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JOURNAL OF NURSING: EXTENSION EFFECT OF CHANGES IN Saturday, August 4, 2012
ADOLESCENT KNOWLEDGE puberty AGE 12-15 YEARS IN RICE MTsN POND DISTRICT DISTRICT JOMBANG JOMBANG
Dr. Suparyanto, M.Kes

EXTENSION EFFECT OF CHANGES IN KNOWLEDGE puberty TEENS AGES 12-15 YEARS IN RICE MTsN POND DISTRICT DISTRICT JOMBANG JOMBANG

(Influence OF THE KNOWLEDGE TO CHANGE ABOUT Counseling Puberty Teenagers aged 12-15 YEARS IN AT MTsN RICE FARMS SUB-DISTRICT AND DISTRICT OF JOMBANG)

Ayu Eni Kurniawati1, Anis satus Syarifah2, Endah Purtiningtyas3
1.program s1 study nursing STIKES pemkab jombang
Study nurses STIKES 2.progam pemkab jombang
3.apotek Seger jombang

ABSTRACT

The growth of reproductive organs undergoing rapid change and already has the ability to reproduce phenomena but it shows some teenagers do not know about reproductive health. Many young women do not realize that since I first entered puberty, he had started to produce eggs. This study aims to determine the influence of illumination Knowing the changes in knowledge about puberty in adolescents aged 1 2-1 5 years in the Pond Rice MTsN Jombang District Jombang.

The study design used in this research is to use Pre-experiment with the kind of one group pre-test and post-test design. The population in this study were all adolescents aged 12-15 years in the Pond Rice MTsN Jombang much as 258 people. The sample size used by 52 respondents. The sampling technique used was simple random sampling. Variable consisted of the independent variables, namely education about puberty. and the dependent variable knowledge about puberty adolescents aged 12-15 years. The data was collected using a questionnaire. Further analyzes tested using Wilcoxon statistical test with a = 0.05.

From the obtained results of research conducted, the results prior to the extension contained 5.8% had good knowledge and after counseling to 63.5%. From the test results obtained significant figures Wilcoxon statistics or probability value (0.000) is much lower than the standard 0.05 or significance (p

From the above results is in getting the influence of education on knowledge of adolescents about puberty puberty aged 12-15 years in the Pond Rice MTsN Jombang District Jombang. Expected results of this study add insight researchers to develop and provide additional data and conceptual contribution of the development of science in health knowledge puberty.

Keywords: education, science, youth, puberty

ABSTRACT

The growth of reproductive organs undergoing rapid change and already have the reproductive ability but rather the phenomenon shows some teens do not know about reproductive health. Many young women do not Realize that since it first entered puberty, he had begun producing eggs. This study aims to Determine the effect of counseling about puberty to the knowledge of teenagers about puberty at age 1 2-1 5 years at Rice Farms MTsN sub-district and District of Jombang.

The research designs used in this study is use the Pre-experiments with one group pre test and post test design types. The population in this study were all teenagers aged 12-15 years at Rice Farms MTsN Jombang in 258 people. The sample size used was 52 respondents. The sampling technique used is simple random sampling. The variables consisted of the independent variables, namely education about puberty. and the dependent variable is the knowledge of teenagers aged 12-15 years about puberty. The data was collected by using a questionnaire. Then statistically analyzed by Wilcoxon test with a = 0.05.

From the results of research was obtained the result, before counseling to 5.8% was have good knowledge and after the counseling to 63.5%. from the results of the Wilcoxon Statistic obtained the test was significant or the probability score was (0000) roomates much lower than the standard of 0:05 or significant (p roomates is significant, so the hypothesis is accepted.

From the results of study above was obtained that there is influence of counseling to teenagers' knowledge at age 12-15 years at Rice Farms MTsN sub-district and district Jombang. Hopefully the research can add insight of Researchers in developing and donations provide additional data and thinking on development in health science knowledge of puberty.

