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Background: Online School was actively carried out during the COVID-19 pandemic in order to reduce social interaction, minimize outdoor activities, and decreasing airborne virus transmission. This activities mainly uses virtual media. During activities, students are advised and ordered to stay inside their house, which causes reduction towards physical activities. Said actions, causes a significant change in their lifestyle and can increase the risk of obesity. Objective: To find out the phenomenon of obesity in conventional education school students, from elementary to high school, during the transition from face-to-face learning to long distance learning. Methods: Reviewing several published scientific articles regarding the phenomenon of increased risk of obesity due to online school during the COVID-19 Pandemic. Results: There is a relationship between online school that increased risk of obesity where are sedentary behavior, stress, and diet. This is because online school makes decreased physical activity, increased screen time, irregular sleep patterns, and stress. This can be experienced by any students. Conclusion: Online learning during the COVID-19 pandemic is proven to escalate risks in students becoming obese, according to an additional increase in their sedentary lifestyle. Hence a modification in their lifestyle and routine is highly needed.

Background: Exclusive breastfeeding is giving breast milk exclusively from newborns to 6 months of age without giving any food. Exclusive breastfeeding is essential for optimal baby growth and development, contains various essential nutrients for babies. In 2018 the coverage of exclusive breastfeeding in Indonesia still reached 65.16%, and the coverage of breastfeeding in East Java itself was still below the target of 76.98%. The low level of exclusive breastfeeding is still a problem because it can cause the baby's immune system to become lower, indigestion and illness risk in the baby is more generous to target. Objective: To determine the relationship between mothers' level of knowledge about breastfeeding and exclusive breastfeeding at Kenjeran Primary Health Center. Methods: This observational analytic study with a cross-sectional study design. The sampling technique was using the purposive sampling technique. Respondents in this study were mothers who had babies 6-24 months. The data collection process was directly asked through a questionnaire and analyzed using the contingency coefficient test. Results: This study involved 51 mothers who gave exclusive breastfeeding and 51 mothers who did not. The results showed that most of the respondents who breastfed and did not have the right knowledge level. Based on the contingency coefficient test results, it was found that there was no relationship between the level of mother's knowledge about breast milk to give exclusive breastfeeding at the Kenjeran Primary Health Center (the value of p = 0.251). Conclusion: There is no relationship between mothers' level of knowledge about breastfeeding and exclusive breastfeeding at the Kenjeran Primary Health Center.

Latar Belakang: Menurut data WHO tahun 2012, stroke merupakan penyakit yang menyebabkan kematian terbesar ketiga di seluruh dunia setelah kanker dan penyakit jantung koroner serta terdapat 6,2 juta kematian disebabkan oleh stroke. Pada kondisi stroke akut sering kali mengalami hipertensi, hiperglikemia,dan leukositosis. Kenaikan kadar gula darah pada pasien stroke yang tidak memiliki riwayat diabetes sebelumnya disebut dengan hiperglikemia reaktif. Hal ini dapat mempengaruhi mortalitas dan morbiditas dari penderita stroke. Dimana kelainan ini kemungkinan disebabkan oleh peningkatan drastis sekresi kortisol sebagai respon terhadap segala jenis situasi stress yang diperantarai oleh susunan sistem saraf pusat melalui peningkatan aktivitas sistem aksis hipotalamus-pituitari-adrenal. penelitian ini dilakukan untuk melihat outcome atau hasil keluaran dari pasien stroke akut yang mengalami hiperglikemia dan akan dievaluasi dengan Indeks Barthel. Tujuan: Untuk mengetahui adanya hubungan antara hiperglikemia reaktif pada stroke fase akut dengan keluaran pasien stroke berdasarkan Indeks Barthel di Rumah Sakit Siti Khodijah Sepanjang Metode: Menggunakan desain cross sectional dengan teknik pengambilan sampel sampling from consecutive admission yaitu menurut kasus yang datang berturut-turut sampai jumlah sampel terpenuhi. Penelitian ini dimulai dengan mengambil daftar pasien yang mengalami stroke iskemik di Instalasi Gawat Darurat, kemudian mengambil data pasien di ruangan rawat inap dengan melihat berkas rekam medis pasien untuk melihat nilai gula darah acak pasien pada fase akut serangan stroke, setelah itu melakukan penilaian Indeks Barthel pada hari kelima pasien dirawat. Hasil: Hasil uji statistik menggunakan Koefisien Kontingensi didapatkan nilai signifikan p: 0.039 (p

