Progress towards universal health coverage and inequalities in infant mortality: an analysis of 4·1 million births from 60 low-income and middle-income countries between 2000 and 2019

BACKGROUND

Expanding universal health coverage (UHC) might not be inherently beneficial to poorer populations without the explicit targeting and prioritising of low-income populations. This study examines whether the expansion of UHC between 2000 and 2019 is associated with reduced socioeconomic inequalities in infant mortality in low-income and middle-income countries (LMICs).

METHODS

We did a retrospective analysis of birth data compiled from Demographic and Health Surveys (DHSs). We analysed all births between 2000 and 2019 from all DHSs available for this period. The primary outcome was infant mortality, defined as death within 1 year of birth. Logistic regression models with country and year fixed effects assessed associations between country-level progress to UHC (using WHO's UHC service coverage index) and infant mortality (overall and by wealth quintile), adjusting for infant-level, mother-level, and country-level variables.

FINDINGS

A total of 4 065 868 births to 1 833 011 mothers were analysed from 177 DHSs covering 60 LMICs between 2000 and 2019. A one unit increase in the UHC index was associated with a 1·2% reduction in the risk of infant death (AOR 0·988, 95% CI 0·981-0·995; absolute measure of association, 0·57 deaths per 1000 livebirths). An estimated 15·5 million infant deaths were averted between 2000 and 2019 because of increases in UHC. However, richer wealth quintiles had larger associated reductions in infant mortality from UHC (quintile 5 AOR 0·983, 95% CI 0·973-0·993) than poorer quintiles (quintile 1 0·991, 0·985-0·998). In the early stages of UHC, UHC expansion was generally beneficial to poorer populations (ie, larger reductions in infant mortality for poorer households [infant deaths per 1000 per one unit increase in UHC coverage: quintile 1 0·84 vs quintile 5 0·59]), but became less so as overall coverage increased (quintile 1 0·64 vs quintile 5 0·57).

INTERPRETATION

Since UHC expansion in LMICs appears to become less beneficial to poorer populations as coverage increases, UHC policies should be explicitly designed to ensure lower income groups continue to benefit as coverage expands.

FUNDING

UK National Institute for Health and Care Research.

Potential Alzheimer's disease drug targets identified through microglial biology research

INTRODUCTION

Microglia, the primary immune cells in the brain, play multifaceted roles in Alzheimer's disease (AD). Microglia can potentially mitigate the pathological progression of AD by clearing amyloid beta (Aβ) deposits in the brain and through neurotrophic support. In contrast, disproportionate activation of microglial pro-inflammatory pathways, as well as excessive elimination of healthy synapses, can exacerbate neurodegeneration in AD. The challenge, therefore, lies in discerning the precise regulation of the contrasting microglial properties to harness their therapeutic potential in AD.

AREAS COVERED

This review examines the evidence relevant to the disease-modifying effects of microglial manipulators in AD preclinical models. The deleterious pro-inflammatory effects of microglia in AD can be ameliorated via direct suppression or indirectly through metabolic manipulation, epigenetic targeting, and modulation of the gut-brain axis. Furthermore, microglial clearance of Aβ deposits in AD can be enhanced via strategically targeting microglial membrane receptors, lysosomal functions, and metabolism.

EXPERT OPINION

Given the intricate and diverse nature of microglial responses throughout the course of AD, therapeutic interventions directed at microglia warrant a tactical approach. This could entail employing therapeutic regimens, which concomitantly suppress pro-inflammatory microglial responses while selectively enhancing Aβ phagocytosis.

Stunting Among Children Under Two Years in the Islands Areas: A Cross-sectional Study of the Maluku Region in Indonesia, 2021

BACKGROUND

The Maluku region encompasses thousands of islands. The study analyzed factors related to stunting among children under two years old in the Maluku Region of Indonesia. Study Design: A cross-sectional study.

METHODS

This cross-sectional study examined 4764 children under two years. In addition to nutritional status (stature), the study analyzed ten independent variables (province, residence, maternal age, marital status, maternal education, employment, wealth, children's age, gender, and early initiation of breastfeeding [EIBF]). Finally, the contribution of various factors to stunting was examined using logistic regression.

