with mental dissertation is mesinah are also active in the activities organized by
the local government melalaui training centers along with village communities
of coral Patihan to conduct skills training for local residents in making
mats. The program is very helpful in increasing the creative power of the
local community and increase revenue to increase household income. in addition,
residents also involve people with mental retardation to participate actively
participate in these activities, so it can be interpreted that the local people are
very open to people with mental retardation.
Various aspects of the functioning of independence that formed the beginning
social values such as participation in various events are part of a sense of
community in accepting the opening of residents with mental retardation. The
support given as a form of legality as citizens in society.
Conclusion and suggestion
The advice given in this study include the provision of social support,
especially in the form of material assistance should be adjusted to the
needs and conditions of each persons with mental retardation, so that the
development of self-reliance capability can be awakened every individual and
the aid can be targeted to the needs of the community. Role of health workers
of family support in providing teaching more optimal
in improving the behaviors that will be taught are broken
down into small parts in sequence and basic routine that can foster personal
performance of providing health care. The quantity in human resources also
need to be increased in a bid assistance responsibility to be given to the
to people with mental retardation. provision of a learning activity in their
daily lives. the role of interaction of social relations within the family such as
communicating effectively with the immediate family and the community by
following religious activities can be a filter in negative behavior
Picture 1 : the activities of person with mental retardation
Provision of optimal support through a person approach the center with
assistance, both material and non- material as well as increased legal
identity as a society through the application of the rules of religious and
1395 Pattern intensive assistance in changing
peoples minds so that people receive medical care through the ministry of
health centers. Extraordinary School SLB as an educational institution to
monitor the condition of people with special needs such as persons with
mental retardation. SLB role can reach out and provide character education in
accordance with the level of mental retardation condition experienced by
people with evaluations involving the participation of family members,
especially the pattern of care provided by parents
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1398
DURATION EFECT OF TREATMENT AND THE FAMILY’S MOTIVATION FOR MEDICATION ADHERENCE OF LEPERS
Ema Mayasari
Stikes Surya Mitra Husada Kediri Email:
eyasaymail.com
ABSTRACT
In the treatment of leper, the problem that often arises is the medication adherence of lepers. Treatment of leprosy is need of the familys role in providing the motivation and
supervision to the lepers to taking medication regularly. Medication adherence influenced due to the treatment of leprosy was 2 years old and supervision period up to 5 years. Long
duration of treatment is what often encourage lepers disobedient to take medication of leprosy.The design of this research was quantitative with correlation design. The
approach was cross sectional. The population was all 38 lepers in Leprosy Hospital of Kediri, and 31 responders were taken as samples by simple random sampling technique.
The duration of treatment and family‟s motivation data were obtained from questionnaires and the drugs consumption obedience data were obtained from the
observation sheets. The result data was expressed in ordinal data scale and analyzed with Chi Square Test. The research resulted that most respondents who have long treatment 6
months as many as 20 respondents 64.5, the family‟s motivation majority of respondents in the low category as many as 14 respondents 45.2, while the majority of
respondents have high levels of adherence drugs with category obedient as many as 19 respondents 61.3. duration of treatment had no effect on medication adherence of
lepers p = 0.098 0.05, while the family‟s motivation had effect on medication
adherence in patients with leprosy in Kediri Leprosy Hospital p = 0.012 0.05. The family‟s motivation would motivate the patients that their lives were still meaningful;
they were still needed, and still loved. It would become the patients‟ inner motivation to rise up again.
Key Word : Leprosy, Duration Of Treatment, Motivation, Medication Adherence
INTRODUCTION
Leprosy is a chronic disease caused by the bacterium Mycobacterium
leprae in the skin and peripheral nerves. The clinical manifestations of this
disease varies greatly with the spectrum that is between the two clinical forms
are lepromatous and tuberculoid. In patients with type lepromatous leprosy
attacks the upper respiratory tract and skin disorders in the form of nodules,
papules, macules and in large quantities. In patients with tuberculoid leprosy skin
lesions are usually single and rare, firm lesion boundary, numbness Zulkifli,
2005.
Nationally, the prevalence of leprosy is about 1.25 case per 10,000
population. According to the Ministry of
1397 Health 2011, the number of leprosy
patients nationwide in 2011 was 17 021 cases. In East Java Province leprosy is
endemic. Based on data in East Java Provincial Health Office in 2010 - 2011
has recorded 6326 cases. From the results of data collection beginning on
12 January 2012, the number of leprosy patients hospitalized in 2010 377 people
and in 2011 had increased by a total of inpatients who registered 752 people
and in 2012 as many as 424 people.
Problems often encountered in the treatment of leprosy patients is the
appearance of disobedience patients in taking medication, it is because the
process of healing leprosy very long that is for one full year and even then if
patients adhere in taking medication, but on the contrary if patients do not comply
then the treatment will even longer Susilowati, 2007.
Treatment of leprosy is in need of the familys role in providing the
motivation and supervision to the patient to take medication regularly. This is
because the process of the treatment of leprosy was 2 years old and supervision
period up to 5 years. The length of this leprosy treatment process that often
encourage patients to take medicine not comply leprosy. Program Multi Drug
Therapy MDT was initiated in 1981, when WHO Chemotherapy Study Group
officially issued recommendations leprosy treatment with MDT-WHO
regimen.