Extranodal non-Hodgkin lymphoma still seems to be a rare case and an issue to discuss a lot. Clinical evidence and guidelines on treatment have not yet been widely published and accessible. We present a case of a forty-five-year-old male with the chief complaint of a bulky and huge right mass in the testis with an ulcer on it. The patient underwent an orchiectomy, and the biopsy showed a malignant round cell tumor, suspected as non-Hodgkin lymphoma. The patient then received the following treatment: chemotherapy with R-CHOP regiment every three weeks, consisting of 6 cycles showing shrinkage size of the testis by day 7 and final complete response after 4th cycle with ADE grade 0 no sexual activity disorder after chemotherapy. This raises hope in developing treatment modalities that the right choice on chemotherapy regimen with complete control on the drug effects may improve clinical outcome and patient’s quality of life.

ABSTRACT Covid-19 patients with Diabetes mellitus (DM) ranked third after hypertension and cardiovascular disease with an estimated 36% of all Covid-19 cases. These patients have a risk of experiencing a higher complication possibility since their metabolic disorder can cause hyperglycemia to the patient. It is showed that the number of deaths reached 7,3%, which is higher than non-diabetes. The increase of DM patients caused by stress factors may trigger the onset of glucose in blood sugar, and the glucose variability became abnormal. This circumstance may cause a glycemic increase that causes the predisposition intensification of susceptible affected by Covid-19. Good management is truly needed for DM patients affected by Covid-19. It is hoped to reduce the risk factor, such as preventing complications and increasing life quality by regular medical check to have a good prognosis. Some research showed that Covid-19 patients with DM are essential in ICU and need more treatment attention as they may experience Acute Respiratory Distress Syndrome (ARDS). Diabetes mellitus patients' treatment strategy is to manage the blood glucose level, especially in post-prandial glucose. This literature aims to know the degree of serious illness of Covid-19 patients by the comorbidity of DM in this pandemic event. Keywords: Covid-19, Sars-Cov-2, Diabetes Mellitus, risk factors, Correspondence: jasminananda@gmail.com

ABSTRACT Infection in the elderly is the second leading cause of morbidity and death in the world after cardiovascular disease. This event is closely related to the increase in the elderly population in the last few decades caused by an increase in human life expectancy. The causes of infection in elderly due to the presence of considerable chronic comorbidities, decreased resistance or immunity to infection, decreased communication power in the elderly and difficulty recognizing signs of infection early. Infection in the elderly is not only more frequent and more severe, but also have specialties related to clinical, laboratory and microbiological presentations. The purpose of this review is to provide an overview of the predisposition of infectious diseases in the elderly, immunesenescence in the elderly, the appropriate diagnostic and treatment approach in cases of infection in the elderly. Keywords : infection, elderly, immunesenescence Correspondence to : drkartikaprahasanti@gmail.com ABSTRAK Infeksi pada usia lanjut merupakan penyebab kesakitan dan kematian terbanyak kedua di dunia setelah penyakit kardiovaskuler. Kejadian ini berhubungan erat dengan peningkatan populasi penduduk usia lanjut pada beberapa dekade terakhir yang diakibatkan oleh peningkatan usia harapan hidup manusia. Penyebab terjadinya infeksi pada usia lanjut banyak disebabkan oleh karena adanya adanya penyakit komorbid kronik, penurunan daya tahan atau imunitas tubuh terhadap infeksi, penurunan kemampuan komunikasi pada usia lanjut sehingga jarang didapatkan keluhan serta sulitnya mengenal tanda infeksi secara dini. Infeksi pada usia lanjut tidak hanya lebih sering terjadi dan lebih berat, namun juga memiliki kekhususan terkait presentasi klinis, laboratorium maupun mikrobiologi. Tujuan dari tinjauan ini adalah untuk memberikan gambaran mengenai predisposisi penyakit infeksi pada usia lanjut, gangguan respon imun pada usia lanjut (immunesenescence), pendekatan diagnosis dan tatalaksana yang tepat pada kasus infeksi pada usia lanjut. Kata kunci : infeksi, usia lanjut, gangguan respon imun Korespondensi : drkartikaprahasanti@gmail.com