Determinants of Pre-Diabetes on Teenagers in Palangka Raya City

Background: Pre-diabetes is a stage prior to diabetes mellitus (DM) and many studies in west countries found the risk factors of diabetes were mostly related to the nutri onal status of being overweight and obese. Dia- betes mellitus is not only experienced by adults but also by teenagers. They have the poten al for pre-diabetes because they may have unhealthy lifestyles such as smoking, consuming alcohol, high-calories, and junk foods and lack of physical ac vity. This study aims to determine the risk factors of pre-diabetes among senior high school students in Palangka Raya, Central Kalimantan, Indonesia. Methods: This study was a qualita ve study using a ques onnaire as an instrument for data collec on. It consists of a set of ques ons on diabetes risk. This research conducted in four public senior high schools in Palangka Raya with the total sample was 131 respondents have par cipated in this research. Results: 25 respondents (19.1%) from a total sample of 131 par cipants suffered from pre-diabetes and 30.5% of respondents had a family with DM. Some students (6.9%) had a smoking habit and 13% incidence of pre- diabetes in high school students related to these factors (R2: 0.13). Only less than half of the total respondents (43.5%) had a normal BMI. As many as 39.7% of respondents were undernourished while the rest were over- weight. Conclusion: Pre-diabetes factors on teenagers in Palangka Raya are female dominate had a history of DM, and being overweight. This study further leads to the importance of weight control that focusing on physical ac vity and dietary management as early precau ons. Health educa on is required to suppress the number of risk fac- tors for diabetes.

The Period of Perineal Wound Healing in Postpartum Mothers Between The Decoction Water Treatments of Bihanong Leaves with Red Betel Leaves

Background: The global prevalence of the second degree of the perineal wound of postpartum mothers is 73.4%. Pharmacological treatments have a cytotoxic effect. Other treatments is non-pharmacological treatments are such as using decoc on waters of binahong leaves and red betel leaves. Both have compounds that accelerate epithelializa on of wounds. This study aims to analyze the differences of the perineal wound recovery period of postpartum mothers between the decoc on water treatments of binahong leaves compared to red betel leaves. Methods: This study is a quasi-experiment post-test only without control group design. There are 32 respon- dents mee ng the inclusion criteria who are taken by accidental sampling. The sample is divided equally into two groups, namely binahong group and the red betel group. Binahong or red betel leaf decoc on waters are used for genital washing a er urina ng at the last rinse at 7 am and 3 pm on 1-3 postpartum days. Perineal wound recovery is assessed by using the REEDA score from the second postpartum day un l the wound fully recovered. Sta s c analysis with chi-square, me series analysis, Mann Whitney and Kruskal Wallis test. Results: The average of perineal wound recovery period of binahong group is 6 days, while the red betel group is 4.69 days. There are significant differences of perineal wound recovery period between the binahong group and the red betel group with a p-value of 0.0001 < α (0.05). Respondents’ characteris cs are age, BMI, frequency of changing pads, and educa onal background between binahong and red betel groups have no significant differ- ences. Conclusion: Red betel leaf decoc on water is recommended for postpartum mothers suffering perineal wounds. Further research is needed with a larger number of respondents and true experiments are needed to analyze the effect of red betel leaves on perineal pain, platelets, and leukocyte level.

The Correlation of Age, Gender, Heredity, Smoking Habit, Obesity, and Salt Consumption with Hypertension Grade in Cirebon, Indonesia

Background: Hypertension is one of the most global killer diseases that causes death. The World Health Or- ganiza on es mated around 1.5 billion people in the world will be diagnosed with hypertension every year. The increasing incidences of hypertension in the world may be affected by several predictors including age, sex-linked, heredity, smoking habit, obesity, and salt consump on. This study has objec ve to examine those predictors to hypertension grade. Methods: This research was used observa onal analy c method with cross-sec onal study. This study involved 136 respondents who came to Kalijaga Permai Public Health Center, Cirebon City. The variables were measured by microtoise, sphygmomanometer, stethoscope, scales, and ques onnaires. Spearman correla on test and lo- gis c regression test was analyzed for this study. Results: 59.9% of respondents were in hypertension grade 1 and 54% of respondents were in high risk age. The bivariate results revealed that age, sex-linked, heredity, and salt consump on were sta s cally correlated with hypertension grade (p=0.001). However, smoking habit and obesity were not sta s cally correlated. Mul vari- ate analysis found that those who add extra salt were 3.3 mes more likely to have hypertension grade 2 and those in high risk age were 3.1 more likely to have hypertension grade 2 as well. Compared with female and those who have nega ve heredity, male and posi ve heredity were 2.7 mes more likely to have hypertension grade 2. Conclusion: Salt consump on, age, sex-linked, heredity was significantly correlated with hypertension grade. Salt consump on was a risk factors which has the highest impact. Public health center should educate people about the recommenda on of daily salt intake to prevent the excessive intake that may affect hypertension.