Key words: Counseling, Knowledge, Teenagers, Puberty


INTRODUCTION
Puberty is a time when a child is experiencing physical changes, psychological, sexual function and maturation. Puberty term used to express the biological changes that include the morphology and physiology that occur rapidly from childhood to adulthood, especially the reproductive capacity of genital alteration juvenile to the adult stage. Growth of reproductive organs (pubic hair, breasts, testicles and penis) undergoing rapid change and already has the ability to reproduce phenomena but it shows some teenagers do not know about reproductive health. Many young women do not realize that since I first entered puberty, he had begun producing cells telur1. The phenomenon that there are many young people who feel worried, fearful in the face of puberty. In order to understand whether or not the normal growth of the sex organs, must know the normal pattern pertumbuhannya2

Lack of knowledge of adolescents about puberty is influenced by age, experience, information that affects young people in receipt of a learning process in this case is receiving information related to puberty. The impact of lack of knowledge of adolescents about puberty may influence adolescent behavior because the behavior based on knowledge of the more lasting than behavior that is not based on knowledge. Teens who have less knowledge causes negative behavior when pubertas3

Environmental influences and vehicle information very freely, greatly affects the lives of at puberty promiscuity that leads to negative behavior and a high curiosity sometimes mejerumuskan teenager to a complicated problem. The impact of the unfavorable environment such as: smoking, sex, drugs, the environment and the behavior of teenagers at first wanted to try and akirnya mejadikan sense to try such as psychological needs and biologis4.

Data Teens Jombang in 2010 at the age of 10-13 years amount to 47,768 people or about 51% of the changes in puberty. Data showed Jombang DHO Adolescent Health Care Coverage in 2010 with the number 6451 thousand teenagers who got counseling on adolescent health is only 1706 thousand approximately 26.4% and the lowest gain among education school (PHO Jombang, 2010). Based on a preliminary study conducted interviews in MTsN Pond Rice Jombang the 10 students on the knowledge of puberty 10 students obtained 7 (70%) of students did not know about puberty, and 3 (30%) of students knew about puberty

Steps that can be taken by teens to improve knowledge about puberty is seeking information from the mass media and electronic and frequently attend seminars about puberty than positive information. While health workers can provide counseling to adolescents with technical discussions and share leafled about puberty, giving insight and understanding to parents about the importance of early sexual education in adolescents that may lead teens to the best things so that the nature and behavior of adolescents can be maintained at masapubertas5

Based on the phenomenon above, the researcher interested in taking the title of research entitled "influence of illumination to changing knowledge on puberty in adolescents aged 12-15 years in MTsN Pond District district handsome handsome".

Problem Formulation
Is there any effect of education on knowledge of the changes of puberty in adolescents aged 12-15 years in the Pond Rice MTsN Jombang District Jombang

Research Objectives
1. Determine the effect of education on knowledge of adolescents about puberty puberty aged 12-15 years in the Pond Rice MTsN Jombang District Jombang
2. Identifying the knowledge of adolescents about puberty ages 12 - 15 years before giving information in MTsN Rice Pond District Jombang Jombang
3. Identifying the knowledge of adolescents about puberty ages 12 - 15 years after giving information on MTsN Pond Rice Kecanatan Jombang District jombang
4. Analyzing the effect of counseling on knowledge of adolescents about puberty puberty aged 12-15 years in the Pond Rice MTsN Jombang District Jombang

LITERATURE REVIEW
Concept Extension
Counseling in general is any planned effort to influence others either individuals, groups, or communities so that they do what is expected by the education. From this definition implied that educational elements: a) the input is a means of education, b) the process (planned effort to influence others), c) output (doing what is expected or behavior). While health education is the application or the application in the field of education in kesehatan5.
Health education is a process to improve the ability of communities to maintain and improve their health. Moreover, to achieve the degree of perfect health, physically, mentally, and socially, then the public should be able to recognize and realize their aspirations, needs, and to change or cope lingkungannya6.

The concept of knowledge
Knowledge is the impression in the minds of men as a result of use of the five senses. Knowledge is also the outcome of a given case, including recall events that never experienced either intentionally or unintentionally, and this happened after the contact or observation of an object tertentu7.

The concept of puberty
Puberty is a natural thing that must be experienced by every normal woman and not have troubled. If it does not happen, then we need gelisah6. Menstruation is a sign that the fertile cycle has begun. Menstruation occurs when the inner lining of the uterine wall and the shed out in the form known as menstruasi7 blood.
Age when a girl began having periods vary greatly. There is a tendency that current child gets mens first time at a younger age. Puberty can come at the age of 12 years, but there is also an 8-year cycle had begun.
  
