusal, picky eating, closed mouth), stress full condition (angry/out of control, miserable, confused/puzzled, worried, impatient, frustrating), removed from the situation (positive thinking, ignored, acceptance, persevering, religious approaches),and action to modify situation (creative, seeking for help, looking for information, giving the nutrition supplement).Conclusion: This study may have implications for the implementation in overcoming child with eating difficulties. By understanding the mother's condition, then the treatment will be more focused and precise.

THE RELATIONSHIP OF URBAN ADOLESCENT STRESSORS TO THE ONLINE ADDICTION OF GAME ON JUNIOR HIGH SCHOOL

Background: The presence of online games has brought great impact on personal development and adolescent adaptation. Urban adolescents are more vulnerable to the complexity and stress. Chronic exposure to social and environmental stress must be related to psychological pressure which can lead adolescent becoming online game addicts. The aim of this study was to determine the correlation between urban adolescent stress and online games addiction.Methods: This is an observational study with a crosssectional study design. Urban adolescent stress was measured using Urban Hassles Index whereas online game addiction was measured using Indonesia Online Game Addiction Questionnaire. This study used chi square as the statistic test.Results: This study included 280 students as research subjects, 112 subjects (40.0%) were online game addicts. Urban adolescent stress has a significant correlation with online games addiction (p = 0.019).Conclusion: There is a correlation between urban adolescent stress and online game addictions.

DYNAMIC OF SERUM FERRITIN LEVEL IN FIRST TRIMESTER PREGNANCY

Background: Incidence of anemia in pregnant women was 37.1%, proportion was similar between urban vs rural areas (36.4% vs 37.8%). According to 2007 RISKESDAS, iron deficiency accounted for most common type of anemia in pregnancy. Iron deficiency anemia in pregnancy has a negative impact both on the mother and the fetus. Serum ferritin is a parameter for iron deficiency. Objective of this study was to overlook serum ferritin levels in trimester 1pregnancy.Methods: The design was retrospective cohort. Samples obtained from first trimester pregnant women who performed a pregnancy check up at Hasanah Graha Afiah Hospital Depok in the period of April 2016 - July 2017. Data were presented in percentages for categorical data. Numerical data presented in medians and ranges for abnormal data distribution; and mean and standard intersections for normal data distribution. This study involved 64 samples that met the inclusion and exclusion criteria.Results: Median serum ferritin levels in this study were still in the normal range of 40.82 (6.97 - 172.66) μg / L. Twenty one subjects (69.1%) had normal serum ferritin level (≥30 μg/L) and 47 (30.9%) had low ferritin level.Conclusions: Median serum ferritin in this study was within normal range. Low level of serum ferritin found in 21 subjects, three among them also suffered from anemia.