Dida Akhmad Gurnida’s research while affiliated with Padjadjaran University and other places

Background: Breast milk is the first, main, and best natural food for babies. Breast milk contains various nutrients needed in the process of growth and development of babies. Breastfeeding is a health behavior carried out by mothers. This study aimed to analyze the factors that influence the provision of breast milk substitutes.Methods: This was a quantitative study, using a cross-sectional design. Data collection was carried out from July to August 2022 on 71 mothers who had babies aged up to 6 months at the Bandar Baru Public Health Center, Pidie Jaya, Aceh, Indonesia. Consecutive sampling technique was used. The variables studied included behavior intentions, social support, accessibility of information, personal autonomy, and situational action. Chi-square was used to assess the relationship between independent variables and the dependent variables.Results: Most mothers were aged 20–35 years (70.4%), had junior high school education (78.9%), were unemployed (76.1%), and most did not provide breast milk substitutes (70.4%). Mothers who provided breast milk substitutes was significantly associated with the mother’s intention to give breast milk (p=0.002) and environmental conditions/situations for action (p=0.001). Mothers with low intentions tended to substitute breastmilk (53.8%). Furthermore, the situation of action influenced mothers to provide breast milk substitutes (48.6%).Conclusion: Factors that influence mothers to provide breast milk substitutes are low intention and environmental conditions/situations to act. Therefore, education for mothers to give exclusive breast milk is encouraged.

Background: Chronic kidney disease (CKD) in children has a long-lived impact, such as an increased risk of bacterial infection. Infection may accelerate disease progression, making early detection crucial. Inflammatory markers typically used for bacterial infection are C-Reactive Protein (CRP) and Procalcitonin (PCT). This study aimed to determine the correlation between levels of neutrophil-to-lymphocyte ratio (NLR) and immature-to-total-neutrophil ratio (I/T ratio) to bacterial infection in children with CKD as indicated by the serum levels of CRP and PCT.Methods: Observational analysis with a cross-sectional design was conducted from January 2019 to November 2021 in children from 3 months to 18 years old with CKD and bacterial infection. Retrospective data were obtained from medical records at Dr. Hasan Sadikin General Hospital, Bandung. Correlation analysis was performed (SPSS program) at a 95% confidence level, and results were considered significant if the p-value <0.05.Results: There were 42 children, and 57% were female; with a median age of 13 years (range 1–17 years). Most patients had normal nutritional status (55%) although 40% were malnourished. Correlation analysis between I/T ratio and NLR with PCT was positive, with r=0.284 (p<0.05) and r=0.265 (p<0.05), respectively, whereas there was no significant correlation of I/T ratio (r=0,154; p>0.05) and NLR (r=0,188; p>0.05) to CRP.Conclusions: NLR and I/T ratios have a significant positive correlation with PCT levels but not with CRP levels. NRL and I/T ratios can be considered as alternative markers for diagnosing CKD in children with a bacterial infection.

Introduction: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (MTB). MTB can inhibit phagolysosomal fusion, so it’s difficult to eliminate, and the BCG vaccine didn’t contain ESAT-6/CFP-10, which caused therapy and immunization couldn’t be optimal in eradicating TB. An immunomodulator is needed to improve the immune system, especially from natural ingredients. A Moringa oleifera plant is known to have immunomodulatory properties because of its nutrients, flavonoids, polyphenols, saponins,alkaloids, and steroids. Material and Methods: This study aims to determine the effect of the M. oleifera leaf extract (MLE) on the phagocytic activity of macrophages, ros, no, Ifn-γ, and IL-10 induced by ESAT-6 in the Peripheral Blood Mononuclear Culture (PBMC) pulmonary TB patients. The research was carried out on PBMC from the blood of six pulmonary TB patients with a post-test-only control group design. The samples were divided into three groups: negative control group, positive control group (induced with ESAT-6), and intervention groups (induced with ESAT-6 and MLE at doses of 1 μg/mL, 2.5 μg/mL, 10 μg/mL, and 25 μg/mL). Results: MLE with a dose of 1 μg/mL significantly increased macrophages’ phagocytic activity, ros/no, Ifn-γ, and decreased IL-10 levels (p < 0.05) as compared to the control group, whereas at a dose of ≥ 2.5 μg/mL, it decreased macrophages phagocytic activity, ros/no, Ifn-γ, and increased IL-10 levels. Discussion: These indicate that MLE at a low dose had immunostimulant activity, but at a higher dose showed immunosuppressive and anti-inflammatory activity.