This regimen consists of a
METHODE
The research design used in this research is quantitative research design
correlation. The approach used is cross sectional research that independent
variables and the dependent variables were measured simultaneously and
carried instantaneous or once Nursalam, 2008. The population in this
study were all lepers in Kediri Leprosy Hospital amounted to 38 people with
samples taken amounted to 31 people by simple random sampling. Independent
variable in the study was duration of
treatment and the family‟s motivation, while dependent variable in this study is
a medication adherence. The analyzed with Chi Square Test.
combination of drugs dapsone,
rifampicin, and klofasimin. Besides overcoming dapsone resistance is
increasing, the use of MDT is also intended to reduce noncompliance of
patients and decrease the dropout rate- medication dro-out are quite high
during dapsone monotherapy. Besides, it is also expected to eliminate the
persistence of the bacteria can MDT leprosy in the network WHO, 2008.
According to Arifin 2008, the family often get bored with the treatment of
leprosy and let his family suffer from leprosy or not taking the medicine. This
ultimately led to drop out.
Based on the above researchers interested in conducting research Effect
duration of treatment and family motivation toward medication adherence
in patients with leprosy in Kediri Leprosy Hospital.
RESULTS AND DISCUSSION
Based on Table 1, it was found that the distribution of 31 respondents
based characteristics of the majority of the respondents aged between 20 years
to 50 years which amounted to 29 respondents 93.5. Most respondents
had education on elementary school is 17 respondents 54.8. Most of the
respondents are male is 18 respondents 58.1. Most respondents did not work
ie 25 respondents 80.6.
Based on Table 2, it was found that the distribution of respondents by
the majority of respondents have a variable length of treatment is less than
6 months is 20 respondents 64.5.
Most respondents have low family‟s motivation of 14 respondents 45.2,
and medication adherence on obedient
category by 19 respondents 61.3. Table 1. Distribution of respondents by Characteristics
Variable F
Age Education
Gender Work
20 years 20 years
– 50 years Elementary School
Junior high school Senior High School
Man female
Did not work Entrepreneur
2 29
17 13
1 18
13 25
6 6,5
93,5 54,8
41,9 3,2
58,1 41,9
80,6 19.4
1398
Table 2 Distribution of Respondents by Variables Variabel
F Duration Of Treantment
Family‟s Motivation
Medication Adherence 6 month
6 months - 1 year low
moderate height
Not obey less obedient
obedient 20
11 14
8 9
8 4
19 64,5
35,5 45,2
25,8
29 25,8
12,9 61,3
Based on Table 3, it was found that most of the 20 respondents with a
duration of treatment is less than 6 months has medication adherence on
obedient category by 15 respondents. There are also some of the 11
respondents with a duration of treatment between 6 months to 1 year with
medication adherence in patients with leprosy in Kediri Leprosy Hospital.
Motivation in principle is an impulse Robbins, 2003. Stanton 2004
also confirmed that motivation is a boost to the needs and desires aimed to obtain
the fulfillment of a need or desire. According Sugiyono 2005, a person
medication adherence on not obey
who has motivation characterized by the category there are 5 respondents. Based
on statistical test results showed that the value of sig. 0098 showed that duration
of treatment had no effect on medication adherence of lepers.
Based on Table 4, it was found that the majority of respondents had a
low motivation from family with medication adherence on not obey
category by 7 respondents. Respondent who
has a height family‟s motivation with medication adherence on obedient
category there are 9 respondents. Based on statistical test results showed that the
value of sig. 0012 showed that the
family‟s motivation had effect on tendency of a challenging task, but not
above his ability. Likewise, the families who have the motivation to remind
members of his family who are sick to take medicine, it will provide the
greatest motivation for patients to carry out therapy obediently. For example, a
husband and child support on sick wife will give a huge motivation to recover.
Society also affect compliance in treatment. Conditioning in society
sometimes impede the patient to carry out treatment obediently for example
when someone is not allowed to smoke but the encouragement of promiscuity in
society lead to patient non-compliance
Mohibbin, 2008. Table 3 Duration Efect Of Treatment for medication adherence of lepers
Medication Adherence of lepers Not Less obedient
Obey Obedient Total
Asymp. Sig.
Duration of 6 monts
3 2
15 20
Treanment 6 monts
– 1 yaars Total
5 8
2 4
4 19
11 31
0,098
1399
Table 4. Effect of Motivation From Families for medication adherence of lepers Medication Adherence of Lepers
Not Less obedient Obey Obedient
Total Asymp.
Sig. Motivation From
Family low
moderate height
Total 7
1 8
3 1
4 4
6 9
19 14
8 9
31 0,012
the family‟s motivation had effect on Found no association with the
level of family motivation medication adherence in patients with leprosy
caused by lack of support from family members, the person feels that his life
still has meaning, are still needed, still cherished. It will be a source of internal
motivation of the patient to get up again. The existence of this motivation will
ultimately arise from the boost in self- lepers that I had to recover from her
illness. Therefore there will be a positive mindset that ultimately propel him to
always take medication as recommended by health officials. On the other hand
patients themselves also have another source of motivation in addition to
family support such as information obtained from friends or other people
related to the principle of treatment of leprosy. The existence of fear if the
disease progresses, causing physical disability and so on will also improve
compliance in taking medication leprosy. Background job that requires
physical appearance also causes adherence to taking medication. But the
most important thing to mention is the motivation of members of his family
who always provide motivation in the treatment of leprosy.
CONCLUSIONS
The conclusion of this study are most respondents who have long
treatment 6 months, the family‟s motivation majority of respondents in
the low, while the majority of respondents have high levels of
adherence drugs with category obedient. duration of treatment had no effect on
medication adherence of lepers, while
1400 medication adherence in patients with
leprosy in Kediri Leprosy Hospital.
