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"ABSTRAKLatar Belakang : Aphanizomenon Flos Aquae merupakan suatu spesiesganggang biru-hijau yang dimanfaatkan sebagai suplemen nutrisi di seluruh duniatermasuk di Indonesia dan diketahui memiliki banyak aktivitas biologisbermanfaat seperti efek anti-inflamasi, anti-oksidan dan analgetik. Osteoartritis(OA) lutut merupakan permasalahan yang cukup sering didapatkan pada lanjutusia (lansia) namun sampai saat ini belum tersedia modalitas farmakologik sebagai terapi ajuvan yang sesuai dan aman pada kelompok lansia. Aphanizomenon Flos Aquae dapat menjadi alternatif yang baik sebagai terapiajuvan dalam tatalaksana pasien lansia dengan OA lutut. Tujuan Penelitian : Mengkaji pengaruh AFA terhadap perbaikan klinis OA lututpada lansia berdasarkan indeks WOMAC.Metode : Dilakukan uji klinis acak tersamar ganda mulai November 2014 hinggaMei 2015 terhadap pasien lanjut usia dengan OA lutut di poliklinik Geriatri danReumatologi di RSUP Hasan Sadikin Bandung. Subjek dibagi menjadi 2kelompok yaitu satu kelompok mendapat kapsul berisi AFA 2 kali 2 kapsul (1,28g/hari) dan kelompok lainnya mendapat plasebo selama 60 hari. Skor IndeksWOMAC dinilai pada hari ke-1 dan hari ke-60 untuk menilai luaran klinis pasienOA. Perbedaan skor indeks WOMAC pada akhir penelitian dianalisis dengan ujiMann-Whitney. Hasil : Dari total 254 subjek didapatkan 98 subjek yang memenuhi kriteria awalpenelitian dan kemudian dilakukan randomisasi menjadi kelompok perlakuan danplasebo, masing-masing terdiri dari 49 subjek. Kedua kelompok sebanding padaseluruh faktor prognostik penting. Setelah analisis, skor indeks WOMACkomposit kelompok AFA berbeda secara bermakna (p<0,001) dibanding plasebopada akhir penelitian dengan masing-masing skor 8 (median,RIK 3-18) vs. 18(median,RIK 8-32). Tidak ditemukan adanya efek samping yang serius selamapenelitian. Simpulan : Aphanizomenon Flos Aquae dapat memperbaiki klinis berdasarkanskor indeks WOMAC serta aman diberikan pada pasien lansia dengan OA lutut.