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (MTB) that lives intracellularly. MTB can inhibit lysosomal enzymes and phagolysosomal fusion, which is challenging to eliminate. These are due to ESAT-6/CFP-10 originating from the RD1 region genome that expresses the Esx-1 type VII secretion system. Esx-1 encodes Esx-A (ESAT-6) and Esx-B (CFP-10), potential vaccine candidates still under research and development. ESAT-6/CFP-10 is predicted to affect macrophage phagocytic activity, IFN-γ, ROS/NO, and IL-10 levels. Several studies have begun to focus on the ESAT-6 antigen due to the high levels of ESAT-6 antibody found in pleural effusion and granuloma fluid. They can last up to 1 year compared to CFP-10 in experimental animals. This study aimed to analyze the effect of ESAT-6 on the phagocytic activity of macrophages, ROS/NO, IFN-γ, and IL-10 in peripheral blood mononuclear cells (PBMCs) cultures of pulmonary TB patients. It is experimental laboratory research with a post-test-only control group design with PBMCs from October 2019 to December 2020 in the Aretha Laboratory Bandung. There were two groups: the negative group (without ESAT-6) and the positive group (with ESAT-6). Six subjects were sampled at the Pindad Hospital in Bandung, and the research was carried out at the Aretha Laboratory in Bandung. Statistical analysis using paired t test. There was a significant difference between the negative and positive groups (p<0.05). ESAT-6 can decrease macrophage phagocytic activity, intracellular ROS/NO, and IFN-γ but increase IL-10 levels.

BACKGROUND: Toxoplasma gondii, Rubella virus, Cytomegalovirus, and herpes simplex virus (TORCH) infection is still a significant burden in developing countries since they potentially increase perinatal death and decrease life quality by causing congenital disorders. As part of TORCH and as one of the most common infections in humans, HSV Type 1 infection also should receive attention. HSV-1 infection induces an immediate reactive oxygen species (ROS) production, indicate that ROS plays beneficial effects in several biological functions, including innate immunity and antiviral responses. HSV-1 preferentially replicate and establish latency in different subtypes of sensory neurons and in neurons of the autonomic nervous system that are highly responsive to stress hormones, including cortisol. AIM: The objective of the study was to detect the latent HSV-1 infection in adults population and its effect on ROS and cortisol levels. PATIENTS AND METHODS: Subjects were enrolled with consecutive-sampling methods among the adults population age 18–40 years old, with no health complaints. We collected their blood to examined IgG HSV-1, ROS, and cortisol levels. RESULTS: A total of 57 subjects with 27 subjects were reactive IgG HSV-1 (herpes group) and 30 subjects were non-reactive IgG HSV-1 (non herpes groups). Mean of cortisol and ROS was 223.2904 nmol/L and 2.23337 IU/mL, respectively. There was a very weak correlation between HSV-1 infection with ROS and cortisol. CONCLUSION: There is a positive effect of latent HSV-1 infection in the adult population on cortisol ROS levels.