ACKNOWLEDGEMENT
In this study are expected in health care workers especially on
personnel handling lepers both in hospitals and in health centers to
disseminate and apply to the families of lepers in order to provide motivation to
lepers taking medication adherence. It is also expected that the community
concerned with lepers and help provide motivation to take medication in order
lepers obediently consume leprosy drugs.
REFFERENCES
Achmad S
. Ruky. 2003
.
Sumber Daya Manusia Berkualitas Mengubah.
Visi Menjadi Realitas
. Jakarta: PT Gramedia Pustaka Utama
Darwis, S.D. 2003.
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. Jakarta : Buku Kedokteran EGC.
Depkes RI. 2000.
Parameter Standar Umum Ekstrak Tumbuhan Obat
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Buku Pedoman Nasional Pemberantasan
Penyakit Kusta, cetakan XVIII
, Jakarta: Direktorat Jenderal
Pengendalian Penyakit dan Penyehatan Lingkungan
Depkes RI. 2007.
Profil Kesehatan Indonesia Tahun 200
6. http : www.depkes.go.id
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Irianto, S. 2010.
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Efendi, Nasrul. 2002.
Keperawatan
Kaplan, Sadock, dkk. 2007.
Psikiatri Kesehatan Masyarakat
. Jakarta : EGC.
Hastomo, W. 2007.
Statistik Kesehatan
. Jakarta : Rinneka Cipta.
Martin Handoko.2008.
Motivasi Daya Penggerak Tingkah Laku
. Yogyakarta: Kanisius.
Hamzah, 2009.
Teori Motivasi Dan Pengukurannya
. Jakarta : Bumi Aksara
1401
Klinis
. Jakarta : EGC. Letnan Dailimonte. 2008.
Gambaran Persepsi Penderita Tentang
Penyakit Kusta Dan Dukungan Keluarga Pada Penderita Kusta
Di Kota Manado
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Niven
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Psikologi kesehatan
. Jakarta : EGC
EFFECT OF GIVING ISOFLAVONE GENISTEIN DURING THE PERIOD OF PRE- PUBESCENT VAGINA HISTOLOGY , ESTRADIOL CONCENTRATION AND
OVULATION IN FEMALE MICE MUS MUSCULUS L 1 YennyPuspitasari; 2 Byba Melda Suhita
Lecturer Nursing Science Program Institute of Health ScienceSurya Mitra Husada
Email : yenny_puspita80yahoo.co.id
ABSTRACT
The condition of precocious puberty is triggered by the brain spontaneously or due to the effects of chemicals from outside the body and this process usually begins at the end of childhood marked signs
of early maturity of the reproductive organs and have been the end of the growth period. Genistein is an isoflavone-containing soybean group that can interact with the animals and the human estrogen
receptor, which causes the effects in the body similar to the hormone estrogen.The aim of this study was to determine the effect of isoflavon genistein over a period of pre-pubescent on the histology of
the vagina, the concentration of estradiol and ovulation in female mice Mus musculus L. This type of experimental research was true experiment, with the design of Complete Random Design.
Experiment consists of two groups: a control group given 0.1 cc of distilled water and the treatment group given isoflavone 6 mg gr BB + 0.1 cc distilled water, each consisting of 12 female mice
were placed into groups randomly , The statistical test used independent t-test. The data were
analyzed using SPSS 18. The result is said to be significantly different if the p value ≤ 0.05. The results showed histological examination of the vagina in the treatment group and the control group
there was no difference in the thickness of the vaginal epithelium in mice pre-puberty. On the results of the examination showed estrogen treatment group higher levels of the hormone estrogen than the
control group. At ovulation test results showed the treatment group and the control group experienced no ovulation in pre-pubertal mice, but at this stage of the growth of tertiary follicles in the treatment
group more numerous than the control group. Isoflavon Genistein not lead to differences in the size of the thickness of the vaginal epithelium in mice pre-puberty, increases the levels of estrogen in pre-
pubertal mice and increase the number of tertiary follicles in mice pre-puberty, does not cause ovulation in pre-pubertal mice.
Keywords: isoflavon genistein, pre-pubescent, histology vaginal estradiol concentration and ovulation INTRODUCTION
Entirely from various sources stated that the precociuos puberty
incident occurred Precocious puberty is a condition in which
puberty occurs early children in general, which is about the age of 9-14 years in girls and 10-
17 years of age in boys. This condition is triggered by the brain spontaneously or due to
the effects of chemicals from outside the body and usually this process began at the end of
childhood less than age 9 years with marked signs of maturation of the reproductive organs
early and have expiration growth. Early puberty can be a part of normal developmental
variation of someone, but it can also be a disease or exposure to abnormal growth
hormone.
1404 predominantly in girls than boys. This is
possible because precocious puberty brings an autosomal dominant genetic trait and more
often as a result of exposure to the hormone estrogen early in infancy. For girls often
caused by idiopathic etiology and vice versa in boys was significantly highest in the brain
caused by the disease.
A research has stated that a girl who are overweight or has a body mass index BMI is
worth obesity often show the physical characteristics of the occurrence of early
puberty. Other studies revealed the substance Bisphenol-A BPA which is a raw material
Group Mean
Std. Deviation
Std. Error Mean Treatmen
t Control
.2464615 5
.0498264 6
.068044848 .010745593
.019642856 .003101985
group Mean
Std. Deviation
Std. Error Mean Treatment
Control 273.9667
256.4500 109.04977
136.33865 31.47996
39.35758 for making goods of plastic and are often used
by infants and young children plastic bottles can stimulate increased levels of the hormone
estrogen, which in turn can lead to precocious puberty.