RESULTS

Children in Maluku province were 1.13 times more likely than those in North Maluku province to become stunted. In addition, children aged 12-13 months were 4.09 times more likely than<12 months, and boys were 1.87 times more likely than girls to have the patterns of stunting. Children in rural areas were 1.10 times more likely to become stunted than those in urban areas (95% confidence interval: 1.06, 1.14). Divorced/widowed mothers were 1.88 times more likely than married mothers. Mothers of all education levels were more likely than those without formal education, and unemployed mothers were 1.07 times more likely than employed mothers to have stunted children. The possibility of becoming stunted was lower when the children were wealthier.

CONCLUSION

Nine variables were related to stunted incidence, including province, residence, maternal age, marital status, maternal education, employment, wealth, children's age, and gender.

SARS-CoV-2 persistence and infectivity in COVID-19 corpses: a systematic review

The persistence and infectivity of SARS-CoV-2 in different postmortem COVID-19 specimens remain unclear despite numerous published studies. This information is essential to improve corpses management related to clinical biosafety and viral transmission in medical staff and the public community. We aim to understand SARS-CoV-2 persistence and infectivity in COVID-19 corpses. We conducted a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocols. A systematic literature search was performed in PubMed, Science Direct Scopus, and Google Scholar databases using specific keywords. We critically reviewed the collected studies and selected the articles that met the criteria. We included 33 scientific papers that involved 491 COVID-19 corpses. The persistence rate and maximum postmortem interval (PMI) range of the SARS-CoV-2 findings were reported in the lungs (138/155, 89.0%; 4 months), followed by the vitreous humor (7/37, 18.9%; 3 months), nasopharynx/oropharynx (156/248, 62.9%; 41 days), abdominal organs (67/110, 60.9%; 17 days), skin (14/24, 58.3%; 17 days), brain (14/31, 45.2%; 17 days), bone marrow (2/2, 100%; 12 days), heart (31/69, 44.9%; 6 days), muscle tissues (9/83, 10.8%; 6 days), trachea (9/20, 45.0%; 5 days), and perioral tissues (21/24, 87.5%; 3.5 days). SARS-CoV-2 infectivity rates in viral culture studies were detected in the lungs (9/15, 60%), trachea (2/4, 50%), oropharynx (1/4, 25%), and perioral (1/4, 25%) at a maximum PMI range of 17 days. The SARS-CoV-2 persists in the human body months after death and should be infectious for weeks. This data should be helpful for postmortem COVID-19 management and viral transmission preventive strategy.

Edukasi Food Preparation untuk Meningkatkan Kompetensi Santriwati di Pondok Pesantren Annuriyyah Kabupaten Jember

Pemenuhan pangan merupakan salah satu aktivitas penting bagi kehidupan. Globalisasi, perkembangan teknologi informasi, dan terjadinya pandemi COVID-19 telah mengakibatkan adanya pergeseran cara pemenuhan kebutuhan pangan manusia, salah satunya ialah peningkatan permintaan frozen food dan munculnya tren penerapan teknik food preparation pada masyarakat. Pondok Pesantren termasuk salah satu lembaga pendidikan formal maupun non formal tertua di Indonesia yang memiliki peranan besar dalam pembangunan nasional, sehingga sistem pemenuhan pangan perlu dikelola dengan baik. Oleh karena itu, dilaksanakan penyuluhan, pelatihan dan pendampingan mengenai Food preparation yang meliputi perencanaan menu, pemilihan bahan makanan, penyimpanan, hingga pengolahannya dengan tetap memperhatikan variasi menu, kelengkapan dan keseimbangan gizi, keamanan, dan kepraktisan. Rangkaian metode pelatihan yang dilakukan adalah ceramah, praktik, diskusi, dan evaluasi. Berdasarkan kegiatan yang telah dilakukan, ada kenaikan jumlah peserta yang memahami teknik food preparation yaitu sejumlah 84%. Peserta juga menyatakan telah menerima berbagai manfaat dari kegiatan tersebut.

