Case-control Approach Research Articles

Utility of a Cancer Predisposition Screening Tool for Predicting Subsequent Malignant Neoplasms in Childhood Cancer Survivors.

Childhood cancer survivors (CCS) are at risk of developing subsequent malignant neoplasms (SMNs) resulting from exposure to prior therapies. CCS with underlying cancer predisposition syndromes are at additional genetic risk of SMN development. The McGill Interactive Pediatric OncoGenetic Guidelines (MIPOGG) tool identifies children with cancer at increased likelihood of having a cancer predisposition syndrome, guiding clinicians through a series of Yes or No questions that generate a recommendation for or against genetic evaluation. We evaluated MIPOGG's ability to predict SMN development in CCS. Using the provincial cancer registry (Ontario, Canada), and adopting a nested case-control approach, we identified CCS diagnosed and/or treated for a primary malignancy before age 18 years (1986-2015). CCS who developed an SMN (cases) were matched, by primary cancer and year of diagnosis, with CCS who did not develop an SMN (controls) over the same period (1:5 ratio). Potential predictors for SMN development (chemotherapy, radiation, and MIPOGG output) were applied retrospectively using clinical data pertaining to the first malignancy. Conditional logistic regression models estimated hazard ratios and 95% CIs associated with each covariate, alone and in combination, for SMN development. Of 13,367 children with a primary cancer, 317 (2.4%) developed an SMN and were matched to 1,569 controls. A MIPOGG output recommending evaluation was significantly associated with SMN development (hazard ratio 1.53; 95% CI, 1.06 to 2.19) in a multivariable model that included primary cancer therapy exposures. MIPOGG was predictive of SMN development, showing value in nonhematologic malignancies and in CCS not exposed to radiation. MIPOGG has additional value for SMN prediction beyond treatment exposures and may be beneficial in decision making for enhanced individualized SMN surveillance strategies for CCS.

The Effect of ACTN3 and VDR Polymorphisms on Skeletal Muscle Performance in Axial Spondyloarthropathies.

BackgroundSpondyloarthritis (SpA) are the most common group of chronic inflammatory rheumatic diseases affecting about 1.5% of the adult Caucasian population. Low back pain is the most common symptom. The aetiopathogenesis of SpA is multifactorial, with well-known genetic and environmental contributions. Furthermore, muscle properties might also be involved in the pathophysiological process and these could be modulated by the genetic background. Alpha-actinin-3 (ACTN3) and Vitamin D receptor (VDR) genes are well-known genes related with muscle performance. Our aim was to analyze four SNPs of these genes and to evaluate their influence in axial SpA (axSpA) susceptibility, phenotype and muscle properties.MethodsWe performed a pilot study based on case-control approach involving 56 participants: 28 axSpA patients and 28 healthy controls matched by age, gender and levels of physical activity. Clinical, epidemiological and muscle characterization data—muscle physical properties (stiffness, tone, and elasticity), strength, mass, and performance, were collected. Two different muscles were considered for analysis, the Multifidus and Gastrocnemius. Four SNPs of ACTN3 (rs1815739) and VDR (rs2228570, rs731236, and rs7975232), were selected, analyzed and correlated with clinical, epidemiological and muscle characterization data.ResultsIn total, 51 individuals (27 axSpA patients and 24 matched controls) were eligible for further genetic analysis, 66.7% being male and with a mean age of 36 years. Muscle physical properties, muscle strength and muscle mass were similar in both groups; however, axSpA patients showed a decrease in muscle performance. None of the studied SNPs were associated with disease susceptibility/phenotype, muscle physical properties, muscle strength or muscle mass. However, ACTN3 rs1815739 and VDR rs2228570 were shown to be associated with muscle performance.ConclusionOur results suggest an association between ACTN3 and VDR polymorphisms and muscle performance in axSpA.