Soybean and processed products are very much consumed by the people of Indonesia,
because besides the price is cheap, soy also contains carbohydrates, high protein, vitamins,
as well as several other important minerals. It is known that soy contains phytoestrogens.
mice were placed into groups randomly . Statistic test used is the independent t-test.
Independent t-test was used to test the concentration of estradiol comparison between
the treatment group and the control, ovulation comparison between treatment and control
group, the thickness of the vaginal epithelium comparison between the treatment group and
the control regardless of estrus phase. The data were analyzed using SPSS 18. The result said
there was to be significantly different if the p value ≤ 0.05.
Phytoestrogens are a material substrate structure, biological activity and properties of
estrogen derived from growing plants. T-TEST INDEPENDENT RESULTS
Genistein was one of the few Isoflavones, including a group of plants, with soybeans and
soy products such as tofu, soy milk, tempeh, soy and vegetable protein become an
important one in the food. Soy isoflavones are a group containing soybean. She has a function
as antioxidants, some isoflavones can interact with the animals and the human estrogen
receptor, which causes the effects in the body similar to the hormone estrogen.
Refers to the breadth and the free consumption of isoflavones genistein in everyday life, as
well as evidence-based isoflavones genistein can cause effects in the body similar to the
hormone estrogen, the research was structured in such a way to to learn whether the hormonal
changes after the administration of the isoflavones genistein significant enough to
induce changes in histology vagina, concentrations of estradiol and ovulation in
female mice Mus musculus L strain DD Webster.
RESEARCH METHODS This type of research is experimental research
is true experiment, with the design of Complete Random Design RAL. Experiment
consists of two groups: a control group given 0.1 cc of distilled water and the treatment
group given isoflavone 6 mg gr BB + 0.1 cc distilled water, each consisting of 12 female
1405 Histology vagina at the age of mice 4 weeks
after administration of isoflavone genistein
That there is no difference in the thickness of the vaginal epithelium children between the
group of mice given isoflavones genistein treatment and control groups. Giving
isoflavones genistein did not cause changes in the size of the thickness of the vaginal
epithelium in mice pre-puberty. With p = 0731 0.05.
The concentration of estradiol in mice at the age of 4 weeks after administration of
isoflavone genistein
There is a difference of estrogen in the control group and the treatment group with a
difference of 0.196635090 and p = 0.000 0.05. Giving isoflavone genistein cause
changes in estrogen levels in the treatment group this is due to the content of isoflavone
genistein provide a great stimulus to increased levels of estrogen in pre-pubertal mice.
Overview of ovulation in the ovaries of mice at the age of 4 weeks after administration of
isoflavone genistein genistein and control groups. Giving
isoflavone genistein causes estrogen levels in pre-pubertal mice was higher than the control
group
3. There is a difference in development of tertiary follicles of mice between treatment
groups were given isoflavones genistein and control groups. Giving isoflavone genistein
causes tertiary follicles in mice pre-pubertal more than the control group. Ovulation is not
found in the control group and the treatment group.
Follicles Std.
N Mean
Deviation Std. Error MeanSuggestion Primer
12 12
6.8333 7.0000
2.08167 .60093 2.00000 .57735
Further research is needed in the longer period of time or the dose needs to be improved in
12 4.3333 1.07309 .30977
order to give the
effects of isoflavones Secondar
12 4.7500
.96531 .27866 genistein on ovulation and estrus phase in
y post-pubertal female mice.
Tertiary De -
12 12
12 12
4.5000 4.2500
2.5833 1.8333
1.24316 .35887 1.05529 .30464
.79296 .22891 .83485 .24100
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untuk wanita menopause. Graff
There is effect of isoflavone genistein on the development of tertiary follicles in the
treatment group. Ovulation is not found in the control group and the treatment group. With a
value of p = 0.034 0.05.
CONCLUSIONS AND SUGGESTIONS Conclusion
1. There is no difference in the size of the thickness of the vaginal epithelium between
the group of mice given isoflavones genistein treatment and control groups. Giving
isoflavones genistein did not cause changes in the size of the thickness of the vaginal
epithelium in mice pre-puberty.
2. There is a difference in estrogen levels between treatment groups given isoflavones
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1408
Formulation and Characterisation of Granule Effervescent Cilembu Sweet Potato
Ipomoea batatas
L. Lamk Extract With Concentration Variation of Citric
Acid and Sodium Bicarbonate Dewi Resti Basuki
INSTITUT ILMU KESEHATAN BHAKTI WIYATA KEDIRI
Abstract
Nowdays there are many people interested in consuming traditional drugs because of the chemical compound. Effervescent granule extract cilembu sweet potato is made from
citric acid, tartaric acid, sodium bicarbonate, saccharum lactis, PVP Polivinylpirolidone, extract cilembu sweet potato. The purpose of this study to determine the effect of varying
concentrations of acid and alkaline source to the physical quality of effervescent granules. The through is use dry granulation method.There are three variations of the formula one
of them with a citric acid concentration of 4.7, 4.3, 3.9. Tartaric acid concentration of 9.4, 8.6, 7.8 and 11.7 base concentration, 12.8, 13.8. Evaluation extracts
include organoleptic test, test-free ethanol, qualitative test. Evaluation of the physical quality of the granules include organoleptic test, test flow properties, the test angle of
repose, solubility test, pH test. Research result show that average pH 4,3., average angle of repose 25,42o., average flow properties 0,740gramdetik, solubility 1 minute second 10
. Data were analyzed by One Way ANOVA test. Statistic data show that there is no meaningfull difference and significance standart p 0,05.
