No abstract

Latar belakang. Stunting merupakan kondisi kurang gizi kronis disebabkan asupan makanan yang kurang dalam waktu lama. Kejadian stunting dapat direduksi oleh salah satu faktor yang memengaruhi pemenuhan gizi anak, yaitu perilaku ibu dalam praktik pemberian makan.Tujuan. Mengetahui hubungan perilaku ibu dalam praktik pemberian makan dengan kejadian stunting.Metode. Studi analitik potong lintang yang dilakukan pada ibu dan anak usia 12-23 bulan di wilayah kerja Puskesmas Jatinangor. Pengambilan data dilakukan dengan wawancara menggunakan instrumen kuesioner yang disusun berdasarkan panduan Ikatan Dokter Anak Indonesia (IDAI) dan World Health Organization (WHO). Pengukuran panjang badan anak menggunakan infantometer. Analisis menggunakan uji chi kuadrat dan Mann Whitney. Hasil. Lima puluh sembilan subjek (27,2%) dari 217 total subjek termasuk kelompok stunting. Angka kemaknaan pemberian makan cukup dan pemberian makan secara responsif dengan kejadian stunting sebesar 0,003 dan 0,012. Ketepatan waktu dan pemberian makan secara aman dengan kejadian stunting memiliki nilai p>0,05. Perilaku ibu dalam praktik pemberian makan secara keseluruhan menunjukkan nilai p<0,05.Kesimpulan. Praktik pemberian makan secara keseluruhan memiliki hubungan dengan kejadian stunting. Kecukupan dalam pemberian makan dan pemberian makan secara responsif memiliki hubungan dengan stunting, tetapi pemberian makan secara tepat waktu dan aman tidak memengaruhi kejadian stunting.

Background. Acquired hemophilia A (AHA) is a potentially life-threatening autoimmune hemostatic disorder where autoantibodies that disrupt the functions of factor VIII (FVIII) are present in the circulation. The early diagnosis of AHA is difficult since the symptoms of AHA differ from those of congenital hemophilia A. Furthermore, the management of AHA is also more complex due to the presence of autoantibodies against FVIII (FVIII inhibitors). Here, we present three case reports and conduct a literature review of AHA with the aim to increase awareness and knowledge regarding the diagnosis and treatment of AHA. Case Presentations. We present three patients diagnosed with AHA in these case reports. The first patient was a young female, while the second and third patients were middle-aged and elderly males, respectively. All patients presented with a chief complaint of bruises without hemarthrosis and a history of bleeding. Laboratory examinations of the patients revealed isolated prolonged aPTT, normal PT, and the presence of autoantibodies against factor VIII, which are characteristics of AHA. Patients were then treated with corticosteroids to reduce the titer level of autoantibodies and received factor VIII transfusion to stop bleeding. Conclusion. AHA can be suspected in patients presenting with symptoms of bruises without hemarthrosis and without the history of bleeding. Isolated aPTT elevation with normal PT should raise high suspicion of AHA. The presence of FVIII inhibitors can help to confirm the diagnosis of AHA. Treatment consists of factor VIII transfusion and corticosteroid therapy. Bypassing agents are recommended as an alternative to FVIII transfusion.

Background: Hypertension may appear concomitantly and share the same pathophysiology with other comorbidities of coronary artery disease (CAD), which may indicate a relation between the two. This study aims to compare the differences between CAD patients with and without hypertension.Methods: This retrospective study includes subjects from the CAD registry in Dr. Hasan Sadikin General Hospital Bandung, from March-September 2022. Hypertension was defined as blood pressure $140/90 mmHg, known history of hypertension, or routinely consumed hypertension medication. Salt intake, history of smoking, low physical activity, body mass index (BMI), heart failure (HF), stroke, type-2 diabetes mellitus (T2DM), chronic kidney disease (CKD), obstructive sleep apnea (OSA), dyslipidemia, and chronic obstructive pulmonary disease (COPD) were compared between CAD patients with and without hypertension.Results: From 173 subjects included in this study, 124 (71.7%) subjects had hypertension, consist of 66.7% of male population and 93.8% of female population. The mean age in CAD patients with hypertension were higher than without hypertension (59.8 ± 8.3 vs 56.4 ± 8.8 years). There was no significant difference (p-value >0.05) regarding salt intake, history of smoking, low physical activity, BMI, diabetes, CKD, OSA, dyslipidemia, and COPD. Significant difference was found with age, female, HF, and stroke (p-value < 0.05). Multivariate analysis showed that hypertension was only independently associated with age [OR 1.04 (1–1.08, p-value 0.045)], female [OR 6.97 (1.57–30.86 p-value 0.01)], and HF [OR 3.5 (1.01–12.82, p-value 0.048)].Conclusion: CAD patients with hypertension was higher in female, older population, and those who have heart failure compared to CAD patients without hypertension.