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ABSTRACTBackground: Aphanizomenon Flos Aquae is a species of blue-green algae whichis commonly used as nutritional supplement in the world, including in Indonesiaand is known to have many beneficial biological activities such as antiinflammatory,anti-oxidantand analgesics. Osteoarthritis (OA) knee is a problemthat is quite common in the older people but until now there has not beenpharmacologic modalities as a adjunctive therapy available which are suitable and safe. Aphanizomenon Flos Aquae may become a good alternative as an adjunctive therapy in older patients with knee OA.Objective : To determine the effect of AFA on the improvement of clinicaloutcome of Knee OA in older patients based on WOMAC index scores.Methods : A double-blind randomized clinical trial was conducted fromNovember 2014 until May 2015 to older adult patients with Knee OA at theGeriatric and Rheumatology clinic in Hasan Sadikin General Hospital. Thesubjects were divided into groups, each group received capsules containing AFA2 times 2 capsules (1.28 gr/day) and the other received placebo for 60 days.WOMAC Index scores were assessed at day 1 and day 60. The difference inassessment of WOMAC index scores of each group at the end of the study wereanalyzed by Mann-Whitney. Results : Out of total 254 subjects, there were 98 patients who met the initialcriteria and were randomized into two groups, AFA and placebo group with eachconsisting of 49 subjects. Both groups were comparable in all importantprognostic factors. The composite WOMAC Index scores in AFA group wassignificantly different than the placebo group at the end of the study (p <0.001),with each score of 8 (IQR,median 3-18) vs. 18 (IQR,median 8-32) respectively.There was no serious adverse events found throughout the study. Conclusion : Aphanizomenon Flos Aquae was able to show clinical improvement based on WOMAC scoring index and safe to use in the older adults with Knee OA.;Background: Aphanizomenon Flos Aquae is a species of blue-green algae whichis commonly used as nutritional supplement in the world, including in Indonesiaand is known to have many beneficial biological activities such as antiinflammatory,anti-oxidantand analgesics. Osteoarthritis (OA) knee is a problemthat is quite common in the older people but until now there has not beenpharmacologic modalities as a adjunctive therapy available which are suitable and safe. Aphanizomenon Flos Aquae may become a good alternative as an adjunctive therapy in older patients with knee OA.Objective : To determine the effect of AFA on the improvement of clinicaloutcome of Knee OA in older patients based on WOMAC index scores.Methods : A double-blind randomized clinical trial was conducted fromNovember 2014 until May 2015 to older adult patients with Knee OA at theGeriatric and Rheumatology clinic in Hasan Sadikin General Hospital. Thesubjects were divided into groups, each group received capsules containing AFA2 times 2 capsules (1.28 gr/day) and the other received placebo for 60 days.WOMAC Index scores were assessed at day 1 and day 60. The difference inassessment of WOMAC index scores of each group at the end of the study wereanalyzed by Mann-Whitney. Results : Out of total 254 subjects, there were 98 patients who met the initialcriteria and were randomized into two groups, AFA and placebo group with eachconsisting of 49 subjects. Both groups were comparable in all importantprognostic factors. The composite WOMAC Index scores in AFA group wassignificantly different than the placebo group at the end of the study (p <0.001),with each score of 8 (IQR,median 3-18) vs. 18 (IQR,median 8-32) respectively.There was no serious adverse events found throughout the study. Conclusion : Aphanizomenon Flos Aquae was able to show clinical improvement based on WOMAC scoring index and safe to use in the older adults with Knee OA."

"TUJUAN: Mengetahui efek metformin atau DLBS3233 terhadap kadar AMH. LATAR BELAKANG: SOPK merupakan sindrom yang diketahui berkaitan dengan resistensi insulin dalam patofisiologi dan peranan AMH dalam patogenesis. Maka salah satu bagian dari tatalaksana SOPK adalah dengan pemberian insulin sensitizing agent ISA. ISA yang telah banyak digunakan yaitu metformin yang terbukti dalam memperbaiki siklus haid, namun obat ini juga menimbulkan efek samping seperti keluhan gastrointestinal yang cukup berat. Sehingga perkembangan obat herbal seperti fraksi bioaktif DLBS3233 memberikan harapan akan ISA yang efektif, namun memiliki efek samping minimal. Peranan ISA dalam efek perubahan AMH masih kontroversial, dan hanya ditemui penelitian yang meneliti metformin. DESAIN DAN METODE: Penelitian ini menggunakan desain uji klinis acak tersamar ganda yang berlangsung pada bulan Maret 2013 hingga Juni 2015 di klinik Yasmin, RSCM Kencana dan RS Hasan Sadikin, Bandung. Subjek penelitian akan mendapatkan metformin sebanyak 2x750mg atau DLBS3233 1x100mg per hari selama enam bulan. Evaluasi kadar AMH akan dilakukan sebanyak dua kali, sebelum dan sesudah pengobatan. HASIL: Sebanyak 20 subjek mendapati metformin dan 18 subjek mendapati DLBS3233. Rerata kadar AMH sebelum pengobatan didapati 9,30 5,06 ng/mL dan 11,27 6,47 ng/mL. Pasca pengobatan, didapati penurunan kadar AMH yang signifikan sebesar 1,52 0,07 p < 0,001. Penurunan kadar AMH didapati lebih tinggi pada grup metformin bila dibandingkan dengan DLBS3233 ? AMH = 1,83 ng/mL vs 1,15 ng/mL. Namun, metformin menimbulkan efek samping yang lebih signifikan dibandingkan DLBS3233 p=0,01. Sebanyak 7 pasien 18,42 hamil selama penelitian ini. Namun efek samping pengobatan jauh dirasakan oleh subjek yang mendapatkan metformin dibandingkan DLBS3233 p=0,01. KESIMPULAN: Baik metformin atau fraksi bioaktif DLBS3233 dapat menurunkan kadar AMH, dan DLBS3233 merupakan pilihan terapi SOPK dengan efek samping yang minimal.