Keywords : Formulation and Characterisation, Granule Effervescent, Sweet Potato
Cilembu
Ipomoea batatas
L. Lamk Extract
INTRODUCTION
Indonesia is widely known as the mega centers of biodiversity after
Brazil‟s second largest, consisting of tropical plants and marine life. Indonesia
there are about 30,000 species of plant and 7,000 of them are known to have a
efficacy as drugs. This biodiversity needs to be researched, developed and
utilized to improve the health and economic goals, while maintaining
sustainability WHO, 2002. The richness like this should be utilized as
well as possible for remembering
people‟s food need increase with population growth. Cilembu sweet
potato is a food that has a high nutritional value and potentially in
Indonesia. Sweet potato varieties when viewed from the color of the tuber
consist of white sweet potato, sweet potato yellow and purple sweet potato
Amin
et al.,
2008. Sweet potatoes
1430 Cilembu known because it has a sweeter
taste than other sweet potatoes Suparman, 2007. Sweet potatoes
Cilembu is a plant of the family Convolvulaceae, which have
carbohydrate, protein, fat and mineral such as iron Fe, phosphorus P and
Calcium K Erawati, 2006. It also contains vitamins, vitamin found in
sweet potato Cilembu such as, vitamin A which contained in the form of
- carotene and vitamin C Meludu, 2010.
Compounds carotene in sweet potatoes Cilembu an antioxidant compound that
can prevent the onset of cancer Winarti, 2010.
Cilembu sweet potatoes beneficial as a powerful antioxidant to neutralize
free radicals malignancy, causing premature aging and heart disease,
thereby it can increasing the durability
and immunity againts degenerative diseases.
chemical reaction solution. The gas produced is carbon dioxide when the
Defined as the effervescent
dissolution effervescent so as to give dosage form of granules which
degenerates gas bubbles as a results of a
METHOD
The study was conducted in Solida Laboratory and Biology of
Pharmacy Laboratory in Pharmacy Institut Ilmu Kesehatan Kediri. The
research was conducted starting in sprakling effect taste like soda water
Lieberman, et al., 1994.
0.5 ml of sample was add with 2.5 ml of Barfoed solution, mixed
and heat on waterbath for 3.5 minute. See the color change occur Panil,
2007.
Februari- Agustus 2015. Research
Seliwanoff Test
material used are sweet potato Cilembu
Ipomoea batatas
L. Lamk , citric
acid, tartat acid, sodium bicarbonate, PVP, saccharum lactis.
a. Preparation of Extract Sweet Potato Cilembu
Ipomoea batatas
L. Lamk
0.5 ml of sample was add with 5 ml of Seliwanoff solution, mixed
and heat on waterbath for 3.5 minute. See the color change occur Panil,
2007
Free Test of Ethanol
Sweet potato Cilembu extract was Sweet Potato Cilembu
were added with sulphuric acid and acetate
collected, the tubers are cut, dried and powedered. 450 gram of the
respective sweet potato Cilembu powder was mixed separately with
1250 ml of ethanol. These mixture were maserated for 24 hours with
acid. Negative reaction indicated by the formation of ester odor from
ethanol.
c. Preparation of Granule Effervescent
Sweet potato Cilembu granule ocasional shaking and filtered with
effervescent was made by wet
filter paper to obtain filtrate which was further evaporated to obtain the
extract.
b. Qualitative Test of Extract Sweet Potato Cilembu
Ipomoea batatas
granulation. First citric acid and tartate acid, mixed until homogen
and sifted with a 16 mesh sieve. Dried in the oven with the
temperature 40◦C. During the heating
L. Lamk process the
granule powder in
Molish Test
2 ml of sample was add with 2 drops of a
-naphtol solution, mixed and add sulfuric acid through the
wall of the reaction tube. See the color change occurs Panil, 2007.
Iodium Test
alternating. After reaching the proper density powder mixture is issued,
made granule 18 mesh sieve and dried in the oven with temperature
40◦C Ansel, 2005.
d. Organoleptis Test of Granule Effervescent Extract Sweet Potato
3 ml of sample was add with 1 Cilembu
Ipomoea batatas
L.
drop of Iodium solution, mixed and see the color change occurs. The blue
color showed that the sample contain amylum and purple color showed that
the sample contain dextrine Panil, 2007.
Barfoed Test
1431
Lamk
Organoleptic test carried out by means of direct view shape, color,
smell and taste.
e. Granule Effervescent Flow Test
A number of granule funnel inserted into the closed bottom. The
bottom of funnel open slowly until
Carbohydrate Test Result
Molish Test Iodium Test
Barfoed Test Seliwanoff Test
+ purple ring - negative
+ red precipitate + red cherry
all the granules out of the funnel and forming a heap on paper. The flow of
granules which is good if the time required to drain 100 gram of
granules
10 seconds Anshory
et al.,
2008.
f. Granule Effervescent Angle of Repose Test
Angle of repose is obtained by measuring the height and diameter
piles granules are formed. When the angle of repose formed
30◦ it showed that preparation can flow
freely and when the angle of repose
40◦ stated that the preparations have
RESULTS AND ANALYSIS
poor flowability. Value angle of repose can show an indication of the
value would be acceptable flow properties owned by a material
Banker., 1989.
g. Granule Effervescent Solubility Test
1 packet of effervescent granules incorporated into the beaker glass
and filled with 200 ml of water at temperature 25◦C.
h. Granule Effervescent Ph Test
pH testing is done by using pH metre, note the value that showed at
pH metre.