The COVID-OUT study protocol: COVID-19 outbreak investigation to understand workplace SARS-CoV-2 transmission in the United Kingdom

Preventing SARS-CoV-2 transmission and protecting people from COVID-19 is the most significant public health challenge faced in recent years. COVID-19 outbreaks are occurring in workplaces and evidence is needed to support effective strategies to prevent and control these outbreaks. Investigations into these outbreaks are routinely undertaken by public health bodies and regulators in the United Kingdom (UK); however, such investigations are typically disparate in nature with a lack of consistency across all investigations, preventing meaningful analysis of the data collected. The COVID-OUT (COVID-19 Outbreak investigation to Understand Transmission) study aims to collect a consistent set of data in a systematic way from workplaces that are experiencing outbreaks, to understand SARS-CoV-2 transmission risk factors, transmission routes, and the role they play in the COVID-19 outbreaks. Suitable outbreak sites are identified from public health bodies. Following employer consent to participate, the study will recruit workers from workplaces where there are active outbreaks. The study will utilise data already collected as part of routine public health outbreak investigations and collect additional data through a comprehensive questionnaire, viral and serologic testing of workers, surface sampling, viral genome sequencing, and an environmental assessment of building plans, ventilation and current control measures. At each site, a detailed investigation will be carried out to evaluate transmission routes. A case-control approach will be used to compare workers who have and have not had SARS-CoV-2 infections during the outbreak period to assess transmission risk factors. Data from different outbreaks will be combined for pooled analyses to identify common risk factors, as well as factors that differ between outbreaks. The COVID-OUT study can contribute to a better understanding of why COVID-19 outbreaks associated with workplaces occur and how to prevent these outbreaks from happening in the future.

Kadar 25(OH)D3 darah pada penderita obesitas

Blood level 25(OH)D3 in obese peopleBackground: Currently, obesity is a world problem, even the World Health Organization (WHO) declared obesity to be a global epidemic and contributes 5% of global deaths in 2015. Recently, many studies have reported an association between vitamin D levels and the incidence of obesity, although the exact mechanism raises many questions. Objective: This study is to examine the correlation between levels of 25(OH)D3 and body mass index (BMI).Methods: The design of this research is an analytic survey with a case control approach. The population of this study was all students of the Faculty of Medicine, Malahayati University, Bandar Lampung. The number of samples in this study were 60 samples with details of 30 case samples (obesity) and 30 control samples (no obesity). The sampling technique used was purposive sampling. The data used are primary data from direct measurement results. The data were analyzed using the correlation test.Results: The results showed that only one sample had normal 25(OH)D3 levels, while most (more than 98%) had low and very low levels of 25(OH)D3. The correlation test showed that there was a significant relationship between 25(OH)D3 levels with BMI (p=0.008; r= -0.0338), gender (p=0.001; r= -0.457), and total cholesterol levels (p=0.009); r= -0,391).Conclusions: There is a relationship between levels of 25(OH)D3 with BMI, the lower the 25(OH)3 blood level, the higher the risk of increasing BMI. Further research is still needed to ensure that giving vitamin D to obese populations can reduce body weight or BMI.

RBM20 Is a Candidate Gene for Hypertrophic Cardiomyopathy

BackgroundThe genetic basis of a considerable fraction of hypertrophic cardiomyopathy (HCM) cases remains unknown. Whether the gene encoding RNA binding motif protein 20 (RBM20) is implicated in HCM and the correlation of clinical characteristics of RBM20 heterozygotes with HCM remain unresolved. We aimed to investigate the association between RBM20 variants and HCM. MethodsWe compared rare variants in the RBM20 gene by exome sequencing in 793 patients with HCM and 414 healthy controls. Based on a case-control approach, we used optimal sequence kernel association test (SKAT-O) to explore whether RBM20 is associated with HCM. The genetic distribution of RBM20 rare variants was then compared between HCM heterozygotes and dilated cardiomyopathy (DCM) heterozygotes. Clinical features and prognosis of RBM20 heterozygotes were compared with nonheterozygotes. ResultsGene-based association analysis implicated RBM20 as a susceptibility gene for developing HCM. Patients with RBM20 variants displayed a higher prevalence of sudden cardiac arrest (SCA) (6.7% vs 0.9%, P = 0.001), increased sudden cardiac death (SCD) risk factor counts and impaired left ventricle systolic function. Further survival analysis revealed that RBM20 heterozygotes had higher incidences of resuscitated cardiac arrest, recurrent nonsustained ventricular tachycardia, and malignant arrhythmias. Mendelian randomization suggested that RBM20 expression in the left ventricle was causally associated with HCM and DCM with opposite effects. ConclusionsThis study identified RBM20 as a potential causal gene of HCM. RBM20 variants are associated with increased risk for SCA in HCM.