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OBJECTIVE: To determine the effect of metformin and DLBS3233 on serum AMH level.

BACKGROUND: PCOS is known to be associated with insulin resistance in the pathophysiology and Anti Mullerian Hormone AMH in the pathogenesis. Thus, one of management of PCOS is to give insulin sensitizing agent ISA. Type of ISA which has been widely used is metformin which proven to improve menstrual cycle, but this medication cause major side effect such as gastrointestinal problems. So, the development of herbal medicine such as Bioactive Fraction DLBS3233, offer effective medicine, with minimal side effects. To date, the role of ISA to effects the changes in AMH still controversial, and studies only examine the effect of metformin to the level of AMH.

METHOD: Double blind randomized controlled trial was conducted in Yasmic Clinic, Cipto Mangunkusumo General Hospital, Kencana and Hasan Sadikin hospital, Bandung within March 2013 until June 2015. PCOS patient diagnosed using Rotterdam All participant get daily dose of metformin 2x750mg or DLBS3233 1x100mg for six months. Evaluation of serum AMH level was conducted twice prior therapy and after the completion of the therapy. Protocol analysis was carried out upon differences of AMH using SPSS 20.

RESULTS: 20 subjects received metformin, while 18 subject received DLBS3233. Level of AMH prior medication was known to be 9,30 5,06 ng mL and 11,27 6,47 ng mL. After six months of therapy, there is significant decrease of AMH level of 1,52 0,07 p 0,001. The decrease level of AMH was observed higher in metformin group compared to DLBS3233 AMH 1,83 ng mL vs 1,15 ng mL. However, metformin causing more side effects compared to DLBS3233 p 0,01. There are total of 7 subjects 18,42 pregnant during the studies.

CONCLUSION: There rsquo s a significant decrease of AMH level after administration of either metformin or DLBS3233. "