Objective: Indonesia accounted for 845.000 tuberculosis (TB) cases, ranked as the second-highest TB incidence in the world. Various studies in childhood TB and vitamin D has overgrown in recent years, but there is no study for vitamin D status in under-five children with pulmonary tuberculosis in Indonesia as tropical country that has an abundant sun exposure. This study evaluates the vitamin D level in under-five children with pulmonary TB compared with healthy children control group. Materials and Methods: This comparative study with a cross-sectional design was conducted in outpatient clinic from February 2019 – February 2020. We selected children ≤5 years old, diagnosed with pulmonary TB; the control group was the random siblings or neighbors who did not have tuberculosis. Differences in 25-hydroxyvitamin D levels in both groups were statistically analyzed with independent t-test. The vitamin D cutoff values were determined using receiver operating characteristic (ROC) curve analysis. Results: A total of 70 patients aged ≤5 years old met the inclusion criteria, 35 childrens were assigned for each group. The 25-hydroxy vitamin D mean level in the TB group was 42.72 nmol/L and 97.74 nmol/L in control group. The TB group has significantly lower 25-hydroxy vitamin D levels than control group (p<0.001). With sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 100%, 97.1%, 97.2%, and 100%, respectively, the optimal cutoff point level for 25-hydroxy vitamin D was 80nmol/L. Conclusion: Serum levels of 25-hydroxy vitamin D in children with pulmonary TB are significantly lower than in healthy children. Further study should be conducted to determine the efficacy of vitamin D supplementation in the treatment of children with tuberculosis.

In Bandung Regency, there are many industries whose workers are breastfeeding mothers with workplace facilities that are not lactation friendly or do not support the implementation of exclusive breastfeeding. This study aims to analyze the relationship between knowledge, attitudes, family support, and the role of health workers regarding exclusive breastfeeding and breastfeeding rights on exclusive breastfeeding patterns for mothers who have breastfeeding facilities in the workplace. The study design was a cross-sectional with saturated sampling technique. The study was conducted on industrial worker mothers who have babies aged more than 6 to 12 months and have breastfeeding facilities at work in the work area of the Bandung Regency Health Center as many as 32 people. The results showed that knowledge with p-value = 0.015, attitude p = 0.015, family support p = 0.015, health workers p = 0.001, and breastfeeding rights p = 0.003 had a relationship with exclusive breastfeeding patterns. The variables that have the most significant relationship are attitudes with an effect of 13.57 times and support from health workers with an effect of 26.60 times on exclusive breastfeeding compared to those without exclusive breastfeeding. The conclusion is that knowledge, attitudes, family support, the role of health workers, and breastfeeding rights have a relationship with exclusive breastfeeding patterns for industrial sector workers who have breastfeeding facilities in the workplace.ABSTRAKDi Kabupaten Bandung terdapat banyak industri yang pekerjanya adalah ibu menyusui dengan fasilitas tempat kerja yang tidak ramah laktasi atau tidak mendukung terlaksananya pemberian ASI eksklusif. Penelitian ini bertujuan untuk menganalisis hubungan antara pengetahuan, sikap, dukungan keluarga, dan peran petugas kesehatan mengenai pemberian ASI eksklusif serta hak menyusui terhadap pola pemberian ASI eksklusif pada ibu yang memiliki fasilitas menyusui di tempat kerja. Desain penelitian cross-sectional dengan tehnik sampling jenuh. Penelitian dilakukan pada ibu pekerja industri yang memiliki bayi usia lebih dari 6 sampai 12 bulan dan memiliki fasilitas menyusui di tempat kerja di wilayah kerja Puskesmas Kabupaten Bandung yaitu sebanyak 32 orang. Hasil penelitian menunjukkan bahwa pengetahuan dengan nilai p=0,015, sikap p=0,015, dukungan keluarga p=0,015, petugas kesehatan p=0,001, dan hak menyusui p=0,003 mempunyai hubungan dengan pola pemberian ASI eksklusif. Variabel yang mempunyai hubungan paling signifikan yaitu sikap dengan pengaruh sebesar 13,57 kali dan dukungan petugas kesehatan dengan pengaruh sebesar 26,60 kali terhadap pemberian ASI eksklusif dibandingkan dengan yang tidak ASI eksklusif. Simpulannya adalah pengetahuan, sikap, dukungan keluarga, peran petugas kesehatan dan hak menyusui mempunyai mempunyai hubungan terhadap pola pemberian ASI eksklusif pada ibu pekerja sektor industri yang memiliki fasilitas menyusui di tempat kerja.Kata kunci: pengetahuan, sikap, dukungan keluarga, peran petugas kesehatan, hak menyusui