Scientist of the week: evaluating effects of a teacher-led STEM intervention to reduce stereotypical views of scientists in young children

ABSTRACT Background Previous research into children’s perceptions of science shows that children like science but often hold stereotypical views of scientists and commonly do not see themselves with a career as a scientist. Purpose The aim of this study is to examine if a carefully designed medium-term, teacher-led STEM intervention, ‘Scientist of the Week’ which showcased a diverse range of working scientists and the skills they need, can lead to a positive change in the perception of scientists among young people. Sample Design and Methods Using a case-control approach, this research used a tracked sample of 118 young people from aged 7 to 11 in a primary school in the North East of England. Words associated with scientists were collected before and after (directly, one month, one year) the intervention from the tracked sample and analysed to assess changes in stereotypical perceptions and any difference in responses between male and female participants. Results Before the intervention, young children held many of the common stereotypes associated with scientists. Shortly afterwards, and one year following the intervention, the use of common stereotypes had fallen significantly across all children, with particular improvements in counter-stereotypical word usage for males. It also found that stereotypical images of scientists as highly intelligent were more difficult to counteract and that many of the positive changes in this view seen in the short term (weeks and months) diminished in the long term (one year later). Conclusions This research has shown that with minimal expense and effort from teachers, negative stereotypes of scientists can be reduced through an intervention that does not require bringing scientists into the classroom. Some of the observed changes persisted in the longer-term, suggesting a lasting alteration in children’s perceptions of scientists following the intervention.

Faktor-Faktor Yang Berhubungan Dengan Kejadian Demam Berdarah Dengue (DBD) Di Desa Panji Kecamatan Sukasada Kabupaten Buleleng

Abstract : The number of dengue cases in Buleleng Regency has increased in 2019 from IR 19,6 to 249,5 per 100.000 population. In the last 5 years, Puskesmas Sukasada I has always been in the top 3 position. The village of Panji experienced an increase in dengue cases from 0 to 50 cases in 2019. The purpose of this study was to determine the factors related to the incidence of dengue in Panji Village, Sukasada District, Buleleng Regency. The study design using the case control approach was carried out in May 2020. Data used from the results of interviews and observations. From the results of statistical tests with Chi Square from 88 respondents it can be concluded about factors that are significantly related to the incidence of DHF including the presence of Aedes aegypti mosquito larvae, the habit of using anti-mosquito repellent, eradication of mosquito nests with 3M plus and the habit of hanging clothes with a value of p 0,05. Respondents' knowledge about DHF is not significantly related to the incidence of DHF. Community participation and cross-sectoral cooperation are needed in the implementation of the DHF PSN to create a larva free village as a way to prevent the transmission of DHF.

