Background: The concept of "stress” has been growing for a long time and has attracted a lot of attention, behaviour, and philosophy of many people in the world. Nowadays, stress has become a popular topic among health care professionals. Nurses are assumed to have heavy and various workloads. The nursing workload is influenced by stressors that can cause stress. At some level, psychological, physiological and sociological symptoms might appear. Job stress related to work stress factors include role ambiguity, role conflict, quantitative work overload, career development, and responsibility toward others, which have an impact on psychological distress and social dysfunction.

Objective: This study aims to determine the psychological distress and social dysfunction in nurses related to job stressors in Haji Hospital Medan.

Method: This research was an analytic research with a cross-sectional method using total sampling of 186 nurses who are still working in Haji Medan Hospital. The instruments used were the Stress Diagnostic Survey to measure work stress and GHQ12 to measure psychological distress and social dysfunction. The statistical tests used were Pearson correlation test (for a normal distribution) and Spearman (for non-normal distribution).

Results: There was a significant relationship between total work stressors and psychological distress (p = 0.0001), also, a weak positive correlation (r = 0.364) showed that total work stressors and psychological distress would increase together. The relation between total work stressors and social dysfunction was statistically significant (p = 0.018) and a very weak negative correlation (r = -0.173) was found, meaning that an increase in total job stress score would lower the social dysfunction score.

Background: RAAB 2013 reported the prevalence of bilateral blindness in South Sulawesi is 2,6%, with the main causes of blindness is cataract (64.3%). This report describes the crash program for cataract blindness control in South Sulawesi within the last 3 years (2014 - 2016). Material and Methods: Collecting the data of cataract infrastructures, human resources, and cataract surgical rate (CSR) from each district in South Sulawesi. From these data, we conduct statistical analysis and crash program planning, establish special and regional teams, and perform advocacy to stake holders of each district to describe the condition of the eye health services and action plans for cataract blindness prevention in each district. Results: The number of cataract surgery in South Sulawesi was 13.988 with CSR 1.753 in 2014. The number of cataract surgery in 2015 and 2016  was increased to 16.295 with CSR 1.954 and 19.147 with CSR 2.383 respectively. In August 2016, an advocacy workshop was held resulting the agreement of all stakeholders from each district in South Sulawesi in the development of the cataract blidness control  program. Conclusions: By implementing a serious and sustained crash program for cataract blindness control involving stakeholders from each district, the number of cataract blindness in South Sulawesi reduced and the CSR target of 3.000 in 2018 can be reached.

Background: Malaria is still considered as a major health problem in the world including in Indonesia, which is regarded as one of the malaria-endemic countries. Since 2006, WHO has recommended the use of artemisinin-based combination therapy (ACT) to treat uncomplicated falciparum malaria. In Indonesia, DHP tablet (combination of dihydroartemisinin and piperaquine) is the first line therapy used in malaria control program, which currently used imported DHP tablet. To produce generic DHP tablet, comparative bioequivalence test between DHP tablet and the drug previously used is needed. Methods: A single dosed, randomized, double-blinded, one-period, and parallel study design was conducted in the present research. Every twenty-four subjects were assigned into two groups, which are test group and comparison group. Results: The results showed that even though in vitro comparison of dissolution test has fulfilled the requirements, in vivo test results has not fulfilled the bioequivalence standards. Obtained geometric mean ratios (90% confidence intervals) of the test drug to comparator drug for dihydroartemisinin were 83.30% (67.06%–103.48%) for AUC_0-t, 83.24% (67.10%–103.26%) for AUC_0-inf, and 75.67% (61.83%–92.61%) for C_max. The geometric mean ratios (90% confidence intervals) of the test drug to comparator drug for piperaquine were 97.31% (76.50%–123.80%) for AUC_0-t, 94.18% (74.18%–119.59%) for AUC_0-inf, and 96.47% (71.80%–129.62%) for C_max. Conclusions: Therefore, the pharmacokinetic profile of the test drug is concluded to be bio-inequivalent with the comparator drug.

Background: MicroRNAs are a class of negative regulators of gene expression. Evidence indicates that miRNAs involved in the pathogenesis of New type 2 diabetes(NT2D)  through decrease the expression of the genes secreting insulin and increase expression of insulin secretion suppressing ones, as well as exocytosis, incorporate in New type 2 diabetes. In this study, we evaluated the expression level of miR-135 in plasma sample of those prone to susceptible diabetes and New type 2 diabetes patients compared to the control group.

Methods:  Subsequently to evaluation of biochemical parameters such as (TG, TC, HDL, and LDL) in susceptible diabetes, New type 2 diabetes and control group, miR-135a level was measured by qRT-PCR in the plasma samples and results were analyzed by  Stata and REST software.

Results: We identified a significant increase in miR-135a expression in New type 2 diabetes and susceptible diabetes samples compared to the control group. AUC in ROC curve analysis was 1.1 respectively (confidence interval of 1.0-1.0) for NT2D and susceptible diabetes group, the best cut-off points for diagnostics in diabetics and susceptible diabetes were 2.00 and 1.02. The optimum sensitivity and specificity for both groups were 100 and 100. Results confirmed the test for 100% confidence in healthy, susceptible diabetes and New type 2 diabetes subjects.

Conclusion: It seems that plasma level of miR-135a can be a desirable biomarker to differentiate T2DM diabetics from the control group.