Background: Various studies in adults have shown a strong association between vitamin D and tuberculosis (TB), both in terms of vitamin D status and the benefits of vitamin D in managing TB. Studies on vitamin D and its relationship with childhood TB still lack in Indonesia as a country with the second-highest TB incidence globally. This study evaluated the effect of vitamin D supplementation on resolution of cough and fever in Indonesian children with pulmonary TB. Methods: We conducted a randomized controlled trial of vitamin D supplementation in children with pulmonary TB and vitamin D insufficiency. Patients were randomly allocated with 1:1 ratio to receive either 1000 IU vitamin D or placebo daily after starting standard TB treatment. The primary outcome in this study was the resolution of fever and cough symptoms reviewed weekly after starting the treatment until the symptoms are resolved. The secondary outcome in this study was 25-hydroxyvitamin D serum level and nutritional status which was reviewed at the end of the trial. Intention to treat analyses were applied. Differences in clinical outcomes between two groups were calculated using Mann-Whitney U test or χ2 test, where appropriate. Findings: A total of 84 patients met the inclusion criteria, aged 6 to 18 years old, newly diagnosed with pulmonary TB and vitamin D insufficiency. Eighty patients (95,2%) completed the six months follow-up. Faster resolution of fever, cough, improved malnutrition status, and higher vitamin D level were found in the intervention group compared to the placebo group (all P < 0.001). Conclusions: Vitamin D is beneficial in improving fever and cough resolution, and improving nutritional status in children with pulmonary TB and vitamin D insufficiency. Determination of adequate supplementation levels of more than 1000 IU requires further research to achieve normal vitamin D levels during the duration of treatment for pulmonary TB in children. Trial registration: ClinicalTrials.gov (NCT05073965).

Coronavirus disease 2019 (COVID-19) is a new type of respiratory infection that first emerged in December 2019 in Wuhan, Hubei, China. COVID-19 is caused by a new type of virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aims to determine the association of SNP CRP rs1800947 gene in suspected COVID-19 patients to length of stay at Al Ihsan Hospital, and Banten Hospital in June-November 2020. This study used data from 60 patients, all patients were suspect COVID-19. The subject was 29 COVID-19 people were confirmed, whereas 31 people were not. A statistics analysis due to pearson correlation and linear multi regretion. This study found a significant assosiation between the subject. The results of this study were the relationship between SNP rs1800947 and outcome, a fairly strong association level relationship was found in the SNP rs1800947 (p-value= 0.045, association= 0.537). The association between length of stay and CRP levels has a low level of association (p-value=0.015, association=0.378). The SNP genotype rs1800947 G had a longer treatment duration of 0.14778 days compared to the SNPrs1800947 C genotype. CRP levels showed that higher CRP levels increased the length of treatment compared to normal CRP levels. Where high CRP levels are at risk of 0.6330 days longer than normal CRP while very high CRP is at risk of 2.9561 days longer than Normal CRP levels. In general, the gene SNP rs1800947 and CRP levels, together affect the outcome of patients with suspected COVID-19.

Latar belakang. Proses inflamasi berkaitan dengan kondisi anisositosis dan gagal jantung yang terjadi secara paralel sehingga menjadikan red cell distribution width (RDW) sebagai penanda yang handal untuk disfungsi jantung. Di negara berkembang, gagal jantung pada anak paling banyak diakibatkan oleh penyakit jantung rematik (PJR). Penelitian mengenai korelasi antara nilai RDW dan fungsi ventrikel kiri yang dinilai dengan ekokardiografi pada anak dengan gagal jantung akibat PJR belum pernah dilakukan sebelumnya. Tujuan. Mengetahui korelasi antara nilai RDW dengan fungsi ventrikel kiri pada anak dengan gagal jantung akibat PJR. Metode. Penelitian observasional analitik dengan desain potong lintang pada pasien gagal jantung akibat PJR yang berusia