"ABSTRAK Latar belakang: Demam, pengurangan waktu tidur, nyeri dan reaksi lokal adalahbeberapa kejadian ikutan pasca imunisasi. Untuk mencegah hal tersebut baiktenaga medis maupun orang tua memberikan profilaksis parasetamol pascaimunisasi. Peraturam Menteri Kesehatan Republik Indonesia dan PedomanImunisasi IDAI belum menetapkan secara tegas boleh atau tidaknya pemberianprofilaksis parasetamol pasca imunisasi.Tujuan: Mengetahui efektivitas pemberian profilaksis parasetamol oral untukmencegah kejadian ikutan pasca imunisasi kombinasi DTwP-Hep B-Hib.Metode: Uji Klinis tersamar acak ganda (double blind randomized control trialI)dengan pemberian parasetamol dan plasebo pada pasien pasca imunisasikombinasi DTwP-Hep B-Hib di Puskesmas Kecamatan Kramat Jati danPuskesmas Kelurahan Batu Ampar selama September 2015 sampai Oktober 2015.Satu hari pasca imunisasi, kelompok perlakuan diberikan parasetamol (40-50mg/kgBB/hari), terbagi 4 dosis sedangkan kelompok kontrol, mendapatkanplasebo. Selama empat hari pasca imunisasi dilakukan pengukuran suhu aksila,lama tidur, dan reaksi inflamasi lokal.Hasil: Subjek penelitian ini terdiri dari 100 bayi yang mendapatkan imunisasikombinasi DTwP-Hep B-Hib ketiga. Karakteristik dasar meliputi usia, jeniskelamin, dan status gizi tidak berbeda di kedua kelompok. Subjek penelitianmendapatkan profilaksis parasetamol (50 subjek) dan profilaksis plasebo (50subjek). Seluruh subjek penelitian tidak demam, tidak mengalami gangguan tidur,dan tidak ditemukan reaksi lokal. Pemberian parasetamol 24 jam pasca imunisasiDTwP-Hep B-Hib menunjukkan penurunan suhu 0,1 OC - 0,2 OC yang bermaknasecara statistik (p < 0,05) pada 24 jam pertama pasca imunisasi. Pemberianparasetamol menunjukkan waktu tidur yang lebih lama namun tidak bermaknasecara statistik (p>0,05) pada lama tidur.ABSTRACT Background: Fever, decreased sleep time, pain and local reaction are adverseevent following vaccination especially DTwP vaccine. Parent and also medicalstaff almost give paracetamol prophylactic to reduce adverse event aftervaccinantion. Peraturam Menteri Kesehatan Republik Indonesia (Ministry ofHealth Republic of Indonesia Health Law) and Pedoman Imunisasi IDAI(Indonesia Pediatric Society Immunization Guideline) never explicitly allowed ornot prophylactic administration of paracetamol post immunization.Objective: To asses the efficacy of prophylactic administration of paracetamolcompared with placebo for prevent adverse event after immunization.Meth0d: A randomized double-blind clinical trials by adminisert paracetamol andplacebo in patients post-immunization DTwP - Hep B - Hib in Kramat Jati districtprimary health care and Batu Ampar sub-distric primary health care duringSeptember 2015 to October 2015. One day after vaccination , the treatment groupwas given paracetamol (40-50 mg/kg/day) , divided into 4 doses , while thecontrol group was given placebo . Axillary temperature , time of sleep , and localreactions was evaluated until 4 day after vaccination.Result: Subjects of this study consisted of 100 infants (50 with paracetamol & 50with placebo) after DTwP-Hep B-Hib third primary immunization. The baselinecharacteristic including age, gender, and nutritional status were similar in bothgroups . All subject showed no fever, no local reaction, and no sleep disturbance.Prophylactic paracetamol 24 hours post DTwP-Hep B-Hib immunization showeda decrease in temperature of 0.1 OC - 0.2 OC (p<0.05) in the first 24 hours postimmunization.Administration of paracetamol showed longer sleep time (p> 0.05)in the first 24 hours post- immunization.;Background: Fever, decreased sleep time, pain and local reaction are adverseevent following vaccination especially DTwP vaccine. Parent and also medicalstaff almost give paracetamol prophylactic to reduce adverse event aftervaccinantion. Peraturam Menteri Kesehatan Republik Indonesia (Ministry ofHealth Republic of Indonesia Health Law) and Pedoman Imunisasi IDAI(Indonesia Pediatric Society Immunization Guideline) never explicitly allowed ornot prophylactic administration of paracetamol post immunization.Objective: To asses the efficacy of prophylactic administration of paracetamolcompared with placebo for prevent adverse event after immunization.Meth0d: A randomized double-blind clinical trials by adminisert paracetamol andplacebo in patients post-immunization DTwP - Hep B - Hib in Kramat Jati districtprimary health care and Batu Ampar sub-distric primary health care duringSeptember 2015 to October 2015. One day after vaccination , the treatment groupwas given paracetamol (40-50 mg/kg/day) , divided into 4 doses , while thecontrol group was given placebo . Axillary temperature , time of sleep , and localreactions was evaluated until 4 day after vaccination.Result: Subjects of this study consisted of 100 infants (50 with paracetamol & 50with placebo) after DTwP-Hep B-Hib third primary immunization. The baselinecharacteristic including age, gender, and nutritional status were similar in bothgroups . All subject showed no fever, no local reaction, and no sleep disturbance.Prophylactic paracetamol 24 hours post DTwP-Hep B-Hib immunization showeda decrease in temperature of 0.1 OC - 0.2 OC (p<0.05) in the first 24 hours postimmunization.Administration of paracetamol showed longer sleep time (p> 0.05)in the first 24 hours post- immunization.;Background: Fever, decreased sleep time, pain and local reaction are adverseevent following vaccination especially DTwP vaccine. Parent and also medicalstaff almost give paracetamol prophylactic to reduce adverse event aftervaccinantion. Peraturam Menteri Kesehatan Republik Indonesia (Ministry ofHealth Republic of Indonesia Health Law) and Pedoman Imunisasi IDAI(Indonesia Pediatric Society Immunization Guideline) never explicitly allowed ornot prophylactic administration of paracetamol post immunization.Objective: To asses the efficacy of prophylactic administration of paracetamolcompared with placebo for prevent adverse event after immunization.Meth0d: A randomized double-blind clinical trials by adminisert paracetamol andplacebo in patients post-immunization DTwP - Hep B - Hib in Kramat Jati districtprimary health care and Batu Ampar sub-distric primary health care duringSeptember 2015 to October 2015. One day after vaccination , the treatment groupwas given paracetamol (40-50 mg/kg/day) , divided into 4 doses , while thecontrol group was given placebo . Axillary temperature , time of sleep , and localreactions was evaluated until 4 day after vaccination.Result: Subjects of this study consisted of 100 infants (50 with paracetamol & 50with placebo) after DTwP-Hep B-Hib third primary immunization. The baselinecharacteristic including age, gender, and nutritional status were similar in bothgroups . All subject showed no fever, no local reaction, and no sleep disturbance.Prophylactic paracetamol 24 hours post DTwP-Hep B-Hib immunization showeda decrease in temperature of 0.1 OC - 0.2 OC (p<0.05) in the first 24 hours postimmunization.Administration of paracetamol showed longer sleep time (p> 0.05)in the first 24 hours post- immunization.;Background: Fever, decreased sleep time, pain and local reaction are adverseevent following vaccination especially DTwP vaccine. Parent and also medicalstaff almost give paracetamol prophylactic to reduce adverse event aftervaccinantion. Peraturam Menteri Kesehatan Republik Indonesia (Ministry ofHealth Republic of Indonesia Health Law) and Pedoman Imunisasi IDAI(Indonesia Pediatric Society Immunization Guideline) never explicitly allowed ornot prophylactic administration of paracetamol post immunization.Objective: To asses the efficacy of prophylactic administration of paracetamolcompared with placebo for prevent adverse event after immunization.Meth0d: A randomized double-blind clinical trials by adminisert paracetamol andplacebo in patients post-immunization DTwP - Hep B - Hib in Kramat Jati districtprimary health care and Batu Ampar sub-distric primary health care duringSeptember 2015 to October 2015. One day after vaccination , the treatment groupwas given paracetamol (40-50 mg/kg/day) , divided into 4 doses , while thecontrol group was given placebo . Axillary temperature , time of sleep , and localreactions was evaluated until 4 day after vaccination.Result: Subjects of this study consisted of 100 infants (50 with paracetamol & 50with placebo) after DTwP-Hep B-Hib third primary immunization. The baselinecharacteristic including age, gender, and nutritional status were similar in bothgroups . All subject showed no fever, no local reaction, and no sleep disturbance.Prophylactic paracetamol 24 hours post DTwP-Hep B-Hib immunization showeda decrease in temperature of 0.1 OC - 0.2 OC (p<0.05) in the first 24 hours postimmunization.Administration of paracetamol showed longer sleep time (p> 0.05)in the first 24 hours post- immunization."