Production of synthetic rutile from tin ore beneficiation byproduct through preoxidation and reductive leaching in hydrochloric acid

This paper examines the effectiveness of the method for producing synthetic rutile from ilmenite through pre-oxidation and reductive leaching of pre-oxidized ilmenite in hydrochloric acid. Thermodynamic simulation of the pre-oxidation of ilmenite concentrate was performed to evaluate the phases formed during the process as a function of temperature. The pre-oxidation experiments were performed at different temperatures between 700 and 1000 °C in a muffle furnace for 6 h. The optimum temperature of pre-oxidation was revealed to be at 700 °C where ilmenite transformed into hematite and rutile, which is in accordance with the result of the thermodynamic simulation. Series of the leaching experiments were carried out under variations of HCl concentration (5-8 M), leaching temperature (70-100 °C), solid/liquid ratio (1/5-1/20 g/mL), ilmenite ore particle size distribution, and duration of leaching (6-12 h). Taguchi method utilizing L16 orthogonal array was adopted in the leaching step to design and reduce the required number of experiments. Analysis of variance (ANOVA) indicated that the temperature and solid/liquid (S/L) ratio were the most influential leaching parameters for the dissolution of iron and titanium. The optimum conditions for maximising the dissolution of iron, while minimizing the dissolution of titanium were at a temperature of 80 °C, HCl of 6 M, S/L ratio of 1/20 g/mL, ore particle size distribution of 44-77 µm (-200 + 325 mesh), and leaching duration of 6 h. The leaching experiment conducted under these conditions resulted in iron extraction of 98.07% with co-extraction of titanium of 11.35%. The leach-residue contains 92.6% rutile, 2.9% hematite, and 2.5% cassiterite which can be classified as synthetic grade rutile.

Genetic Analysis of TPOX, CSF1PO, D3S1358, D8S1179, vWA, D5S818, and TH01 Short Tandem Repeats Loci in Nias Population, Indonesia

BACKGROUND: Nias is an island located off the western coast of Sumatra, Indonesia. Nias is situated above the Eurasian and Indo-Australian subduction zone plates. This makes it prone to earthquakes and tsunamis. Genetic analysis and genetic variation of short tandem repeats (STR) locus are not widely known. These data are valuable for individual identification and paternity testing. METHODS: Seven STR loci (TPOX, CSF1PO, D3S1358, D8S1179, vWA, D5S818, and TH01) were analyzed using 25 healthy and unrelated persons Nias population. Allele frequency, power of discrimination (PD), expected heterozygosity, and probability of exclusion (PE) were calculated. RESULTS: We found 40 alleles. The allele with highest frequency was alleles 9 at the TH01 loci. While the lowest frequency were allele 9 at the CSF1PO loci, allele 12 at the TPOX loci, alleles 17 and 18 at the D8S1179 loci, and alleles 16 and 20 at the vWA loci. The highest Expected Heterozygosity, PD, and PE at the D8S1179 loci. The highest number of alleles is also at D8S1179 loci. All loci followed the Hardy–Weinberg equilibrium (p > 0.05). The PD values for all tested loci ranged from 80.6 to 94.5%. CONCLUSION: We report the allele frequencies and forensic statistical parameters of seven STR loci (TPOX, CSF1PO, D3S1358, D8S1179, vWA, D5S818, and TH01) in the Nias population, which can be used as a forensic database reference for Nias populations.

Family Perceptions Toward Muslim Corpses Management of COVID-19 Patients in Padang City

Dr. M. Djamil Hospital as a referral center of COVID-19 cases in West Sumatera has a COVID-19 protocol in managing the corpses of COVID-19 patients. This study explores factors that affect patient’s family perception toward procedures of handling COVID-19 corpses. We held a qualitative study with phenomenological design to explore the family perceptions toward Muslims corpses management of COVID-19. Ten deep interviews were conducted with the ones who had their family members died by probable or confirmed COVID-19 and the corpses were managed according to COVID-19 protocols. Data triangulation was accomplished via in depth-interviews with two mortuary officers in Dr. M. Djamil Hospital. Three main themes were identified are the corpse management in COVID-19 patients, contributing factors regarding burial procedure during the COVID-19 pandemic, and challenges in managing corpses of  COVID-19 patients