Hubungan Pengetahuan Dan Pendapatan Kepala Keluarga Dengan Kepemilikan Jamban Sehat

Abstract: The people in Dauh Puri Kaja Village still do a lot of defecation in the river, this is because people who behave in defecating do not have healthy latrines in their households. Researchers want to know the relationship between knowledge and income of household heads with ownership of healthy latrines. This type of research uses an analytic survey with an interview method with a case control approach. The sample of the study was 72 households consisting of 36 families who did not have healthy latrines as the case group and 36 families who had healthy latrines as the control group. The sampling technique was purposive sampling. Data were collected using a questionnaire sheet, statistical analysis using the Chi Square test. The results of the level of knowledge of the head of the household regarding healthy latrines were 38 respondents (52.8%) with a poor level of knowledge. The results of the income level of the head of the family, namely having a low income level, were 41 respondents (56.9%).The results of the Chi Squares test show that there is a relationship between knowledge and ownership of healthy latrines (ρ value = 0,000 0,05) and the level of a strong relationship (CC = 0,615). And there is a relationship between the income of the head of the household and ownership of a healthy latrine (ρ value = 0.000 0,05) and the level of relationship is moderate (CC = 0,574). It is recommended that the community increase their knowledge of healthy latrines.

Abstract 817: Probing the diabetes - colorectal cancer link using gene - environment interaction analyses

Abstract Background: Type 2 diabetes mellitus (T2D) is an established risk factor for colorectal cancer. However, the mechanisms underlying this relationship are unclear and it is not known if the association is modified by genetic variants. To provide insights into the molecular pathways potentially linking diabetes and colorectal cancer, we undertook a large-scale gene-environment interaction analysis (GxE). Methods: We tested multiplicative statistical interactions between approximately 7 million common (allele frequency >1%) genetic variants and T2D status in 31,529 colorectal cancer cases and 42,861 controls of European ancestry from 3 genetic consortia (GECCO/CCFR/CORECT). Statistical methods included traditional case-control logistic regression, case-only analyses, joint tests (2df/3df), and two-step approaches. We also explored additive and multiplicative interactions between polygenic risk score (PRS) of the known genome-wide significant loci for colorectal cancer and T2D. Results: Overall, T2D was positively associated with colorectal cancer risk [odds ratio [OR]: 1.25 (95% confidence interval [CI]: 1.14-1.36)]. A statistically significant interaction was identified between T2D status and an intronic variant in LRCH1 (rs9526201) and colorectal cancer risk using the 2-d.f. joint test (p-value:1.44x10-8). A statistically significant additive scale interaction between PRS for colorectal cancer and T2D was found (p-value: 1.8x10-10) such that the observed risk of developing colorectal cancer for individuals with T2D and a 1 standard deviation (SD) higher increment of PRS compared to non-diabetics with the lowest PRS was 0.184 more than if there was no interaction between T2D and PRS. Conclusion: These results suggest that variation in a gene related to immune function may modify the association of T2D with colorectal cancer and potentially provide novel insights into the biology underlying this relationship. Furthermore, our data show that genetic risk prediction models for CRC may need to consider non-genetic risk factors. Citation Format: Niki Dimou, Andre E. Kim, Orlagh Flanagan, Neil Murphy, Emmanouil Bouras, Peter T. Campbell, Graham Casey, Steven Gallinger, Stephen B. Gruber, Li Hsu, Mark A. Jenkins, Yi Lin, Victor Moreno, Conghui Qu, Edward Ruiz-Narvaez, Mariana C. Stern, Yu Tian, Kostas Tsilidis, W. James Gauderman, Marc J. Gunter, Ulrike Peters. Probing the diabetes - colorectal cancer link using gene - environment interaction analyses [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 817.