Critics on Policy of Soy-Based Infant Formula in Indonesia: Compared to Australian and New Zealand Food Standards

Background: World Health Organiza on (WHO) recommends breast milk as sole and the most complete infant food during the first 6 months. However, in certain circumstances, when breas eeding is not possible, not de- sired or not advised, infant formulas like those are made of soy can be given to newborns. However, the safety of long-term use soy-based formula has been argued due to the possible adverse effects of phytoestrogen, phytates and aluminum in human body as well as the consequences of agrochemicals residue. Therefore, those problems should be taken into account while developing, reviewing or amending policy of infant formulas. This ar cle re- views the adequacy of soy-based infant formula policy in Indonesia to an cipate issues in SIF consump on. Methods: Australian and New Zealand Food Standards Code was used to compared to the decree of Indonesian NADFC. The results were described narra vely and analyzed from the perspec ve of the author. Results: Accordingly, only small aspects of SIF are regulated in Indonesian policy. The use of SPI for SIF in In- donesia is not a compulsory though scien fically another source may trigger diarrhea in newborn baby. No clause related to aluminum content, zinc to copper ra o, isoflavone level, GM soy and pes cide residue found in In- donesian policy. Conclusion: Apparently, very limited provision regarding SIF has been covered by Indonesian policy. The regu- la on of SIF marketed and manufactured in Indonesia should be more specific and developed based on recent clinical and epidemiological studies. On the other hand, Indonesia needs a comprehensive system where society may par cipate in reviewing the laws.

Alcohol Consumption and Current Situation of Drinking Risk Level Among University Students in Mandalay Region

Background: In Myanmar, alcohol consump on among university students had been recognized as a major pub- lic health concern. A cross-sec onal study was done to inves gate drinking alcohol and risk level assessment using the Alcohol Use Disorder Iden fica on Test (AUDIT) and examined the reasons of alcohol uses and types of beverage preference consumed. Methods: The two universi es from three districts in Mandalay region were randomly selected, from which 976 students (stra fied by academic year and sex) were contributed in self-administered ques onnaire. Results: The mean age at first drinking alcohol among the par cipants was 16.36±0.15 years with range of 16 to 19 years. The drinking risk level assessment using the AUDIT test, nearly half of the par cipants 48.7% were abstainers and 86 (8.8%) were high risk drinkers while 28 (2.9%) had alcohol dependency. Among those, 57.8% had experiences of alcohol drinking and the favorite beverage of the university students who drink alcohol was beer. Binary logis c regression analysis indicated that gender, smoking habit and living situa on for drinking were significant predictors of alcohol consump on among university students. The results found out that living separately with parents and smoking habits were important factors for drinking alcohol with sta s cally signifi- cant at 95% confidence level. Conclusion: It provided evidence-based findings for knowing the alcohol consump on risk level among univer- sity students to prevent social depriva on and health risk behaviors. Findings from this study indicate a need for law governing, strictly prohibits the sale of alcohol directly or indirectly to those under the age of eighteen years. The alcohol interven on program can be helpful in modifying behaviors change communica on in health promo on of university students.

In Vitro Inhibitory Activity of Dayak Onion (Eleutherine bulbosa Mill.) Essential Oil Against Klebsiella pneumoniae

Background: The cases of Klebsiella pneumoniae infec on in West Java province is s ll high. Klebsiella pneu- moniae bacterium can produce the Extended Spectrum Beta Lactamase enzyme leading to an bio cs resistant, so it is important to look for natural and inexpensive an bio c alterna ves; one of which is Dayak onion plant (Eleutherine bulbosa Mill). The content found in Dayak onion is believed to inhibit the growth of Klebsiella pneu- moniae bacteria. This study aims to determine the effec veness of Dayak onion essen al oil on the growth of Klebsiella pneumoniae bacteria. Methods: This study was an experimental study with a post-test control group design using the culture of Kleb- siella pneumoniae on the media Muller Hinton Agar in 7 groups. Groups 1 to 5 (K1 to K5) were given sequen ally Dayak Onion essen al oil solu on in 10% DMSO solvent with concentra ons of 50%, 25%, 12.5%, 6.25%, and 3.125%. Group 6 (K6) was posi ve control (+) with 5 μg Levofloxacin, and Group 7 (K7) was Nega ve (-) with 10% DMSO. The treatment results were measured by the diameter of the host zone and the collected data were analyzed using One-way ANOVA with appropriate Post hoc analysis. Results: The results showed that that there are differences in each group to inhibit the growth of bacteria (p <0.005). K1 are higher than K2, K3, K4, K5, and K7 with increasing concentra ons showed greater inhibi on. Levofloxacin (K6) showed the highest inhibitory power. Conclusion: The results showed that that there are differences in each group to inhibit the growth of bacteria (p <0.005). K1 are higher than K2, K3, K4, K5, and K7 with increasing concentra ons showed greater inhibi on. Levofloxacin (K6) showed the highest inhibitory power.