Assesment of Thyroid Function and Its Association with Free Thyroxin Hormone among Pregnant Women in Areas with Previous History Iodine Deficiency in Magelang, Indonesia

Iodine deficiency in pregnant woman can affect growth and development of fetus. People who live in an area that had affected by previous iodine deficiency may continuously affect by abnormal thyroid function. The aim of the study is to assess thyroid function, that was measured by the concentrations of thyroid stimulating hormone, and its relationships with free thyroxine (fT4) among pregnant women in the two different geographic areas with previous history of iodine deficiency in Magelang, Central Java, Indonesia. Cross-sectional study was conducted in two types of location (replete and non-replete area) in Magelang, Central Java, Indonesia. A total of 243 aged between 15-45 y old with no pregnancy complication from two different geographics areas of iodine replete and sufficient were include in study. Blood biochemical markers such as free thyroxine hormone and thyroid stimulating hormone were assessed by Elisa method. Median of fT4 in non-replete and replete area was 1.18 (0.63-3.5) ng/dL; 1.12 (0.37-1.95) ng/dL, respectively. Whilst, median of TSH in replete area was 1.27 (0.09-8.21) ng/dL and non replete area was 1.3 (0.01-8.67) ng/dL. Correlation between fT4 and TSH showed significat relationship in non-replete area, r=-0.39 (<0.05), but it was not significant in replete area, r=-0.08 (>0.05). In addition, scatter plot showed the relationship between fT4 and TSH levels pattern in the replete area more widespread. Pregnant womens who live in areas that had affected severe iodine deficiency intake may have abnormal thyroid function but it still euthyroid maintain by adequate iodine intake.

5 Years Retrospective Study of Child Sexual Abuse at Dr. M. Djamil Hospital Padang Indonesia

Introduction. The purpose of this study was to analyze the profile of child sexual abuse cases. Methods. The research design was a cross-sectional analytic method. Data were obtained from medical records of child sexual abuse at Dr. M. Djamil Hospital Padang from 2012 to 2016. The sample was 114 medical records of child sexual abuse. Results. The highest incident was in the year of 2015 (28.9%). The highest age range of the victims was 11-18 years old (66.7%). Most victims were junior high school students (27.2%). The highest incident was rape (38.6%). Many of the victims were assaulted by 1 perpetrator (85.1%). An intact hymen was found in 20.2% cases and the highest non-intact hymen was old complete laceration (27.2%), The highest external genitalia examination result was no injuries (69.3%). Most of the victims had previous sexual experience (31.6%). The most commonplace of sexual abuse was the perpetrator's house (21.9%). The boyfriend was the highest rank of the sexual perpetrator (27.1%).  There was a significant relationship between child sexual abuse category and status of the hymen (p=0.00). Conclusion. Child sexual abuse categorized as molestation, rape and consent sex, while rape was the highest incident of child sexual abuse. There were various hymen lacerations had found in the victims of child sexual abuse.

Effect of knife-fish bone powder addition on characteristics of starch and seaweed kerupuk as calcium and crude fiber sources

Knife-fish bone is waste processing of kerupuk and amplang that have not been utilized optimally and potentially cause environmental pollution. Processing into a fish bone powder is one way to reduce environmental pollution and provide added value.It can be used as a fortification source of calcium in food products. Seaweed species are widely used in food processing as crude fiber and iodine sources. Therefore, it is necessary to do the processing of kerupuk with fortification of knife fish bone powder and seaweed as calcium and crude fiber sources. The objective of this research was to determine the effect of adding knife fish bone powder on characteristics of starch and seaweed kerupuk. The treatment in this study wasthe percentage of addition of knife fish bone powder: 0%, 5%, 10.15%, 20%. Calcium and crude fiber of both starch and seaweed kerupuk values varied significantly (p<0.05).Proximate values varied significantly (p<0.05) of both starch and seaweed kerupuk, except for protein and fat content. Phosphorous and whiteness level values significantly (p<0.05) for both starch and seaweed kerupuk.

