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Abstract : Chronic kidney disease (CKD) is a serious health problem in children with increasing prevalence and mortality rate. One of the most common complications in CKD is anaemia. When the kidneys fail to function, erythropoietin (EPO) production decreases significantly and reduces red blood cells production in the bone marrow. There have been no studies looking for a link between severe CKD and iron deficiency anaemia in Indonesia. This study assessed the relationship between severe stage CKD and the prevalence of iron deficiency anaemia in children. This research was an observational analytic study with a cross-sectional design involving thirty children at progressed stage of CKD. Research was carried out at Haji Adam Malik hospital, Medan, Indonesia from January to March 2022. Iron status examination was carried out. The relationship between severe CKD and iron deficiency anaemia was analysed using Kruskal Wallis test. There were four (4/10, 40%) children with iron deficiency anaemia at stage 3A. Two (2/4, 50%) children at stage 3B had iron deficiency anaemia. One third of children at stage 4 had iron deficiency anaemia (1/3, 33.3%). Eight (8/13, 61.5%) children at stage 5 had iron deficiency anaemia. Kruskal Wallis analysis test did not show any relationship between CKD stage and iron deficiency anaemia (p = 0.711). Iron deficiency anaemia was more common in progressed stages of CKD, where stage 5 had the highest incidence of iron deficiency anaemia. However, this study showed no significant relationship between severe CKD and iron deficiency anaemia.

Abstract : Inulinase is an enzyme that converts inulin to fructose. This enzyme can be isolated from the endophytic mold of red dahlia tubers (Dahlia sp.L). The most critical steps to producing large-scale inulinase enzymes are to separate endophytic molds, then identify the type of mold and assess the best activity of the inulinase enzyme based on temperature and PH. The method is to isolate endophytic molds, make crude enzymes with Potato Dextrose Broth (PDB) media and fermentation culture, test the optimum PH of the inulinase enzyme, and conduct molecular identification of endophytic molds with ITS1 and ITS4 primers. The results obtained were the isolation of the red dahlia tuber mold, and five isolates were obtained, namely UD 1, UD 2, UD 3, UD 4, and UD 5. The results of qualitative inulinase screening by measuring the clear zone were UD 1:>2 (+ ++), UD 2:>2 (+++), UD 3: <1-2 (++), UD 4: < 1 (+), and UD 5: <1-2 (++). The result of the highest inulinase measurement at UD2 based on variations in temperature and PH was at a temperature variation of 350C and PH 6.0 was 1.322222222, and the lowest was at a temperature variation of 50 and PH 4.0 was 0.282716049. The result of identifying molecular based on BLAST analysis found Fusarium sp species, thus adding a new variant of the inulinase enzyme from red dahlia tubers that can be used by industry to produce fructose through enzymatic reactions.

Abstract : Neonatal jaundice is a common clinical problem during the neonatal period, especially in the first week of life. Healthy infants can develop idiopathic neonatal jaundice with prevalence of 60% - 80%. The liver is the site of albumin synthesis which binds unconjugated bilirubin from the breakdown of erythrocytes and helps in transport to the liver. Low albumin production will reduce the transport and binding capacity. To determine the relationship between umbilical cord blood albumin levels and the occurrence of neonatal jaundice in term newborns. Prospective cohort of term neonates with normal birth weight of 2500-4000 grams from February 2020 until December 2020 at the RSUP. H. Adam Malik Medan according to the inclusion and exclusion criteria. To assess the correlation between two variables using Pearson correlation test with alternative spearman correlation test followed by simple linear regression. A total of 38 newborns were analyzed and 20 newborns met the inclusion criteria. The correlation of umbilical cord blood albumin levels with total serum bilirubin and indirect bilirubin levels on the third day showed a negative correlation (r value -0.759 and r -0.851) with p value <0.001 indicating a significant correlation. Meanwhile, there was no significant correlation between umbilical cord blood albumin and direct bilirubin with r value is -0,442 and p value is 0.051. The regression equation obtained is indirect bilirubin = 23,007 – 4,108 umbilical cord albumin levels. Indirect bilirubin levels can be estimated based on the value of umbilical cord albumin.

Abstract : The COVID-19 pandemic has impacted changes in hospital health services at Dr Kariadi in patients with malignancy and suspected malignancy both in the diagnostic process, surgery and in routine procedures such as chemotherapy, radiotherapy and palliative. This change was influenced by government policies such as lockdowns, patient fear of transmission of COVID-19, and limitations on facilities, infrastructure, and medical personnel. The duration of the delay in health services impacts patient outcomes. Assess the impact of delaying services for patients suspected of malignancy or malignancy infected with COVID-19. This research was conducted using observational and cross-sectional study methods. Secondary data was taken from medical records of patients with suspected malignancy and malignancy infected with COVID-19 obtained from January 2020 to August 2021. Data were analyzed using binary logistic regression. 157 patients with suspicion of malignancy and malignancy in January 2020 - August 2021 at dr. Kariadi Semarang consists of 86 male patients and 71 female patients with an average age of 49 years. The analysis showed that delaying treatment and duration affected the patient's outcome status (p <0.05).

Abstract : The fact that Covid-19 virus will not vanish completely requires people to have healthy behavior to control and prevent the spread (Covid-19 Preventive Behavior CPB). This is a systematic review and meta-analysis study that aims at providing a more reliable summary with a high level of evidence to estimate the scale of the effect of each component or perception of the HBM theory on Covid-19 prevention behavior. Articles were searched through databases from January – November 2022. The sources were from various databases such as: PUBMED and Google Scholar. No attempt was conducted to specifically search for unpublished articles. The keywords used were “Health Belief Model"[Mesh]” AND “covid preventive behavior”, AND “covid-19 preventive behavior”. 6 articles were eligible to be analyzed using RevMan5.4. the analysis results of the HBM predictor for increasing CPB are: susceptibility (RR: 1.03; 95% CI: 0.92 - 1.16; p value = 0.62), low self-efficacy, statistically these results are significant (RR: 1.48; 95% CI: 1.06 - 2.06; p value= 0.05), severity (RR: 1.05; 95%CI: 1.02 - 1.08; p value = 0.0006), perceived barrier (RR: 0.82; 95%CI: 0.75 – 0.90; p value < 0.0001), perceived benefit (RR: 1.22; 95%CI: 1.06 – 1.41; p value = 0.006), Cues to action (RR: 1.38; 95%CI: 1.03 – 1.85; p value < 0.00001). Self-efficacy, severity, perceived barrier, perceived benefit, and cues to action have significant effects on CPB. These results indicate that HBM can be used as one of the bases in efforts to establish Covid-19 prevention behavior.