Extract Sweet Potato Cilembu
and 2.158 . From the free of ethanol
Ipomoea batatas
L. Lamk
450 gram sweet potato Cilembu were collected on replication 1, 2 and 3
respectively 36.608 gram; 24.153gram, and 11.333gram with extract rendemen
test showed no reaction indication esterification odor from the form of
ethanol. It showed that sweet potato Cilembu
Ipomoea batatas
L. Lamk was free from ethanol.
value respectively 8.135 ; 5.367
Qualitative Test of Extract Sweet Potato Cilembu
Ipomoea batatas
L. Lamk
Table 1.1 Results Qualitative Test of Extract Sweet Potato Cilembu
Ipomoea batatas
L. Lamk
Molisch test was used to test all cabohydrate compounds. Molisch
positive test results obtained with the formation of a purple ring, so its showed
that extract sweet potato Cilembu
Ipomoea batatas
L. Lamk contained
carbohydrate compound. Iodium test but these extract contained
monosaccarides and disacarides. Barfoed test was used to separate
the monosaccarides and disaccharides. Results of Barfoed test showed positif
results red precipitate, it showed that extract sweet potato Cilembu
Ipomoea
was used to separate polysaccharides,
batatas
L. Lamk contained
monosaccharides and disacarides. Results of Iodium test showed negatif
results no change color, it showed that extract sweet potato Cilembu
Ipomoea
monosaccarides. Seliwanoff test was used for identificate of fructose. Results
of Seliwanoff test showed positif results red cherry, it showed that extract sweet
batatas
L. Lamk not contained
potato Cilembu
Ipomoea batatas
L. amylum or dextrine polysaccharides
4 Lamk
contained fructose.
Organoleptic Result
Formula I Formula II
Formula III Shape
Granule Granule
Granule Color
Cream Cream
Cream Smell
Distinctive smell sweet potato
Cilembu Distinctive
smell sweet potato Cilembu
Distinctive smell sweet potato
Cilembu Taste
Fresh like a soda
Fresh like a soda
Fresh like a soda
Organoleptis Test of Granule Effervescent Extract Sweet Potato
Cilembu
Ipomoea batatas
L. Lamk
Making the effervescent granule using combination of two kinds acid,
namely citric acid and tartate acid, because the used of a single acid given
the difficulties in the formation of froth. If citric acid used as single acid, it will
resulted sticky mixture and will be difficulty in the granules formation,
while the used of any tartate acid agglomerate. Sodium bicarbonate used
as forming the base reaction and act to neutralize the citric acid and tartate acid.
Sodium bicarbonate also can produce foam and CO
2
and completely soluble in water Pulungan, 2004.
Organoleptic testing done by directly observing the shape, smell,
color and taste of granule effervescent. The results of organoleptic test granule
effervescent its showed that the granule effervescent meet the requirements.
granules produced will be easy to Table 1.2 Results of Organoleptic Test Granule Effervescent of Sweet Potato Cilembu
Extract
Ipomoea batatas
L. Lamk
Granule Effervescent Flow Test
Flow test supplied by flowing 100 grams of granules through a funnel. If
the flow time of 100 grams of granules less than 100 seconds, the granules have
good flow rate. Flow time was influenced by the shape, size, porosity,
density, force electrostatics, and the frictional forces of particles and the
experimental conditions. Tartate acid has a density greater than that of citric
acid granules which contain more tartaric acid will have a greater density,
molecular weight will more easily flow
2 due to gravity greater Anshory, 2007.
Effervecent granules have an average yield of Formula 1, Formula 2 and
Formula 3 respectiveley 0.740; 1.343 and 1.508. The third formulation has
good flow properties, due to the weight of more than tartaric acid citric acid so
that the molecular weight will be more easily flow due to the force of gravity is
greater. Data processed by statistical and showed sig 0.05 so that the data
obtained virtually no difference.
Formula Replicate
Speed of flow grams
I 1
2 3
1.250 0.462
0.510 Mean
0.740 II
1 2
3 1.785
1.008 1.237
Mean 1.343
III 1
2 3
1.879 1.295
1.351 Mean
1.508
Formula Replicate
Angle of Repose I
1 2
3 24.69◦
25.02◦ 26.56◦
Mean 25.42◦
II 1
2 3
27.20◦ 25.97◦
25.64◦ Mean
26.27◦ III
1 2
3 23.03◦
23.82◦ 27.25◦
Mean 24.70◦
Table 1.3 Results of Granule Effervescent of Flow Test Sweet Potato Cilembu
Ipomoea batatas
L. Lamk
Granule Effervescent Angle of Repose Test
Table 1.4 Results of Granule Effervescent Angle of Repose Test Sweet Potato
Ipomoea batatas
L.
Lamk
speed so that the angle of repose alirnya Test the angle of repose according
formed the greater Lee, 2004.
to Wadke and Jacobson 1989 granules Effervescent
granules showed an will flow better if the angle of repose
formed 25-45 . The size of the angle of
repose is strongly influenced by the size average angle of repose for F1, F2 and
F2 respectively 5.42 , 26.27, 24.7.
Angle of repose test results meet the of the tensile force and the frictional
requirements, because the results
forces between the particles. If the tensile force and the friction force was
small, the granules will be faster and easier pouring. Angle of repose was also
influenced by the particle size, the smaller particle size , the higher the
particle cohesiveness that will reduce the
2 obtained were within a predetermined
range that was 25-45 . The data was
processed by the angle of repose statistics and get the sig 0.05 so that
the data obtained virtually no difference.