The concept of youth
Teenagers are the developmental period during which individuals experience changes from childhood into adulthood, usually between the ages of 13-20 years old. Adolesens term usually indicates the point where reproduction may occur. pubertal hormonal changes cause changes in the appearance of the young people and mental development resulting in the ability to hypnotize and dealing with abstractions 8.

METHOD
In this study, the authors pre-experimental research design is a research design that is used to find a causal relationship with the involvement of research in the manipulation of the variables bebas9. Type of research is one group pretest-posttest design, a design experiment carried out by pre-test before the intervention and then after being given intervention test10 post.
Population is the research object or objects to be diteliti11. The population is all adolescents aged 12-15 years in the Pond Rice MTsN Jombang 258 people as part sample population to be studied or partial amount of the characteristic possessed by populasi10. In this study sample was mostly teenagers aged 12-15 years in the Pond Rice MTsN Jombang by 52 people.
Menurut12 if population> of 100 then it could take 10-15% or 20-25%. In this study, researchers took a sample of 20% of the population.
So: 20% x 258 = 51.6 = 52
            
Sampling technique, which is used in this study is the probability sampling method is simple random sampling random sampling manner regardless of the strata is in populasi10 members.
 In a random sampling or random sampling lotrey can use techniques such as the gathering and sweepstakes until the desired number of samples met. Election by taking 20% ​​of male students and 20% female students and female students aged 12-15 years with a lotrey techniques.

A variable is something that is used as a characteristic, trait, or the size of which is owned or acquired by a unit of study on the concept of understanding something tertentu11. Independent Variable (Variable-Free) The independent variable is the variable that the cause of the change or the onset of the dependent variable (tied) 10.

The independent variable in this study is the extension of pubertas.Variabel Dependent (Dependent Variable) The dependent variable is the variable that is affected or be caused by variable bebas10. The dependent variable in this study is the knowledge of adolescents about puberty aged 12-15 years. Data collection is an activity of research for data collection to be used for penelitian11.

The process of data collection is done in the following way: Ask for permission letter from the research STIKES Jombang regency and Principal MTsN Jombang Rice Pond, then Establish approaches and deliver information to potential respondents and respondents were invited to fill out a letter of approval, after which the respondent is given an explanation of the purpose of the researcher, then give an explanation on how the respondents answered the questionnaire, and Distributing the questionnaire and pre-test respondents are welcome to fill it. Then Provide counseling at pubertal Thereafter respondent Distribute post test questionnaires to the respondents. Once the questionnaire is answered those, then do the data processing.
Once the data is gathered, it is done through the stages of data processing Editing, Coding, Scoring, and Tabulating.Untuk know the relationship between the variables, Wilcoxon paired test performed statistical tests to the significant level of 0.05 using SPSS 16 for windows to determine whether there is influence between two variables the independent variables and the dependent variable

RESULTS
In this chapter will be described the results of research conducted at Rice Pond MTsN Jombang Jombang district on May 20, 2012 with 52 respondents.

TABLE. 1 The frequency distribution of respondents by knowledge of adolescents about puberty in adolescents aged 12-15 years prior to the extension in the Pond Rice MTsN Jombang District Jombang.

No Knowledge Frequency Percentage (%)
1 Good 3 5.8
2 Self 20 38.5
3 Less 29 55.8
Total 52 100
Source: Primary Data 2012

Based on the table above shows the majority (55.8%) knowledge of adolescents about puberty in adolescents aged 12-15 years before being given counseling is less by 29 respondents

Tables. 2 The frequency distribution of respondents by knowledge of adolescents about puberty in adolescents aged 12-15 years performed after counseling in MTsN Rice Pond District Jombang Jombang.


No Knowledge Frequency Percentage (%)
1 Good 33 63.5
2 Self 19 36.5
3 Less 0 0
Total 52 100
Source: Primary Data 2012

Based on the table above shows the majority (63.5%) knowledge of adolescents about puberty in adolescents aged 12-15 years after the extension was granted either by 33 respondents.

Tables. 3 Frequency distribution of respondents by knowledge of adolescents about puberty in adolescents aged 12-15 years before and after counseling in MTsN Rice Pond District Jombang Jombang.