Perbedaan Rerata Indeks Cephalic dan Indeks Frontoparietal antara Suku Minangkabau dan Suku Jawa

Indeks Kefalometris merupakan nilai yang menggambarkan morfologi bentuk kepala manusia. Indeks cephalic dan indeks frontoparietal termasuk dalam indeks kefalometris dan dapat menunjukkan perbedaan suku dan jenis kelamin. Tujuan penelitian ini adalah membandingkan indeks cephalic dan indeks frontoparietal pada laki-laki dan perempuan antara suku Minangkabau dan suku Jawa. Penelitian ini dilakukan dengan metode cross sectional pada 18 laki-laki dan perempuan dari suku Minangkabau dan suku Jawa yang tinggal di Kota Padang, Sumatera Barat. Indeks cephalic dan indeks frontoparietal ditentukan dari perhitungan hasil pengukuran panjang kepala, lebar kepala dan lebar dahi responden. Pada data dilakukan uji normalitas Shapiro-Wilk dan uji t tidak berpasangan untuk melihat perbedaan rerata pada kedua kelompok. Rerata indeks cephalic pada suku Minangkabau adalah 75,98 ± 0,77 untuk perempuan dan 77,41 ± 1,42 untuk laki-laki. Rerata indeks cephalic pada suku jawa adalah 86,10 ± 1,05 untuk perempuan dan 87,58 ± 1,52 untuk laki-laki. Rerata indeks frontoparietal pada suku Minangkabau adalah 91,30 ± 4,25 untuk perempuan dan 91,54 ± 4,38 untuk laki-laki. Rerata indeks frontoparietal pada suku jawa adalah 92,02 ± 3,23 untuk perempuan dan 92,04 ± 2,22 untuk laki-laki. Simpulan studi ini adalah terdapat perbedaan rerata indeks cephalic yang signifikan antara suku Minang dan Suku Jawa, juga terdapat perbedaan yang signifikan antara laki-laki dengan perempuan Minangkabau dan laki-laki dan perempuan Jawa, tetapi tidak terdapat perbedaan rerata indeks frontoparietal yang bermakna pada laki-laki dan perempuan suku Minangkabau dan Jawa.

Perbedaan Rerata Indeks Cephalic dan Indeks Frontoparietal antara Suku Minangkabau dan Suku Jawa

Indeks Kefalometris merupakan nilai yang menggambarkan morfologi bentuk kepala manusia. Indeks cephalic dan indeks frontoparietal termasuk dalam indeks kefalometris dan dapat menunjukkan perbedaan suku dan jenis kelamin. Tujuan penelitian ini adalah membandingkan indeks cephalic dan indeks frontoparietal pada laki-laki dan perempuan antara suku Minangkabau dan suku Jawa. Penelitian ini dilakukan dengan metode cross sectional pada 18 laki-laki dan perempuan dari suku Minangkabau dan suku Jawa yang tinggal di Kota Padang, Sumatera Barat. Indeks cephalic dan indeks frontoparietal ditentukan dari perhitungan hasil pengukuran panjang kepala, lebar kepala dan lebar dahi responden. Pada data dilakukan uji normalitas Shapiro-Wilk dan uji t tidak berpasangan untuk melihat perbedaan rerata pada kedua kelompok. Rerata indeks cephalic pada suku Minangkabau adalah 75,98 ± 0,77 untuk perempuan dan 77,41 ± 1,42 untuk laki-laki. Rerata indeks cephalic pada suku jawa adalah 86,10 ± 1,05 untuk perempuan dan 87,58 ± 1,52 untuk laki-laki. Rerata indeks frontoparietal pada suku Minangkabau adalah 91,30 ± 4,25 untuk perempuan dan 91,54 ± 4,38 untuk laki-laki. Rerata indeks frontoparietal pada suku jawa adalah 92,02 ± 3,23 untuk perempuan dan 92,04 ± 2,22 untuk laki-laki. Simpulan studi ini adalah terdapat perbedaan rerata indeks cephalic yang signifikan antara suku Minang dan Suku Jawa, juga terdapat perbedaan yang signifikan antara laki-laki dengan perempuan Minangkabau dan laki-laki dan perempuan Jawa, tetapi tidak terdapat perbedaan rerata indeks frontoparietal yang bermakna pada laki-laki dan perempuan suku Minangkabau dan Jawa.