Formula Replicate
Time Solubility I
1 2
3 2 minute 2 second
2 minute 1 minute 55 second
II 1
2 3
1 minute 29 second 1 minute 20 second
1 minute 15 second III
1 2
3 1 minute 10 second
1 minute 5 second 1 minute 2 second
Formula Replicate
pH I
1 2
3 4.5
4.3 4.1
Mean 4.3
II 1
2 3
4.6 4.7
4.8 Mean
4.7
Granule Effervescent Solubility Test
Table 1.5 Results of Granule Effervescent Time Solubility Test Sweet Potato
Ipomoea batatas
L.
Lamk
Testing solubility, solubility time is one of the physical properties of a
typical dosage effervescent, where the effervescent preparation is good to have
time late for 5 minutes. The test results all showed results less than 5 minutes.
Data processed by One Way ANOVA statistical processing of the data is
obtained sig 0.05 so that the data obtained virtually no difference.
from the late third time this formulation
Granule Effervescent Ph Test of Sweet Potato
Ipomoea batatas
L.
Lamk
formulations that showed the most acid pH testing is done to determine
the pH value is generated by the pH is F1 with an average pH of 4.3 .
This may imply that the pH of the effervescent granule preparation in order
effervescent granules sweet potato
to comply with the requirements cilembuwas eligible. pH must be acidic
specified pH. Terms effervescent dosage i.e pH pH 6. pH testing is done by
dipping the pH meter previously calibrated with buffer solution into the
effervescent granules have been dissolved beforehand with distilled
water until a constant figure shows recorded.The results of all three
formulations show the results of a pH of effervescent as sodium bicarbonate
require acidic reagents, in the presence of hydrogen ions provided by the
developer of the acid, sodium bicarbonate react to release carbon
dioxide Estiasih et al., 2009. The data is processed using statistics and generate
sig 0.05 so that the data obtained virtually no difference .
less than 6, the pH of the three Table 1.6 Results of Granule Effervescent pH Test of Sweet Potato
Ipomoea batatas
L.
Lamk
2
III 1
2 3
5.8 5.5
5.7 Mean
5.6
Conclution
Sweet potatocilembu
Ipomoea batatas
Lamk extract can be processed
into a preparationattractive and practical effervescent granules.
The granule effervescent of sweet potato Cilembu
Ipomoea batatas
Lamk extract has good physical quality, it was
Ginseng Jawa Tlinum paniculatum Dengan Variasi
Kadar Pemanis Aspartam.
Jurnal Ilmiah Farmasi Vol 4
No.1.http:journal.uii.ac.idindex.p hpJIFarticleview480391.pdf.
diakses Selasa, 29 Mei 2012.
Erawati, C. M., 2006, Kendali
Stabilitas
showed on organoleptic test, angle of
Betakaroten Selama Proses
repose test, solubility test, pH test which
Produksi Tepung UbiJalar
are met the requirement of granule
Ipomea batatas
L. Thesis
effervescent dossage form.
Acknowledgment
Further studies are needed to see the effectiveness of the dosage
effervescent granules of sweet potato Cilembu
Ipomoea batatas
Lamk and
also to look at new formulation to repair physical quality from granule
effervescent of sweet potato cilembu
Ipomoea batatas
Lamk extract.
Reference
Amin, A. R, Syaiful, S. A., dan Mubaraq, S., 2008, Penampilan
diterbitkan, Program Studi Ilmu Pangan, Institut Ilmu Pertanian
Bogor, Bogor. Estiasih, T. dan Ahmadi, K. 2009.
Teknologi Pengolahan Pangan. PT Bumi Aksara Jakarta.
Lachman, L., Lieberman, H.A., Kanig, J.L., 1994,
Teori dan Praktek Industri Farmasi II,
Edisi III, diterjemahkan oleh Siti Suyatmi
dan Iis Aisyah, Universitas Indonesia Press, Jakarta, 644-645,
651, 681687.
Lee, R., E., 2004.
Effervescent Tablets: Key Facts About A Unique,
Fenotipik dan Daya Hasil
Effective Dossage Form.
CSC Tanaman Ubi
Jalar Lokal
Publishing, Tablets and Capsules. Sulawesi Selatan,
J.Agrivigor,
7 3, 263-271 Anonim. 2010. Budidaya Ubi Jalar
Cilembu Sebagai Komoditas Unggulan.
http:tatangkostama n.blogspot.com201009budid
aya-ubi-jalar cilembu-st1.html.
12 September 2011.
Ansel, H.C. 1989.
Penganta Bentuk Sediaan Farmasi.
Terjemahan : Farida Ibrahim. Edisi keempat.
Universitas Indonesia Press, Jakarta.
Anshory, H., Syukri, Y., dan Malasari, Panil, Z. Memahami teori dan praktik
biokimia dasar medis : untuk mahasiswa kedokteran,
keperawatan, gizi, dan analis kesehatan penulis, Zulbadar
panil.- Jakarta : EGC, 2007.
Pulungan. dkk. 2004. Membuat Effervescent Tanaman Obat.
Trubus Agrisarana, Surabaya. Suparman, 2007,
Bercocok Tanam Ubi Jalar,
Azka Mulia Media, Jakarta WHO. 2002.
Traditional Medicin
–
GrowingNeeds and Potential
.Geneva Winarti, Sri. Makanan Fungsional Sri
Y., 2007.