"ABSTRAKLatar belakangBerbagai studi terdahulu melaporkan bahwa alfacalcidol mampu meningkatkan kekuatan otot, keseimbangan dan signifikan dalam menurunkan kejadian jatuh pada ras Kaukasia. Namun belum ada penelitian yang membuktikan peran alfacalcidol terhadap mobilitas fungsional pada ras Asia.TujuanMengetahui pengaruh pemberian alfacacidol 0,5 µg selama 90 hari terhadap mobilitas fungsional dasar perempuan usia lanjut di Indonesia.MetodeDilakukan uji klinis acak tersamar ganda pada bulan April-September 2012 terhadap 95 pasien perempuan usia lanjut di Poliklinik Geriatri RS Cipto Mangunkusumo Jakarta, Indonesia. Subyek dibagi menjadi kelompok yang mendapat alfacalcidol dan kalsium 500 mg sehari sekali selama 90 hari dan kelompok yang mendapat plasebo dan kalsium 500 mg. Dilakukan uji timed-up and Go Test (TUG) pada awal dan akhir penelitian. Dilakukan analisis per protokol dan uji Mann-Whitney untuk melihat perbedaaan mobilitas fungsional pada kedua kelompok setelah intervensi.Hasil95 subyek dirandomisasi dan dibagi menjadi dua kelompok, terdiri dari 48 subyek yang mendapat plasebo dan 47 subyek mendapat alfacalcidol. Setelah tiga bulan pengamatan didapatkan perbaikan waktu uji TUG yang signifikan pada kedua kelompok (2,49 vs 1,83 detik; p<.0001). Terdapat perbaikan waktu uji TUG yang signifikan dari kelompok alfacalcidol dibandingkan dengan kelompok plasebo (9,01 vs.10,07 detik; p = 0.028).KesimpulanAlfacalcidol dengan dosis 0,5 µg satu kali per hari selama 90 hari terbukti mampu meningkatkan mobilitas fungsional dasar pada perempuan usia lanjut Indonesia.