FAKTOR YANG MEMPENGARUHI KEJADIAN STUNTING PADA ANAK USIA 2-5 TAHUN DI KEPULAUAN MANDANGIN

Stunting is a linear growth disorders, caused by chronic malnutrion of nutrient intake or chronical nor recurrence infectious diseases, showed by Z-score height according to age less than -2 SD. The aim of this study was to analize factors related to stunting on 2-5 years old children In Pulau Mandangin Kabupaten Sampang. This study was analytic study with case control approach. The population of this study were every mother of children with 2-5 years age who lived in Pulau Mandangin in 2019. Case group were mother of children with 2-5 years ages with stunting diagnosis (76 respondents). Control group were mother of children with 2-5 years ages without stunting diagnosis (152 respondents). Simple random sampling technic was used on sample retrieval and data retrieval using questioner. The data analized by using univariate, bivariate (chi-square) and multivariate analysis with logistic regression test with 5% (α=0,05) level of significance. The study result showed that related variable to stunting were low birth weight baby with p-value 0,015. Genetic history with p-value 0,008, nutrient intake with p-value 0,011, exclusive breast milk with p-value 0,004, and environment with p-value 0,009. The result of multivariate analysis nutrient intake had great risk of stunting (p=0,013 OR=4,0, 95% CI=1,091 –14,821). Nutrient intake is dominant factors related to stunting incident. There was influence of low birth weight status, genetic, exclusive breast milk, nutrient intake and environment. While economic status was not related to stunting incident on children with ages 2-5 years in Pulau Mandangin Kabupaten Sampang.

THE RELATIONSHIP OF THE MENSTRUAL CYCLE, MENSTRUAL LENGTH, FREQUENCY OF MENSTRUATION, AND PHYSICAL ACTIVITIES WITH THE INCIDENT OF ANEMIA IN ADOLESCENTS GIRLS AT ISLAMIC BOARDING SCHOOL

Background: Currently anemia is still a health problem. One of the causes of anemia is bleeding that occurs during menstruation. Menstrual disorders can be influenced by body weight, frequency of exercise, physical activity, diet, environmental exposure. Women with long menstrual periods cause more blood to flow, which can lead to anemia.Objectives: This study aims to determine the relationship between menstrual cycles, menstrual length, menstrual frequency, and physical activity with the incidence of anemia in adolescent girls in Islamic boarding schools.Methods: This study used an observational analytic method with a case-control approach. The calculation of the formula used hypothesis test for an odds ratio, obtained a total sample of 84 people. The sampling technique was quota sampling who met the inclusion criteria.Univariate analysis was analyzed using descriptive statistical tests. Bivariate analysis was analyzed using Chi Square and Fisher Exact Test that was carried out to determine the relationship between each independent variable and the dependent variable. The research instrument for variable menstrual cycle, menstrual length, and frequency of menstruation used questionnaires that used adolescents as respondents, while for variables of physical activity using an international physical activity questionnaire (IPAQ). Blood collection to determine anemia levels using a hemocue tool (easy touch).ResultsThe results showed the factors associated with anemia were menstrual cycle (p = 0.024; OR = 5.45), menstrual length(p = 0.026; OR = 8.2), and frequency of menstruation (p = 0.026; OR = 2.16), while the unrelated factor was physical activity.Conclusion: Menstrual cycle, menstrual length, and frequency of menstruation is a factor affecting anemia, while physical activity is not a factor affecting anemia.

Candidate gene family-based and case-control studies of susceptibility to high Schistosoma mansoni worm burden in African children: a protocol

Background: Approximately 25% of the risk of Schistosoma mansoni is associated with host genetic variation. We will test 24 candidate genes, mainly in the Th2 and Th17 pathways, for association with S. mansoni infection intensity in four African countries, using family based and case-control approaches. Methods: Children aged 5-15 years will be recruited in S. mansoni endemic areas of Ivory Coast, Cameroon, Uganda and the Democratic Republic of Congo (DRC). We will use family based (study 1) and case-control (study 2) designs. Study 1 will take place in Ivory Coast, Cameroon, Uganda and the DRC. We aim to recruit 100 high worm burden families from each country except Uganda, where a previous study recruited at least 40 families. For phenotyping, cases will be defined as the 20% of children in each community with heaviest worm burdens as measured by the circulating cathodic antigen (CCA) assay. Study 2 will take place in Uganda. We will recruit 500 children in a highly endemic community. For phenotyping, cases will be defined as the 20% of children with heaviest worm burdens as measured by the CAA assay, while controls will be the 20% of infected children with the lightest worm burdens. Deoxyribonucleic acid (DNA) will be genotyped on the Illumina H3Africa SNP (single nucleotide polymorphisms) chip and genotypes will be converted to sets of haplotypes that span the gene region for analysis. We have selected 24 genes for genotyping that are mainly in the Th2 and Th17 pathways and that have variants that have been demonstrated to be or could be associated with Schistosoma infection intensity. Analysis: In the family-based design, we will identify SNP haplotypes disproportionately transmitted to children with high worm burden. Case-control analysis will detect overrepresentation of haplotypes in extreme phenotypes with correction for relatedness by using whole genome principal components.