Knowledge Pre Test Post Test
f% f%
Both 3 5.8 33 63.5
Pretty 20 38.5 19 36.5
Less 29 55.8 0 0
Total 52 100 52 100
Source: Primary Data 2012

Table 3 shows that knowledge about puberty before the extension of the 52 respondents 55.8% had less knowledge and after counseling 63.5% had good knowledge.

Wilcoxon test obtained from ρ = 0.000 <0.05 means that there is influence of illumination on the change of knowledge about puberty in adolescents aged 12-15 years in the Pond Rice MTsN Jombang District Jombang. From the results of Wilcoxon test diketahuai that results count -5.929 Z> Z table 1.96 (where the price (-) not calculated because of the absolute) and ρ = 0.000 <0 means = "means" that = "that" can = "can" be interpreted = "means" received = "received" rejected = "rejected" = h0 "h0" h1 = "h1" span = "span" a = "a">

DISCUSSION
Knowledge of adolescents about puberty in adolescents aged 12-15 years prior to extension
Knowledge of adolescents about puberty in adolescents aged 12-15 years before the extension is less. This situation is caused by a factor that is the source of information. That the majority of respondents get information resources from the teacher.
Knowledge is a variety of symptoms encountered and acquired through observation of human senses. Knowledge occurs when someone uses the senses or his intellect to recognize certain objects or events that have never seen or felt before. For example, when someone tasting a new dish known, he will gain knowledge about the shape, flavor, and aroma of the dish 13.

Based on the results of the study showed that the majority (71.2%) of respondents get information resources from teachers by 37 respondents
 Menurut15. that if the information is growing very rapidly, the knowledge is growing very fast. Sources of information will sharpen the brain to think that increasing one's knowledge. In other words, the fewer people get the less knowledge.

Knowledge of adolescents less because fewer teens are getting information about puberty they are getting information about puberty only from their teachers so the time or materials that give to adolescents is very short, while the issues of puberty immense that most teenagers still think that puberty is a taboo and rarely discussed the causes they lack knowledge.

Knowledge of adolescents about puberty in adolescents aged 12-15 years performed after counseling
The majority (63.5%) knowledge of adolescents about puberty in adolescents aged 12-15 years after the counseling is done well. This is because teens are getting education about puberty from researchers.

Counseling in general is any planned effort to influence others either individuals, groups, or communities so that they do what is expected by the education. From this definition implied that educational elements: a) the input is a means of education, b) the process (planned effort to influence others), c) output (doing what is expected or behavior). While health education is the application or the application in the field of health education (Notoatmodjo, 2007).

Counseling or health education is one of the factors that can affect a person's knowledge, it can be seen from these results yield good knowledge increased to as many as 33 respondents (63.5%) due to extension in which education can increase knowledge of teen. It may also be supported by the way the officers are able to convey the material in a clear and attractive so that it can be followed by respondents with good and of course the media and methods used appropriately so as to help the youth to understand the material as well as show the pictures and provide leaflets on each each respondent. In this case means health education is very important in improving adolescent knowledge as suggested by the above theory.
Effect of counseling to changes in knowledge about puberty in adolescents aged 12-15 years

According to Table 3 shows that the Knowledge of puberty of 52 respondents before counseling 55.8% have less knowledge and after counseling 63.5% had good knowledge.
Sub Jombang Jombang.
The statement above is in accordance with the concept of Health education is a process to improve the ability of communities to maintain and improve their health. Moreover, to achieve the degree of perfect health, physically, mentally, and socially, then the public should be able to recognize and realize their aspirations, needs, and to change or cope with the environment 14.
Counseling is done in MTsN Rice Pond District Jombang Jombang be said to be successful, it is because the respondent notice counseling or information provided by researchers and support young people who have a great curiosity that investigators easily incorporate the concept of puberty in those who could be proved by many respondents were asked about the response to the problems of puberty. With the extension about puberty respondents know and understand about puberty and can repeat the case was presented by researchers after doing research.

Conclusion
1. Knowledge of puberty in adolescents aged 12-15 years prior to the extension in the Pond Rice MTsN Jombang Jombang district is less (55.8%).
2. Knowledge of puberty in adolescents aged 12-15 years performed after counseling in MTsN Rice Pond District Jombang Jombang was good (63.5%).
3. There is the influence of education on changes in knowledge about puberty in adolescents aged 12-15 years in the Pond Rice MTsN Jombang District Jombang.