HUBUNGAN KADAR HEMOGLOBIN DENGAN KADAR HORMON TIROKSIN BEBAS (FT4) PADA ANAK SEKOLAH DASAR

Latar Belakang. Anemia karena kekurangan zat besi masih menjadi masalah gizi utama di Indonesia. Kondisi ini dapat menurunkan produktifitas dan gangguan pertumbuhan pada anak usia sekolah. Zat besi merupakan bagian penting dari  thyroperoxidase (TPO) yang berperan dalam sintesis hormon tiroid. Tujuan. Mengukur hubungan antara kadar hemoglobin dengan kadar hormon tiroid bebas (free Thyroxine / fT4) pada anak sekolah dasar. Metode. Penelitian cross-sectional dilakukan di daerah perdesaan pegunungan Kabupaten Wonosobo yang mempunyai riwayat daerah endemis Gangguan Akibat Kekurangan Iodium. Sebanyak 141 anak usia sekolah dasar diukur status gizi, kadar hemoglobin dan free Thyroxine (fT4). Besar sampel dihitung berdasarkan Pearson product-moment correlation coefficient. Data dianalisis menggunakan uji statistik korelasi Pearson. Hasil. Sebanyak 47,5% partisipan tergolong pendek, 24,1% menderita anemia, rata- rata kadar hemoglobin dan hormon tiroid bebas berada pada kisaran normal 12,6 g/dL dan 1,5 ng/dL secara berturutan. Terdapat hubungan positif antara kadar hemoglobin dengan kadar hormon tiroid bebas dengan rho sebesar 0,24 (p < 0,05). Kesimpulan. Kadar hemoglobin berhubungan dengan kadar hormon tiroksin bebas (fT4).  

Korelasi Kadar Alkohol dengan Derajat Luka Dalam Hal Pembuatan Visum Et Repertum pada Pasien Kecelakaan Lalu Lintas Rumah Sakit M. Djamil Padang

Angka kejadian kecelakaan lalu lintas masih cukup tinggi. Salah satu penyebab terjadinya kecelakaan lalulintas adalah penggunaan alkohol. Tujuan penelitian ini adalah menentukan korelasi antara kadar alkohol dan derajatluka dalam hal pembuatan visum et repertum pasien kecelakaan lalu lintas selama bulan Agustus sampai November2017. Pasien kecelakaan lalu lintas yang masuk ke UGD RSUP Dr. M Djamil diperiksa kadar alkohol pada nafasnya.Jika positif kadar alkohol di nafas maka akan dilanjutkan pengambilan darah dan akan di periksa kadar alkoholnyamenggunakan GC-MS. Derajat luka dinilai dari tingkat keparahan cedera sesuai derajat luka menurut Kitab UndangundangHukum Pidana (KUHP). Hasil penelitian didapatkan 859 pasien kecelakaan yang bisa diperiksa kadar alkoholpada nafasnya, tetapi hanya 10 orang yang positif. Rerata kadar alkohol di nafas adalah 0,41 mg/dl. Rerata kadaralkohol pada darah adalah 32, 04 gr/dl. Kadar alkohol pada darah pada penelitian ini tergolong kadar yang rendah halini sesuai juga dengan temuan luka pada pasien berupa luka derajat ringan hingga sedang. Simpulan studi ini adalahtidak terdapat hubungan antara kadar alkohol dengan derajat luka. Keterbatasan penelitian ini adalah jumlah sampelyang sedikit sehingga diperlukan penelitian yang lebih lanjut.