Risk Factors of Sectio Caesarea Delivery at Djafar Harun Hospital

The number of mothers giving birth with sectio caesarae delivery at BLUD R.S H.M Djafar Harun North Kolaka in 2015 was 254 people, then increased in 2016 to 521 people. The purpose of this study was to analyze the risk factors for the incidence of Sectio Caesarea delivery at H.M Djafar Harun Hospital, North Kolaka. This type of research is an analytic observational study with a case-control study approach. The study population was 68 with a sample of 136 people using the Accidental Sampling Technique. Data analysis using the Odds Ratio test. The results of the risk analysis based on narrow pelvic factors showed the value of OR= 9,681; LL= 2,728; UL= 34,355, and then placenta previa factor showed the value of OR= 6,484; LL= 0,759; UL= 55,385. In conclusion, narrow pelvis is a strong risk factor and placenta previa is not a strong risk factor for Sectio Caesarea delivery. It is hoped that the hospital will seek to identify high-risk pregnancies, complications or pregnancy abnormalities so that they can be detected early so that they are able to more optimally handle complications during childbirth.

FAKTOR-FAKTOR KEJADIAN SKABIES PADA SANTRI DI PONDOK PESANTREN NURUL ISLAM DESA KARANGJATI SAMPANG CILACAP

Background: Scabies is a contagious skin disease. Sarcoptes scabiei is a scabies mite that causes inflammation, an itchy reaction and a rash on the skin. Factors that play a role in scabies transmission include knowledge, attitudes, personal hygiene, economic status, and gender. Objective: To find out the factors which cause scabies in students at Nurul Islam Islamic Boarding School in Karangjati Village, Sampang Cilacap. Method: The type of this research was an analytic observation method with a case-control approach. The sampling technique in this research was the total sampling technique, with 25 samples for case samples (scabies) and 35 samples for case-control samples (nonscabies). The data were analyzed using the Chi-Square test with Odd ratios and logistic regression. Results: Chi-square test results showed a relationship between knowledge (p = 0.017; OR = 6.417), attitude (p = 0.002; OR = 6,000), personal hygiene (p = 0.029; OR = 8,500), economic status (p = 0.015; OR = 9,600), and gender (p = 0.004; OR = 4,929) with the occurrence of scabies at Nurul Islam Islamic Boarding School in Karangjati Village. Logistic regression analysis showed that attitude was the most dominant variable related to the occurrence of scabies (p = 0.008 ExpB = 6.835). Conclusion: There is a relationship between knowledge, attitudes, personal hygiene, economic status and gender in students with the occurrence of scabies at Nurul Islam Islamic Boarding School in Karangjati Village. The most dominant factor with the incidence of scabies is the attitude of students.

Assessing the crash risks of evacuation: A matched case-control approach applied over data collected during Hurricane Irma

Recent hurricane experiences have created concerns for transportation agencies and policymakers to find better evacuation strategies, especially after Hurricane Irma—which forced about 6.5 million Floridians to evacuate and caused a significant amount of delay due to heavy congestion. A major concern for issuing an evacuation order is that it may involve a high number of crashes in highways. In this study, we present a matched case-control based approach to understand the factors contributing to the increase in the number of crashes during evacuation. We use traffic data for a period of 5 to 10 min just before the crash occurred. For each crash observation, traffic data are collected from two upstream and two downstream detectors of the crash location. We estimate models for three different conditions: regular period, evacuation period, and combining both evacuation and regular period data. Model results show that, if there exist a high volume of traffic at an upstream station and a high variation of speed at a downstream station, the likelihood of crash occurrence increases. Using a panel mixed binary logit model, we also estimate the effect of evacuation itself on crash risk and find that, after controlling for traffic characteristics, during evacuation the chance of a crash is higher than in a regular period. Our findings have implications for evacuation declarations and highlight the need for better traffic management strategies during evacuation. Future studies may develop advanced real-time crash prediction models which would allow us to deploy proactive countermeasures to reduce crash occurrences during evacuation.