REFERENCES
1. Aden. , 2010. Psychological Changes In Puberty Period. http://www.cyber-net.com. Retrieved January 22, 2012.
2. Sarwono. , 2007. Obstetrics. London: Community Development Foundation Library.
3. Suliha. , 2008. Knowledge Teens About Puberty. http://repository.usu.ac.id/bitstream. Retrieved February 2, 2012.
4. Rendra. , 2009. Factors affecting puberty. http://www.inforemajasehat.com. Retrieved January 22, 2012.
5. Asrori. , 2011. Adolescent Development Psychology Students. Jakarta. Earth Literacy.
6. Dariyo. , 2008. Developmental Psychology. Bandung. Rosdarkarya
7. Rustam. , 2008. Synopsis of Obstetrics Volume 2. Jakarta. Rineka Jakarta.
8. Potter. , 2005. Fundamentals of Nursing. EGC. Jakarta.
9. Nursalam. , 2008. Concept and Application of Nursing Research Methodology. Jakarta: Salemba Medika
10. Hurlock. , 1998. According to the characteristics of adolescents Hurlock.http :/ / poems-blogspot.com.Diakses 3 April 2012.
11. Notoatmodjo. , 2010. Methods for Health Research. Jakarta: PT. Rineka Copyright
12. Arikunto, 2006. Research Procedures. New Edition. Jakarta: Rineka Notices.
13. Meliono. , 2008. Knowledge Indonesian Wikipedia Encyclopedia Bebas.http :/ / www.wikipedia.com.id accessed on /. February 10, 2012.
14. Effendy. , 2004. Fundamentals of Nursing. Jakarta. EGC.
15. Retnowati. , 2006. Teen action in puberty. http://www.sofia-psy.staff.ugm.ac.id. Retrieved February 23, 2012.

AIDS singkatan acquired immune deficiency syndrome dan adalah tahap akhir infeksi yang disebabkan oleh virus yang disebut Human Immunodeficiency Virus atau HIV. Virus ini menyebabkan kerusakan yang parah terhadap sistem kekebalan tubuh.

Berapa banyak orang yang mempengaruhi HIV/AIDS?

AIDS adalah keenam penyebab utama kematian di antara orang-orang yang berusia 25-44 di Amerika Serikat. Ini adalah sebuah perbaikan karena itu adalah pembunuh nomor satu pada tahun 1995.
Pada akhir 2010, sekitar 91,500 orang di Inggris yang hidup dengan HIV. Dari jumlah tersebut, sekitar 1 dalam 4 (22.000 total) tidak tahu mereka terinfeksi.
Organisasi kesehatan dunia (WHO) memperkirakan bahwa sekitar 34 juta orang di dunia yang hidup dengan HIV. Virus ini tersebar luas terutama di sub-Sahara Afrika, seperti Afrika Selatan, Zimbabwe, dan Mozambik.

Penyebab AIDS

AIDS disebabkan oleh infeksi HIV. Virus menyerang sistem kekebalan tubuh yang meninggalkan individu yang rentan terhadap mengancam kehidupan infeksi dan kanker. Umum bakteri, jamur, parasit dan virus yang biasanya tidak menimbulkan penyakit serius pada orang dengan sistem kekebalan tubuh yang sehat dapat mengubah mematikan untuk pasien AIDS.

Bagaimana penularan HIV

HIV dapat ditemukan di semua cairan tubuh yang termasuk air liur, Jaringan sistem saraf dan cairan tulang belakang, darah, air mani, cairan pre-seminal, yang merupakan cairan yang keluar sebelum ejakulasi, sekresi vagina, air mata dan air susu ibu. Hanya darah, air mani, dan payudara susu telah ditunjukkan untuk mengirimkan infeksi kepada orang lain.
Virus ini ditularkan melalui kontak seksual termasuk seks oral, vagina dan anus yang tidak aman dan melalui transfusi darah yang terkontaminasi yang mengandung HIV.
Lain modus penularan adalah jarum suntik atau suntikan dengan HIV terinfeksi individu.
Wanita hamil dapat menularkan virus ke nya bayi yang belum lahir melalui sirkulasi darah bersama mereka, atau ibu menyusui dapat menularkan kepada bayinya dalam ASI nya.
Infeksi HIV tidak menyebar oleh kontak biasa, nyamuk, menyentuh atau memeluk.

Siapa yang beresiko?