Storage Stability of High Fiber Snack Bar

Background: Recently, there has been considerable interest in increasing the dietary fiber content in food products because of inadequate dietary fiber consump on when considering the daily recommended intake. To in- crease dietary fiber intake, dietary fiber for fied foods are recommended. This study aimed to develop a high fiber snack bar (HFSB) using a combina on of Jerusalem ar choke powder (JAP) and low-fat desiccated coconut (LFDC) as sources of dietary fiber. Methods: The changes in physicochemical and microbiological proper es, and sensory acceptability were mea- sured during storage at 35 oC and 45 oC for 12 weeks. Therefore, the shelf-life of the products was calculated by Q10 test. Results: The HFSB had a higher L* value (lightness) than control (C) due to the addi on of LFDC. Total dietary fiber of the HFSB was approximately 3.7 mes higher than that of the C formula. The L*, a*, and b* values of both C and HFSB were sta s cally significant different (p<0.05) a er storage. The total color different ( E) values of the HFSB were higher than those of the C formula due to inulin from JAP, which par cipated in the Maillard reac on. During storage, the moisture content (MC) and water ac vity (aw) of the HFSB remained more stable compared to those of the C due to the water-holding capacity of the fiber used. The aw of the C and HFSB during storage were in the range of 0.57to 0.60 and 0.53 to 0.57, respec vely. Those ranges should be stable against microbial growth. Higher storage temperature would increase the TBARS values and decrease the pH (p<0.05) of the C and HFSB due to deteriora on. In terms of shelf-life calcula on, the C and HFSB snack bar could be kept in metalized polyester at 30 oC for 11 weeks. Conclusion: The JAP and LFDC exhibited great poten al for use as fiber ingredients. Although the JAP and LFDC influenced the physicochemical proper es and sensory acceptability, the shelf-life of both C and HFSB was com- parable. Therefore, further studies should be conducted to extend the shelf-life of the formulated snack bar.

Knowledge, Attitudes, and HIV/AIDS Risk Behaviors of Myanmar Migrant Workers in Thailand

Background: HIV/AIDS is s ll a problem in the health care system of developing countries. Migrant workers are considered a vulnerable popula on for HIV infec on. The current informa on on HIV/AIDS and migrant workers is useful to provide suitable effec ve health interven ons for the preven on of HIV/AIDS. This study aims to describe knowledge, a tudes and HIV/AIDS risk behaviors among Myanmar male migrant workers in Thailand. Methods: A cross-sec onal study was conducted in Myanmar male migrant workers aged 18-60 years collected from February to May 2018. A total of 400 migrant workers who live in Patumthani provinces were selected by a convenience sampling method. Descrip ve sta s cs were used to explore knowledge, a tudes and HIV/AIDS risk behaviors of par cipants. Results: The mean age of the par cipants was 33 years, ages ranged from 18 to 60 years old, achieved pri- mary school (40.40%), and married (54.30%). An average living in Thailand was 3.25 years and monthly income was 9,166 baht (∼286 USD), respec vely. A majority of par cipants had a poor level of HIV/AIDS knowledge (55.25%) and a fair level of an a tude about HIV/AIDS disease and preven on (61.25%). Risk behaviors related to HIV/AIDS of par cipants who had sex with non-partners were 40.58%. Conclusion: Most par cipants had poor knowledge and a fair a tude of HIV/AIDS. Risk behaviors related to HIV/AIDS of the par cipants were rela vely high. Moreover, most of par cipants had less access to health care services. This results confirmed that an urgent need to provide health interven on to increase knowledge on HIV/AIDS of Myanmar migrant workers in Thailand.

Effect of Red Fruit Oil Soap (Pandanus Conoideus Lam.) as Wound Cleansing on Wound Healing and the Number of Bacterial Colonies among Grade II Diabetic Ulcer Patients at Griya Wound Care Clinic Kudus, Indonesia

Background: Diabetic ulcer is an open wound on the skin layer to the dermis due to hyperglycemia and neuropathy. This condition often causes infection and becomes an inhibitor in the wound healing process. Red fruit oil soap can be used as an alternative cleansing to reduce the number of bacterial colonies and accelerate the wound healing process.Aims: This present study aimed to observe the effect of red fruit oil soap in the cleansing process to reduce the number of bacterial colonies and the wound healing process in grade II Diabetic ulcer patientsMethods: This is a quasi-experimental study with the pre-test post-test non-equivalent control group design. Wound cleansing in the intervention group used 0.9% NaCl solution and red fruit oil soap with a pH of 5.74, while the wound cleansing in the control group used 0.9% NaCl solution. Bacterial colonies were assessed and the type of bacteria was observed by the swab method. The wound healing was assessed with Bates-Jensen Wound Assessment Tool (BWAT) instrument for 14 days with observations every 3 days. Analysis test used Mann Whitney and Repeated Measure ANOVA.Results: There was no difference in the mean of the number of bacterial colonies between the wounds that were cleansed with 0.9% NaCl solution and red fruit oil soap and the wounds which were cleansed by using 0.9% NaCl solution (p> 0.05). The mean of the number of colonies in the intervention group until the 14th day reduced by 3.14x106 and in the control group was reduced h 1.40x106. There was a significant decrease in the wound healing scores in each group, in each assessment for 14 days.Conclusion: This study found that the wound cleansing using red fruit oil soap and 0.9% NaCl solution could reduce the number of bacterial colonies on the wound surface and accelerate the wound healing process among patients with grade II diabetic ulcer.