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"Penyakit Graves merupakan penyakit autoimun yang melibatkan antibodi TSH-R dalam menstimulasi kelenjar tiroid sehingga terjadi sintesis dan sekresi hormon tiroid yang berlebih. Sebanyak 50% pasien penyakit Graves mengalami kekambuhan setelah terapi obat antitiroid selesai diberikan. Faktor genetik salah satunya polimorfisme gen FCLR3 rs7528684 diketahui berperan terhadap kejadian penyakit Graves. Namun, belum ada studi yang mengidentifikasi keterkaitan polimorfisme gen FCRL3 rs7528684 dengan kekambuhan penyakit Graves. Untuk itu, penelitian ini bertujuan untuk mengetahui hubungan polimorfisme gen FCRL3 rs7528684 terhadap kekambuhan penyakit Graves. Desain penelitian yang digunakan adalah studi cross sectional yang dilakukan pada 80 pasien penyakit Graves. Hasil isolasi DNA pasien dilakukan pemeriksaan genotyping dengan menggunakan metode tetra primer ARMS-PCR. Hasil penelitian menunjukkan terdapat 2 variasi genotip pada pasien penyakit Graves yaitu genotip GG (2,5%) dan genotip GA (97,5%). Pada kelompok kambuh, 100% memiliki genotip GA sehingga frekuensi alotip G dan alotip A masing-masing 50%. Sementara itu, pada kelompok tidak kambuh, didapatkan 6,1% genotip GG dan 93,9% gentoip GA dengan frekuensi alotip G dan alotip A yaitu 53,03% dan 46,97%. Berdasarkan hasil analisis uji statistik, disimpulkan bahwa tidak terdapat hubungan antara genotip dan alotip gen FCRL3 rs7528684 dengan kekambuhan penyakit Graves pada populasi Jakarta.

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Graves' disease is an autoimmune disease in which TSH-R antibodies stimulate the thyroid gland, resulting in excess thyroid hormone synthesis and secretion. 50% patients with graves’ disease relapse after finishing antithyroid drugs treatment. Genetics factor such as FCRL3 rs7528684 SNP contribute to the development of Graves' disease. However no study has yet identified an association of the FCRL3 rs7528684 SNP with Graves' disease recurrence. Therefore, this study aims to determine the association between the genetic polymorphism of FCRL3 rs7528684 and the recurrence of Graves' Disease. This cross-sectional clinical study was performed in 80 Graves' disease patients. DNAs of GD patients were isolated and then genotyped using tetra primer ARMS-PCR method. There are two genotype variations in patients with Graves' Disease, namely GG genotype (2,5%) and GA genotype (97,5%). In the relapsed group, 100% had the GA genotype, so the frequencies of G allotype and A allotype were 50% each. Meanwhile, in the remission group, there are 6,1% GG genotype and 93,9% GA genotype with G and A allotype frquencies were 53,03% and 46,97%, respectively. Based on statistic tests analysis, there is no association between the genotype and allotype of the FCRL3 rs7528684 SNP and Graves' disease recurrence in Jakarta's population."