Yang risiko tertinggi termasuk pengguna narkoba suntikan yang berbagi jarum, bayi yang lahir dari ibu dengan HIV (terutama jika ibu tidak menerima terapi anti-HIV selama kehamilan), mereka terlibat dalam seks atau anal yang tidak aman dengan individu positif HIV, dan mereka yang menerima transfusi darah atau pembekuan produk antara 1977 dan 1985 (sebelum pemeriksaan HIV menjadi praktek standar).

Gejala HIV/AIDS

Infeksi HIV dapat menyebabkan gejala tidak selama satu dekade atau lebih. Pada tahap ini, operator dapat mengirimkan infeksi kepada orang lain tanpa sadar. Jika infeksi tidak dideteksi dan ditangani, sistem kekebalan tubuh secara bertahap melemah dan AIDS berkembang.
Akut infeksi HIV memakan waktu beberapa minggu untuk bulan untuk menjadi bebas-gejala infeksi HIV. Kemudian menjadi gejala awal infeksi HIV dan kemudian berlangsung ke AIDS.

Bagaimana kemajuan penyakit ditandai?

Maju infeksi HIV dengan darah menunjukkan lebih tinggi beban virus dan tetes jumlah sel T CD4 di bawah 200 sel/mm3. Sel-sel CD4 adalah jenis sel T. Sel T adalah sel-sel sistem kekebalan tubuh. Mereka juga disebut "sel pembantu."
Ada sekelompok kecil pasien yang mengembangkan AIDS sangat lambat, atau tidak sama sekali. Pasien ini disebut nonprogressors, dan banyak tampaknya memiliki perbedaan genetik yang mencegah virus secara signifikan merusak sistem kekebalan tubuh mereka.

Infeksi oportunistik

Ini adalah infeksi yang biasanya tidak mempengaruhi individu dengan sistem kekebalan tubuh yang sehat tapi pasien AIDS rentan terhadap infeksi. Ini termasuk infeksi virus seperti:

• virus herpes simpleks
• infeksi herpes zoster
• kanker seperti Sarkoma Kaposi, non-Hodgkin limfoma
• infeksi jamur seperti kandidiasis
• infeksi bakteri seperti tuberkulosis

Infeksi lain termasuk angiomatosis Bacillary, Candida esofagitis, Pneumocystic mengalami radang paru-paru, AIDS demensia, Cryptosporidium diare, cryptococcal meningigits dan Toxoplasma ensefalitis.

Perawatan bantu

Ada tidak ada obat untuk AIDS setelah berkembang. Ada agen yang tersedia yang dapat membantu menjaga gejala di Teluk dan meningkatkan kualitas dan panjang hidup bagi mereka yang telah mengembangkan gejala.
Narkoba terhadap HIV termasuk terapi antiretrovirus. Ini mencegah replikasi virus HIV dalam tubuh. Kombinasi dari beberapa obat antiretrovirus, disebut terapi antiretrovirus sangat aktif (HAART), telah sangat efektif dalam mengurangi jumlah partikel HIV di dalam aliran darah. Mencegah replikasi virus dapat meningkatkan jumlah sel T atau jumlah sel CD4 dan membantu sistem kekebalan tubuh sembuh dari infeksi HIV.
Obat-obatan juga diresepkan untuk mencegah infeksi oportunistik jika jumlah CD4 rendah.

Hasil dari HIV

AIDS ini hampir selalu berakibat fatal tanpa pengobatan. HAART namun telah secara dramatis meningkat jumlah waktu orang-orang dengan HIV tetap hidup.

Pencegahan HIV

Seks aman ukuran dengan penggunaan kondom, menghindari penggunaan obat-obatan terlarang atau bersama jarum atau jarum suntik, menghindari kontak dengan darah dan cairan dengan memakai pakaian pelindung, masker, dan kacamata dll membantu mencegah penularan.
HIV-positif wanita yang ingin menjadi hamil mungkin membutuhkan terapi sementara mereka hamil untuk mencegah penularan kepada bayinya. Dinas Kesehatan Umum merekomendasikan bahwa wanita yang terinfeksi HIV di Amerika Serikat menghindari menyusui untuk mencegah transmisi HIV untuk bayi mereka melalui ASI.

Anda Mendengkur? Waspadai Resiko Penyakit Jantung