Background: Kidney stones is one of the many causes of chronic kidney disease (CKD) in clinical and kidney fibrosis in histopathology presentation. Its occurs characterized by the presence of glomerulosclerosis (GS), tubulointerstitial fibrosis (TIF) and tubular atrophy (TA). This research aims to find out that the effect of glomerulosclerosis index (GSI), tubular index (TI), and matrix metalloprotein (MMP-9) against serum creatinine (SC) and estimated glomerular filtration rate (eGFR)  in kidney stone disease.  Methode: A total of 62 samples of kidney biopsy patients during kidney stone surgery in Sanglah General Hospital Denpasar-Bali, from February until December 2013. Kidney tissue biopsy stained with Masson's Trichrome.  Determination of GSI was counted GS in 30 glomerular in power field 400, and TI was counted normal tubular in 30 glomerular in power field 400, and MMP-9 was carried out using Kit Methode. Structural Equation Modelling (SEM) program Analysis of Moment Structure (AMOS) was used to analyze the effect of GSI, TI, and MMP-9 against SC and eGFR in kidney stone patients.  Results: Descriptive analysis were male 43 (69.35%), and female 19 (30.65%). Age (years) 50.0 ± 10.56; SC (mg/dl) 1.71 (0.47 to 6.76); GSI (glomerosclerosis/30 glomerular) 11 (0-30); TI (normal tubulars/30 glomerular) 850.24 (118 to1523); eGFR (ml/min) 65.41 ± 20.47; Leukocytes (cells/mm3) 7.82 ± 1.89; and MMP-9 (ng/ml) 6.13 (0.05 to 28.37). Direct and total effect (direct and indirect effect) were GS to eGFR = -0.16 and 0.33; TI to eLFG = 0.28 and 0.36, GS to SC = 0.31; TI to SC = -0.14; MMP-9 to SC = -0.16; SC to eGFR = -0.55. Conclusion:  Direct and total effect of GSI to eGFR were negative (-) 16% and (-) 33%; TI to eGFR were positive (+) 28% and (+) 36%. Direct effect (without indirect effect; direct effect as same as a total effect) of GSI, MMP-9, and TI to SC were positive (+) 31%, negative (-) 16%; and negative (-) 14% consecutively. Direct effect or total effect of SC to eGFR were negative (-) 55%. The results concluded that the effect measurements of urinary MMP-9, and GSI, and TI score to SC were negative (-) 16 %, positive (+) 31 % and negative (-) 14 % consecutively. The effect measurements of urinary MMP-9, and GSI, and TI score to eGFR were negative (-) 0.09 %, negative (-) 16 %, and positive (+) 28 %.

Background: The implantation rate of IVF remains low due to the adverse effect of ovarian stimulation on endometrial receptivity. Integrin β3, E-cadherin and Leukemia Inhibitory Factor (LIF) are the best markers known for endometrial receptivity evaluation. In this study, the effect of adding Letrozole to antagonist protocol based on the expression of integrin β3, E-cadherin and LIF level during implantation window was investigated. Letrozole is an inhibitor of aromatase that can prevent the supraphysiological estrogen level. The goal of the study was to prove that adding Letrozole to IVF antagonist protocol can increase the expression of Integrin β3, E-cadherin, and LIF concentration of mice uterine. 

Methods: This is an experimental study with a post-test only group design using Balb/c mice mimicked ovarian stimulated IVF. Antagonist protocol was applied to one group as ovarian stimulation, while the other group received the combination of Letrozole and antagonist protocol.  Uterus samples were collected 48 hours after ovarian stimulation. Integrin β3 and E-cadherin expression were detected by immunohistochemistry technique and LIF level assay by ELISA. Normality test was carried out using Shapiro-Wilk, and homogeneity test by Levene’s T. Comparison between integrin β3 and E-cadherin expression were tested by Mann-Whitney and Fisher's exact, while comparison of LIF was tested by Mann- Whitney, with p<0.05 considered as significant. Path analysis was done to measure each variable contribution.

Results: The Letrozole + GnRH antagonist treated mice showed significantly higher integrin β3 (2.71 + 0.61 vs 1.04 + 0.08, p<0.05) and E-cadherin (3.73 + 0.28 vs 1.16 + 0.29, p<0.05) expression in endometrium. It also showed significantly higher level of uterine LIF (1.78 + 0.13 vs 1.66 + 0.17 ng/ml, p<0.05) during implantation window than GnRH antagonist treated mice alone. Expression of integrin β3 (c2= 22.91, p<0.05) and E-cadherin (c2=36.00, p<0.05) were significantly higher in Letrozole group compared to control.

Conclusion: Letrozole caused higher expression of Integrin β3, e-cadherin, and, LIF concentration in Mice uterine stimulated by antagonist protocol. Letrozole had the highest contribution to the increase of E-cadherin.  Integrin β3 together with E-cadherin and Letrozole had 31.4% contribution to the increase of LIF.

The present study investigated the relationship between spiritual intelligence and life expectancy and self-regulation among students. The study was a descriptive and correlational research. The population included all high school female students in Tehran province. Using Cochran formula, 384 students were selected as the sample through multi-step cluster random sampling. The instruments included King Spiritual Intelligence Questionnaire (2008), Hope Scale Schneider (1991), and Boufard self-regulation questionnaire (1995). The data was analyzed through descriptive and inferential statistics (multivariate regression and canonical correlation).  The results showed that there is a positive relationship between the spiritual intelligence and life expectancy and self-regulation. Also, through Canonical analysis, it was showed that spiritual intelligence explained 26% and 2.5% of variance in life expectancy and self-regulation, respectively. Regression analysis of spiritual intelligence components showed that transcendental consciousness, personal meaning generation, and expanded state of consciousness all together explained 17.4 % of variance in life expectancy. Similarly, 18% of the variance in self-regulation was explained by personal meaning generation and expanded state of consciousness. Due to the important role of spiritual intelligence in life expectancy and self-regulation, it is suggested that spiritual intelligence training for students be taken into account.