"Clinical Pathway (CP) merupakan perangkat alat multidisiplin ilmu yang digunakan untuk perawatan kesehatan berbasis bukti (evidence based). CP memiliki fungsi menyeragamkan terapi sehingga mampu meminimalkan komplikasi dan kesalahan pengobatan. Rumah Sakit Pusat Otak Nasional (RS PON) merupakan rumah sakit rujukan otak dan persarafan nasional. Stroke perdarahan menjadi penyakit kedua tertinggi di RS.PON. Keberagaman keputusan dilakukannya operasi atau tidak, meskipun sudah masuk indikasi, menjadi poin penting untuk menganalisis implementasi pelaksanaan Clinical Pathway ini.Tujuan penelitian: menilai implementasi CP stroke perdarahan yang telah dijalankan sehingga diharapkan mampu menjadi dasar penentu kebijakan rumah sakit jejaring maupun rumah sakit seluruh Indonesia. Menilai hubungan antara variabel-variabel dalam clinical pathway terhadap Length of Stay (LOS), morbiditas dan mortalitasMetode: ​​Penelitian ini menggunakan metode mixed method, dengan pendekatan retrospektif. Dalam penelitian kuantitatif dilakukan analisis univariat dan multivariat, dimana menggunakan data sekunder dari rekam medis pasien stroke perdarahan yang dirawat di RS PON pada januari 2020 - Desember 2021. Dari total populasi 1254 pasien setelah dilakukan kriteria inklusi dan inklusi didapatkan 1001 pasien. Penelitian kuantitatif, dilakukan dengan menganalisis pengaruh implementasi CP terhadap lama hari rawat, morbiditas (nilai NIHSS) dan mortalitas. Faktor risiko dan efek atau penyakit yang terjadi di masa lampau diukur melalui catatan historis. Sementara pengumpulan data secara kualitatif menggunakan kuisioner dan wawancara secara mendalam kepada Kepala Bidang Pelayanan Medis, Kepala Komite Medis, Kepala Komite Keperawatan, Kepala Divisi Vaskular, Dokter Spesialis Neurologi, Dokter Spesialis Bedah Saraf, Dokter IGD, Perawat, Fisioterapi, Terapi wicara, Gizi dan Farmasi untuk mengetahui tahapan proses Clinical Pathway di RS PON. Total responden 129 orang. Penelitian kualitatif menilai pengetahuan tenaga medis dan paramedis terkait CP, implementasi, supervisi, monitoring dan evaluasi.Hasil: penelitian kuantitatif menemukan adanya hubungan antara beberapa variabel yang berada dalam CP, seperti pemeriksaan penunjang, terapi sesuai indikasi dan penyakit komorbid terhadap LOS, morbiditas dan mortalitas. Sementara pada penelitian kualitatif menilai implementasi CP di RS PON memerlukan perbaikan dari segi sosialisasi, implementasi, monitoring dan evaluasi.

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Clinical Pathway is a multidisciplinary toolkit used for evidence-based health care. The Clinical Pathway has the function to unify the therapy so as to minimize complications and medication errors. The National Brain Center Hospital (PON Hospital) is a national brain and nervous referral hospital. Hemorrhagic stroke is the second-highest disease in PON Hospital. The diversity of decisions to have surgery or not, even though it is indicated, is an important point to analyze the implementation of this Clinical Pathway.

Objective: to evaluate the implementation of CP bleeding stroke that has been carried out so that it is expected to be the basis for determining policy for network hospitals and hospitals throughout Indonesia. Assessing the relationship between variables in clinical pathways on Length of Stay (LOS), morbidity, and mortality

Methods: This study uses a mixed-method, with a retrospective approach. In this quantitative study, univariate and multivariate analyzes were carried out, which used secondary data from the medical records of hemorrhagic stroke patients treated at the PON Hospital in 2020-2021. From the total population of 1254 patients, after the inclusion and inclusion criteria were carried out, there were 1001 patients. Quantitative research was conducted by analyzing the effect of Clinical Pathway implementation on length of stay, morbidity (NIHSS value), and mortality. `Risk factors and effects or diseases that occurred in the past are measured through historical records. Meanwhile, qualitative data collection used in-depth interviews with the Head of Medical Services, Head of the Medical Committee, Head of Nursing, Head of the Vascular Division, Neurology Specialist, Neurosurgeon Specialist, Emergency Room Doctor, Nurse, Farmation, physiotherapist, speech therapist, nutritionist to find out the stages of the Clinical Pathway process at the PON Hospital. The total number of respondents are 129 people. Qualitative research assesses the knowledge of medical and paramedical personnel related to CP, implementation, supervision, monitoring, and evaluation.

Result: Quantitative research found a relationship between several variables in CP, such as investigations, therapy, and comorbid with LOS, morbidity, and mortality. Meanwhile, qualitative research showed that the implementation of CP in the PON Hospital was still unsatisfactory in terms of socialization, implementation, monitoring and evaluation.

Conclusion: Implementation of CP is associated with clinical outcomes of hemorrhagic stroke patients."

"This book will discuss several cellular pathways involved in controlling immune response in the context of infectious diseases, their biological consequences and potential "hijack" of these pathways for the benefit of pathogen leading towards pathogen persistence as opposed to clearance."