Riwayat Pemberian MP-ASI dan Sosial Ekonomi dengan Kejadian Stunting pada Balita

Stunting is a condition of failure to thrive in children under five due to a chronic lack of nutritional intake. According to WHO, Indonesia is the third country with the highest incidence in Southeast Asia at 27.7%. This study aims to determine the relationship between the history of complementary feeding and economic status with the incidence of stunting in children under five in Ngjajaran Village, Tuntang District, Semarang Regency. The research design used was observational analytic with a case-control approach. The research sample was 88 toddlers consisting of 22 cases and 66 controls taken by simple random sampling technique. Data were analyzed using chi-square test. The results showed that there was a relationship between the history of complementary feeding and the incidence of stunting in toddlers with p value = 0.004; OR=4.929 (95% CI 1.745-13.936); there is a relationship between economic status and the incidence of stunting in children under five with p value = 0.047; OR=0.327 (95% CI 0.120-0.890). Closing: The conclusion in this study is that there is a relationship between the history of giving complementary feeding and economic status with the incidence of stunting in children under five in Ngajaran Village, Tuntang District, Semarang Regency.

Relationship Of Nutritional Components In Toddlers Aged 25-59 Months To Stunting And Short Stature Incidents In Pragaan District, Sumenep Regency

Stunting and short stature are height per-age <-2SD for specific age and gender. The process of stunting and short stature starts from the womb until the beginning of life. The direct cause of stunting is the lack of nutritional intake in the first 1000 days of life, which can inhibit height growth. Study aimed to investigate the association between the relationship of nutritional components in toddlers to stunting and short stature incidents in Pragaan District, Sumenep Regency. Observational analytic with a case-control approach, using the Purposive-Sampling method. The research sample consisted of 76 toddlers aged 25-59 months. The statistical analysis used was the chi-square test and logistic regression test. The result of chi-square test and logistic regression for stunting on nutrient intake variable ( p = 0.000, OR = 26,3, CI 95% (4,630-153,573), history of breastfeeding (p=0,000, OR=72,6,CI95% (7,63-690,78), iodized salt (p=0,000, OR=8,5,CI 95% (1,833-39,421), FE tablet (p=0,000,OR=37,00, CI 95%(3,762-363,91). The result of chi-square test and logistic regression for short stature on nutrient intake variable (p=0.001, OR=7,2,CI 95% (2,260-23,400), history of breast feeding (p=0,007, OR=4,500,CI 95% (1,210-16,742), iodized salt (p=0,007, OR=19,125, CI 95% (5,062-72,259), FE tablet (p=0,149). There is a relationship between nutritional components intakes such as breastfeeding history and iodine salt consumption with stunting and short stature in Pragaan District, Sumenep Regency.

Risk factors associated with spontaneous abortion in Dr. Soetomo General Hospital Surabaya: a case-control study