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Winarti –Edisi pertama
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Effervescent Dari Ekstrak
2 Yogyakarta : Graha Ilmu, 2010
DO ELDERLY USE COMMUNITY HEALTH CENTERS FOR OUTPATIENT CARE? Gerardin Ranind Kirana
1
, Hari Kusnanto Josef
2
, Mubasyisyir Hasanbasri
1
1
Public Health Program Faculty of Health Science IIK Bhakti Wiyata
2
Health Policy and Management Faculty of Medicine Gadjah Mada University
3
Field Epidemiology Training Program Faculty of Medicine Gadjah Mada University Email: gerardinranindkirana90gmail.com
Abstract
Health care programs for elderly in community health centers were very diverse, one of which was village-
based health care programs as we known in Indonesia as “Posyandu” for elderly. The program showed that the government is responsible for the availability of health services for the elderly
especially at community health centers. Besides community health centers, private practitioner was also a type of health facilities that exist in society. The existence of private practitioner would lead the
public, particularly the elderly to have a broad opportunity in choosing outpatient care. The purpose of this study was to analyse the outpatient utilization in community health centers by elderly in Eastern
Indonesia 2012, when compared with outpatient care in private practitioner. These was a quantitative research using secondary data Indonesia Family Life Survey East 2012. The samples were 246
elderly, with inclusion criteria were elderly aged ≥ 60 years old and elderly with Self-Rated Health Status categorized as Somewhat Unhealthy and Unhealthy. The data would be presented as odds-
ratio. The older age of the elderly OR: 1,69, with the female gender OR: 4,11, the lower level of education OR: 1,74 and living in rural areas OR: 1,28, and with the purpose of outpatient
utilization for treatment the illness OR: 26,5, the elderly are more likely to opt utilize outpatient health services in private health facilities. According to test results obtained logistic regression,
gender factor and the purpose of outpatient care utilization were the most dominant factor. Contrary to the expectations, the elderly especially those living in rural areas, used private practitioner rather than
community health centers. In the future, the government is expected to be able to improve the quality of community health centers, and provide pro-elderly health services that can reach the elderly in rural
areas, such as homecare services and “Posyandu” for elderly. Keywords: Elderly, Outpatient Care Utilization, Public and Private Health Services.
1444
Introduction
The eldery population are a susceptible population towards the health problems, so that
the percentage of elderly health services utilization was very high. According to the
Indonesia Family Life Survey East 2012, percentage of outpatient by elderly health service
utilization in Eastern Indonesia in 2012 only 20.63. The percentage is quite small when
compared to some study in America, which stating that the elderly is the age group that has
the biggest number of health service utilization compared to other age groups. Health care
programs for elderly in community health centers are diverse, one of which was village-based
health care programs as we known in Indonesia
as “Posyandu” for elderly. The program showed that the government is responsible for the
availability of health services for the elderly especially at community health centers. Besides
community health centers, private practitioner was also a type of health facilities that exist in
society. The existence of private practitioner would lead the public, particularly the elderly to
have a broad opportunity in choosing outpatient care. The purpose of this study was to analyse
the outpatient utilization in community health centers by elderly in Eastern Indonesia 2012,
when compared with outpatient care in private practitioner.
Method
This study is a quantitative research using secondary data Indonesia Family Life Survey
East 2012 and the data‟s design is cross-sectional survey. Indonesia Family Life Survey IFLS
East 2012 is a large-scale survey conducted in 7 provinces in Indonesia, East Nusa Tenggara, East
Result
Elderly aged over 75 years have lower odds-ratio to utilize outpatient care in community health
centers OR: 0.75; 95 CI: 0.25 to 2.28 and higher odds-ratio to use outpatient care in private
practitoner OR: 1 , 69; 95 CI: 0.52 to 5.43 compared to the elderly aged 60-74 years.
Female elderly have lower odds-ratio to utilize outpatient care in community health centers OR:
0.53; 95 CI: 0.23 to 1.21 and higher odds-ratio to use outpatient care in private practitoner OR:
1.28; 95 CI: 0.34 to 1.61 compared to male elderly.
Elderly with basic education have lower odds- ratio to utilize outpatient care in community
health centers OR: 0.49; 95 CI: 0.17 to 1.45 and higher odds-ratio to use outpatient care in
private practitoner OR: 1.74; 95 CI: 0, 20 to 13.8 compared to more educated elderly.
Elderly in rural areas have lower odds-ratio to utilize outpatient care in community health
centers OR: 0.53; 95 CI: 0.23 to 1.21 and higher odds-ratio to use outpatient care in private
practitoner OR: 1.28; 95 CI: 0, 34 to 1.61 compared to elderly in urban areas.
Elderly with the purpose of outpatient care for illness treatment have high odds-ratio to utilize
community health centers and private practitioner, but the elderly in this category have
higher odds-ratio to use outpatient care in private practitioner OR: 26.5; 95 CI: 6.4 to 110.4
than in community health centers OR: 23.0; 95 CI: 7.9 to 66.2.
Kalimantan, Southeast Sulawesi, Maluku, North Maluku, West Papua and Papua, with the topic
around the household and community. The survey was conducted by SurveyMETER on the
behalf of TNP2K, PRSF, and Australian Aid, and is a continuation of the survey held by IFLS in
1993, 1997, 2000, and 2007 by the RAND Corporation. The samples are 246 elderly, with
inclusion criteria were elderly aged ≥ 60 years old and elderly with Self-Rated Health Status
categorized as Somewhat Unhealthy and Unhealthy. Data were analyzed using STATA
software version 12. The data will be presented as odds-ratio.
1445