"Penyakit tidak menular (PTM) merupakan penyebab utama kematian di dunia maupun di Indonesia. Salah satu intervensi kunci dan cara yang paling efektif untuk menurunkan PTM adalah pengendalian faktor risiko PTM, diantaranya pemanfaatan Posbindu PTM sebagai wadah deteksi dini faktor risiko PTM. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan perilaku masyarakat dalam pemanfaatan Pos Pembinaan Terpadu Penyakit Tidak Menular di wilayah kerja Puskesmas Mogang Kabupaten Samosir. Penelitian ini menggunakan pendekatan mix method dengan sequential explanatory design (urutan pembuktian) diawali dengan penelitian kuantitatif terhadap 246 orang responden sesuai dengan kriteria inklusi dan dilanjutkan dengan penelitian kualitatif dengan melakukan wawancara mendalam, focus group discussion dan observasi pelaksanaan kegiatan Posbindu PTM. Data dianalisis secara univariat, bivariat, multivariat dan analisis tematik. Hasil penelitian menunjukkan bahwa rata-rata pemanfaatan Posbindu PTM dalam satu tahun hanya 3.2 kali. Faktor dominan yang berhubungan secara signifikan pada CI 95% secara berturut turut adalah sikap (P value 0.001), umur (P value 0.001), ketersediaan sarana (p value 0.005), dukungan tokoh masyarakat (p value 0.007), pengetahuan (p value 0.008), dukungan keluarga (p value 0.021). Disarankan kepada Dinas Kesehatan, Puskesmas Mogang untuk melaksanakan resosialisasi program Posbindu PTM, meningkatkan komunikasi, informasi dan edukasi bagi masyarakat, pembenahan terhadap sarana dan prasarana, meningkatkan kerjasama dan koordinasi dengan lintas sektor serta mengembangkan pemberdayaan masyarakat terintegrasi melalui kelompok-kelompok potensial.

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Non-communicable diseases (NCD) are a major cause of death in the world and in Indonesia. One of the key interventions and the most effective way to reduce NCD is the control of NCD risk factors, including the use of IDP of NCD as a forum for early detection of NCD risk factors. This study aims to analyze the factors that are related to the behavior of the community in utilizing the Integrated Development Post of Non Communicable Disease in the working area of the Mogang Public Health Center in Samosir Regency. This study uses a mix method approach with sequential explanatory design (sequence of evidence) which begins with quantitative research on 246 respondents according to inclusion criteria and continued with qualitative research by conducting in-depth interviews, focus group discussions and observations on the implementation of IDP of NCD activities. Data were analyzed by univariate, bivariate, multivariate and thematic analysis. The results showed that the average utilization of IDP of NCD in one year was only 3.2 times. The dominant factors that are significantly related to 95% CI respectively are attitude (P value 0.001), age (P value 0.001), availability of facilities (p value 0.005), support from community leaders (p value 0.007), knowledge (p value 0.008 ), family support (p value 0.021). It is recommended to the Health Office, Mogang Health Center to carry out the resocialization of the IDP of NCD program, improve communication, information and education for the community, improve facilities and infrastructure, increase cooperation and coordination with cross-sectors and develop integrated community empowerment through potential groups."

"Cytopathology of infectious diseases is the first book of its kind to focus entirely on the cytopathology of infectious diseases. It contains all of the pertinent information about the cytology of infectious diseases and microorganisms and will serve as an ideal handy reference. This unique volume covers the cytomorphology of various microorganisms and the host reactions they elicit, and also incorporates an update on advances in the field. Newly recognized infections such as the recent discovery of the Merkel Cell Polyomavirus (MCV) are included, as well as the utility of new immunostains (e.g. CM2B4 for MCV) and the role of molecular techniques that assist in the identification, classification and even quantification of microorganisms. Each chapter is succinctly written and concisely referenced with key published articles and resources. The volume includes practical pointers, useful diagnostic criteria, differential diagnoses and potential pitfalls. Many color images of high resolution that illustrate microorganisms (e.g. branching hyphae) and host reactions (e.g. viral cytopathic effect) are included throughout. Relevant tables with diagrams that provide quick reference guides are incorporated. "