Giant ovarian cyst itself is defined as a cyst >10 cm in diameter from radiological- examination or the size of the cyst exceeds the umbilicus. Extra-large benign and malignant cysts of the ovary are uncommon and involve diagnostic and management challenges. We present the case of a 20-year-old nulliparous woman who was referred to our center with complaints of abdominal pain and heavy breathing. She benefited from a salphingo-oophorectomy laparotomy procedure. Benign and malignant gynecologic and non-gynecologic etiologies are included in the differential diagnosis of an abdominal mass. Because of the infrequent occurrence or absence of distinctive clinical presentation of the giant ovarian cyst, accurate preoperative diagnosis is challenging.

The quality of instant baby porridge leads to nutrient content, consumer’s acceptability and shelf life. The use of freshwater snail flour (Pila ampullacea) as a substitution in the product increases the product nutrition value. The study analyzed nutrients content, acceptability, and shelf life of instant baby porridge. An experimental study with a completely randomized single factor design by using the three ratios of freshwater snail flour KS 0 (0%), KS I (10%), and KS II (15%). The acceptability test (hedonic test) was held on 25 semi-trained panelists and Arrhenius for shelf life analysis. Data were analyzed using One-way ANOVA, Krusskal wallis test, and Mann-Whitney. The substitution of freshwater snail flour could affect the nutrient content of carbohydrate, protein, fat, fiber, water, ash, iron, zinc, and calcium (p<0.05). The substitution could affect the consumer’s acceptance properties include color, flavor, texture, and taste (p<0.05). The shelf-life testing for 15 days obtained results, KS 0 formula in temperature 35oC, 45oC and 50oC is 7.13; 2.13 and 2.16 months respectively. KS I Formula in temperature 35oC, 45oC and 50oC is 39, 40, 41 days. KS II Formula in temperature 35oC, 45oC and 50oC is 6 years 7 months, 6 years 8 months, and 6 years 9 months. Based on nutrient content analysis, the substitution of freshwater snail flour could have enhanced protein, zinc, iron, calcium, and fat. KS I, the best formula obtained has 20 g contribution in one serving, fulfilled the energy adequacy of 14.41%, carbohydrates, 15.36%, protein 17.7%, fat 10.27%, fiber 1.7%, water 0.16%, iron 11.25%, zinc 10%, calcium 35.10% and the shelf life in temperature of 35oC is 39 days, 45oC has a shelf life of 40 days and 50oC has a shelf life of 41 days.

Background: Adherence is an important matter in the succession of hypertension medication. Despite the fact, it was found that many with hypertension had not used antihypertension medications as prescribed.Objective: To acknowledge the factors correlated to antihypertension medication adherence.Method: We used an observational, cross-sectional study model with a quantitative analytical approach. Some 131 qualified hypertensive patients of Ngluwar Public Health Center were recruited in February and March of 2021. A sampling method of purposive sampling was used. The data obtained were statistically analyzed using the chi-square test. Results: Eighty-two respondents (62.6%) had high medication adherence and 49 respondents (37.4%) were low at medication adherence. The statistical analysis results are as follows. Level of education (p = 0.374, PR = 1.264, CI 95% = 0.765-2.090), job status (p = 0.025, PR = 0.591, CI 95% = 0.367-0.953), comorbidity (p = 0.366, PR = 1.239, CI 95% = 0.772-1.988), duration of hypertension (p = 0.604, PR = 1.124, CI 95% = 0.722-1.751), family support (p = 0.142, PR = 1.396, CI 95% = 0.890-2.190), health worker support (p = 0.002, PR = 1.994, CI 95% = 1.313-3.028), affordability (p = 0.329, PR = 1.246, CI 95% = 0.802-1.937) and accessibility (p = 0.564, PR = 1.240, CI 95% = 0.623-2.468), and polypharmacy (p = 0.573, PR = 0.848, CI 95% = 0.488-1.474).Conclusion: Job status and health worker support were significantly correlated to antihypertensive medication adherence.

Stunting is one of the nutritional problems with high frequency in Indonesia. One cause of stunted children is the improper complementary feeding practice. A good quality diet contains macronutrients (protein) and micronutrients (iron, zinc, and calcium) are linearly correlated with children’s growth. A freshwater clam was a local food enriched with highprotein and zinc that is potential to be nutritional complementary foods. However, this was substituted by full cream milk in instant baby porridge. The purpose of this study was to analyze the effect of freshwater clams flour substitution on energy, protein, fat, carbohydrate, fiber, zinc, calcium, and iron as well as physical properties (bulk density, water absorption, and solubility) in instant baby porridge. The design of this study was a single factor completely randomized design with the ratio of freshwater clams flour as substituted in the instant baby porridge as 0% (F0), 5% (F1) and 10% (F2). There was also an effect of substitution of freshwater clamss flour (Pilsbryoconcha exilis) on energy, carbohydrate, protein, fat, moisture content, ash, crude fiber, calcium, iron, and zinc (p = 0.0001) in instant baby porridge. Variation in the percentage of freshwater clamss flour substitution did not significantly influence the bulk density (p = 0.085), solubility (p = 0,05) and water absorption (p = 0.341). Instant baby porridge F0 contained protein, calcium, iron, and zinc less than the requirements. Instant baby porridge F1 had protein and zinc less than the requirements, but calcium and iron levels met the requirements. Meanwhile, the level of protein, iron, calcium and zinc on instant baby porridge F2 met the requirements. Instant baby porridge with the substitution of freshwater clams flour increased the nutrient content which includes protein, fiber, calcium, iron, and zinc but decreased carbohydrate and fat content. Both formulations had a bulk density and solubility which meet the requirement. However, water absorption did not meet the requirements.