Korelasi Kadar Alkohol dengan Derajat Luka Dalam Hal Pembuatan Visum Et Repertum pada Pasien Kecelakaan Lalu Lintas Rumah Sakit M. Djamil Padang

Angka kejadian kecelakaan lalu lintas masih cukup tinggi. Salah satu penyebab terjadinya kecelakaan lalulintas adalah penggunaan alkohol. Tujuan penelitian ini adalah menentukan korelasi antara kadar alkohol dan derajatluka dalam hal pembuatan visum et repertum pasien kecelakaan lalu lintas selama bulan Agustus sampai November2017. Pasien kecelakaan lalu lintas yang masuk ke UGD RSUP Dr. M Djamil diperiksa kadar alkohol pada nafasnya.Jika positif kadar alkohol di nafas maka akan dilanjutkan pengambilan darah dan akan di periksa kadar alkoholnyamenggunakan GC-MS. Derajat luka dinilai dari tingkat keparahan cedera sesuai derajat luka menurut Kitab UndangundangHukum Pidana (KUHP). Hasil penelitian didapatkan 859 pasien kecelakaan yang bisa diperiksa kadar alkoholpada nafasnya, tetapi hanya 10 orang yang positif. Rerata kadar alkohol di nafas adalah 0,41 mg/dl. Rerata kadaralkohol pada darah adalah 32, 04 gr/dl. Kadar alkohol pada darah pada penelitian ini tergolong kadar yang rendah halini sesuai juga dengan temuan luka pada pasien berupa luka derajat ringan hingga sedang. Simpulan studi ini adalahtidak terdapat hubungan antara kadar alkohol dengan derajat luka. Keterbatasan penelitian ini adalah jumlah sampelyang sedikit sehingga diperlukan penelitian yang lebih lanjut.

DNA MITOKONDRIA (mtDNA) SEBAGAI SALAH SATU PEMERIKSAAN ALTERNATIF UNTUK IDENTIFIKASI BAYI PADA KASUS INFANTISIDA

Forensik molekuler merupakan salah satu cabang ilmu kedokteran forensik yang memanfaatkan perkembangan teknologi biologi molekuler dalam memecahkan berbagai kasus forensik seperti pencarian orang hilang, pelacakan pelaku pembunuhan, kasus ragu ayah dan infantisida. Infantisida atau pembunuhan anak sendiri merupakan pembunuhan yang dilakukan oleh ibu kandung terhadap bayinya segera setelah bayi tersebut lahir karena takut ketahuan. Salah satu hal penting dalam pengelolaan kasus infantisida adalah pengungkapan identitas jenazah orok dan pelaku infantisida agar proses hukum terhadap tersangka pelaku menjadi jelas. Penggunaan DNA (Deoxyribose Nucleic Acid) mitokondria atau mtDNA sebagai salah satu cara untuk mengetahui hubungan antara barang  bukti  medis  dengan  pelaku  berkembang  pesat  setelah  era  90an.  DNA  mitokondria memiliki beberapa kelebihan dalam identifikasi yaitu laju mutasi mtDNA lebih tinggi daripada nDNA (variasi tinggi dalam  populasi), mtDNA diturunkan hanya dari pihak ibu dan sel manusia dapat memiliki ribuan kopi mtDNA yang sama serta dapat diterapkan pada jenazah bayi dalam keadaan busuk lanjut. Perbandingan antara sampel DNA bayi dengan sampel DNA tersangka ibu menggunakan metode sekuensing PCR (Polymerase Chain Reaction). Pengambilan kesimpulan akhir pada pemeriksaan hubungan keibuan pada mtDNA harus dikombinasi dengan pemeriksaan forensik lainnya.

Developing a competence-based addiction medicine curriculum in Indonesia: the training needs assessment

Indonesia has one of the fastest growing, injecting drugs user-driven, human immunodeficiency virus (HIV) epidemics in Asia. Coverage of needle and syringe programs (NSPs), opioid substitution therapy (OST), and antiretroviral treatment (ART) is increasing, but is still low, whereas professional training in addiction medicine is not yet established. Urgent development and scaling-up of professional capacity in comprehensive, evidence-based addiction medicine is needed. In this article the results of the first step is presented, being the training needs assessment (TNA) and the process of further developing a national evidence- and competence-based addiction medicine curriculum in Indonesia.