The Maternal Mortality Ratio (MMR) in Indonesia is still fairly high. One of the top three causes of maternal death is bleeding. Spontaneous abortion is an early pregnancy problem leading to the occurrence of bleeding and direct maternal death. The causes of spontaneous abortion vary and can be caused by multiple factors. Early identification of risk factors is necessary to reduce mortality and morbidity due to spontaneous abortion and its complications. This study's objective was to identify the risk factors of spontaneous abortion in Dr. Soetomo General Hospital. This study was an observational analytic with a case-control approach. The population was all pregnant women hospitalized at the Obstetrics and Gynaecology Department in Dr. Soetomo General Hospital from January 2017 to December 2018. The samples were 120 in total, included 40 cases and 80 controls taken by consecutive sampling. The data were analyzed using univariate and bivariate analysis with the Chi-square test. The results based on the bivariate analysis showed history of previous abortion (p <0.001), chronic maternal disease (p <0.001), hemoglobin levels (p = 0.020), maternal age (p= 0.026), gravidity (p= 0.036), and infection (p= 0.037) had significant correlation with spontaneous abortion. In conclusion, risk factors associated with spontaneous abortion in Dr. Soetomo General Hospital were history of previous abortion, chronic maternal disease, anemia, advanced maternal age, multigravidity, and infection. Positive pregnancy outcomes are expected to play a role in reducing MMR in Indonesia. Therefore, high-risk pregnant women are suggested to carry out regular Antenatal care recommendations with intensive supervision.

Risk Factors of Body Mass Index (BMI), Age of Menarche, Parity and Hormonal Contraception of Genu Osteoarthritis in Female Patients

Osteoarthritis (OA) is a degenerative disease related to joint cartilage and commonly occurs in the knee joint. The 2013 National Survey recorded the prevalence of joint diseases in East Java was 26.9%. OA affected more women than men due to the estrogen and caused disabilities in many women. This study aimed to find the relationship between Body Mass Index (BMI), age of menarche, parity, and the use of hormonal contraceptives against OA in genu at Universitas Airlangga Hospital, Surabaya. This was an analytic observational study with a case-control approach. Data collection was carried out through a short interview using a questionnaire. The sample size was calculated using a formula and found that the study required 42 patients with OA in the case group and 42 patients without OA in the control group. The case group was dominated by patients with 56-60 years old age (62.1%), BMI 23-24.9 kg/m2 (58.7%), menarche age 12-13 years (53.6%), multiparous (52.6%), having contraception pill usage history (62.3%) particularly using combination pills (60.5%) with a mean duration of use > 1 year (56.8%). There was a relationship between BMI and type of hormonal contraceptive used against genu OA in female patients at Universitas Airlangga Hospital Surabaya.

The Analysis of Stunting Incidence Factors in Toddlers Aged 23-59 Months in the Work Area of the Padang Tiji Community Health Center, Pidie Regency, 2020

Aceh is ranked third nationally for child stunting, behind East Nusa Tenggara (NTT) and West Sulawesi (Sulbar). Currently, he explained, the government is aggressively campaigning for the prevention and handling of stunting. This is because the prevalence of stunting for infants under five years of age (toddlers) in Indonesia in 2018 was 30.8%. Based on a report from Puskesmas Padang Tiji in 2018, there were 114 (18.4%) toddlers aged 23-59 months who experienced stunting, while in 2019 it increased to 138 (20.9%) toddlers with stunting. The purpose of this study was to analyze the incidence of stunting in children aged 23-59 months in the Padangtiji Community Health Center in 2020. This research method uses a case control approach. In the study, the control samples were toddlers who came to Posyandu who were randomly selected. The research sample was 50 cases and 50 controls, namely 1: 1. This research was conducted on December 10, 2020 to December 21, 2020. The statistical test used is the chi-square test by looking at the OR value and data analysis using univariate and bivariate analysis. The results of this study were the relationship between the incidence of stunting with exclusive breastfeeding (P = 0.016) (OR = 3.071), birth weight (P = 0.678), infectious diseases (P = 0.523) and birth spacing (P = 0.043) (OR = 2,421). The conclusion of this study is that there is a relationship between exclusive breastfeeding and birth spacing with the incidence of stunting in toddlers aged 23-59 months in the working area of Puskesmas Padang Tiji in 2020. The suggestions are expected to further improve health promotion in the form of counseling related to the causes and prevention of stunting in order to increase knowledge mothers regarding stunting and prevention related to infectious diseases in reducing morbidity that can lead to stunting.