Introduction: Being in the ring of fire have caused Indonesia prone to emergency and disasters. This condition should make a positive correlation to level of citizen’s knowledge and attitude towards emergency and disaster situation. However, there is no study to assess this condition. This study aims to assess the knowledge and attitude of Indonesian in emergency and disaster using a cross-sectional study collected from questionnaire interviewed by trained medical students in four centers (Jakarta, Depok, Padang, and Makassar).Method: Samples were collected using random cluster sampling. Out of 570 samples participated, most of the respondents had a poor knowledge (56.1%) and attitude (60.7%). Result: There is a significant relationship between knowledge and attitude (p<0.001). Age, education, and training on disaster can affect both knowledge and attitude towards emergency and disaster situation (p<0.05). However, disaster experience only had a significant contribution towards knowledge (p<0.05) but not the attitude (p = 0.856). Conclusion: Most of the population in this study had poor knowledge and attitude in emergencies. These presented data also indicate that training on disaster is urgently needed to give impact on citizen’s awareness. Moreover, further research is needed.

Background:Peripartum cardiomyopathy (PPCM) is a life-threatening condition, refers to rare dilated cardiomyopathy causing heart failure in late pregnancy or early postpartum woman. The diagnosis was based on pregnant/peripartum woman who had sudden cardiac decompensation without any history of cardiac disease. Pre-eclampsia (PE) could be co-existed with PPCM because of similar pathophysiology mechanism, which leads to higher mortality. Hereby we present the challenges of managing PPCM complicated with severe PE in suburban areas.Case Illustration:A 36-year-old woman referred to hospital with shortness of breath. Her past medical history was remarkable for severe-PE and had undergone caesarean section two-day-ago. Upon arrival, her saturation-75%, HR-120x/min, BP-140/80 and RR exceeds-40x/min. She was in respiratory distress with JVP increased, coarse crackles at basal lungs, and leg swelling. Laboratory studies were unremarkable. The x-ray revealed cardiomegaly and ECG showing LVH. Initial echocardiography demonstrated left ventricular systolic dysfunction with ejection fraction-34%. The patient was suggestive for PPCM with previous history of PE. Continuous administration of IV-furosemide-5 mg/h, spironolactone-25 mg, bisoprolol-2.5 mg, and candesartan-8 mg were administered. Her condition improved rapidly with increased saturation from 75% to 95% and significant reduced in dyspnoea. She was transferred to intensive cardiovascular unit for further management and discharged after 7-days for outpatient control.Discussion:PPCM is a devastated diagnosis among pregnancy woman. The diagnosis should be distinguish from PE induced heart failure. In PPCM, the echocardiography findings is related with left ventricular systolic dysfunction and reduced EF, whereas diastolic dysfunction with preserved EF is identified in PE induced heart failure patient. PE is associated with PPCM based on the shared pathophysiology. It is related with the angiogenic imbalance and excess expression of antiangiogenic factor sFlt1 soluble fms-like tyrosine kinase-1, which have found increased in both of the diseases. This is explained why PE has been recorded to occur in 30% of PPCM cases and it contributes to the increasing maternal mortality when most of the causes of maternal death are preventable.

Pendahuluan. Pasien diabetes melitus tipe 2 (DMT2) pada umumnya memiliki satu atau lebih komplikasi kronik pada saat terdiagnosis. Deteksi dini dan pencegahan sangat penting untuk mengurangi angka mortalitas dan morbiditas terkait DMT2, terutama pada kelompok dengan risiko tinggi seperti anak penderita DMT2. Studi ini bertujuan untuk mencari faktor-faktor yang berkaitan dengan status prediabetes pada anak dari penderita diabetes melitus tipe 2.Metode. Studi ini merupakan studi potong lintang yang melibatkan 54 anak dari penderita DMT2. Subjek dikumpulkan secara konsekutif. Status prediabetes ditentukan melalui HbA1C berstandar national glycohemoglobin standardization program (NGSP). Aktivitas fisik ditentukan melalui kuisioner global physical activity questionnaire (GPAQ)-versi Bahasa Indonesia. Tekanan darah dan data antropometrik diukur secara langsung. Analisis bivariat dan multivariat dilakukan dengan IBM SPSS 23.Hasil. Dilakukan analisis terhadap 54 subjek. Mayoritas subjek adalah perempuan (79,6%) dan rerata umur adalah 38,8 tahun. Proporsi prediabetes mencapai 31,5%. Analisis multiavariat menunjukkan hubungan bermakna antara riwayat paternal DMT2 (adjusted OR 7,520; IK 95%=1,071-52,784), lingkar pinggang berisiko (adjusted OR 5,482; IK 95%=1,019-29,504) terhadap status prediabetes.Simpulan. Riwayat paternal DMT2 dan lingkar pinggang berkaitan dengan status prediabetes pada anak dari penderita DMT2.Kata Kunci: Anak penderita DM tipe 2, HbA1C, intoleransi glukosa, prediabetes The Role of Paternal History of Type 2 Diabetes Mellitus on Prediabetes Status among The Offspring of Type 2 Diabetes Mellitus Patients Introduction. Since patients with type 2 diabetes mellitus (T2DM) often present with one or more chronic complications, at the time of diagnosis, early detection and prevention is essential to reduce T2DM-associated mortality and morbidity, espescially among high risk population such as the offspring of T2DM. This study aimed to investigate several factors associated with prediabetes status among the offsprings of T2DM patients.Methods. A cross-sectional study was conducted involving 54 offsprings of T2DM patients. Subjects were recruited consecutively. We collected demographic data, anthropometric measurement, blood pressure, and HbA1c level. Physical activity were assessed by using Indonesian version of global physical activity questionnaire (GPAQ). Prediabetes status was investigated by standardized national glycohemoglobin standardization program (NGSP) HbA1c. Bivariate statistical and multivariate analysis was performed by using IBM SPSS 23.Results: The majority of subjects were female (79.6%) and the mean age was 38.8 years old. The proportion of prediabetes was 31.5%. Multivariate analysis showed significant association among paternal history of T2DM (adjusted OR 7.520; 95%CI=1.071-52.784), waist circumference at risk (adjusted OR 5.482; 95%CI=1.019-29.504), and prediabetes status.Conclusion: Paternal history of T2DM and waist circumference were associated with prediabetes status among the offspring of T2DM patients.

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