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ABSTRACTBackgroundPrevious studies reported the D-analog alfacalcidol, increases muscle power and balance and lead to a highly significant decreases in the number of fallers and falls in Caucasian elderly community-dwelling population.ObjectiveTo determine the effect of alfacalcidol on functional mobility in Indonesian elderly women community-dwelling population.MethodsA randomized, double-blind controlled trial was conducted in elderly women subjects geriatric clinic of Cipto Mangunkusumo National Hospital Jakarta Indonesia on April-September 2012. Intervention group was given 0,5 mcg alfacalcidol and 500 mg calcium daily for 90 days and another group was given placebo and 500 mg calcium. Balance test, Timed-up and Go Test (TUG) was measured at the beginning and after 3 months. Per protocol analysis to functional mobility after intervention between the two groups was performed.Results95 subjects were fulfiling study criteria and randomized into 2 groups, containing 47 subjects in alfacalcidol group and 48 subjects in placebo group. Both groups were comparable in all important prognostic factors including age, BMI, nutritional status, muscle strength. After three months the mean time in alfacalcidol group used for the TUG was decrease significantly by 2,49 s (p<.0001). There were significant improvement of the median time for TUG in the group that received alfacalcidol compared to placebo (9,01 vs.10,07 p = 0.028).ConclusionTreatment with 0.5 mg alfacalcidol with calcium effectively improved functional mobility in Indonesian elderly women."

"Pendahuluan Edukasi dan kepatuhan minum obat antihipertensi pada pasien hipertensi usia lanjut adalah salah satu faktor yang menjadi bagian tatalaksana hipertensi secara holistik dan komprehensif, mengingat hipertensi merupakan salah satu masalah pada usia lanjut yang sangat penting, dan memberikan dampak berbagai komplikasi kardiovaskular yang tinggi pada usia lanjut.TujuanMempelajari pengaruh edukasi terstruktur dan kepatuhan minum obat antihipertensi dalam bentuk pengisian checklist untuk membantu penurunan tekanan darah sebagai bagian dari tatalaksana hipertensi pada pasien usia lanjutMetodeDilakukan uji klinis acak tersamar ganda mulai Oktober 2012 hingga Februari 2013 terhadap 188 pasien usia lanjut dengan hipertensi di tiga poliklinik di RSCM Jakarta Indonesia. Subyek dibagi menjadi 3 kelompok, yaitu kelompok I yang mendapat edukasi terstruktur dan checklist, kelompok II yang mendapat edukasi terstruktur dan kelompok III tanpa edukasi terstruktur dengan checklist. Edukasi terstruktur dan checklist diberikan sebanyak 3 kali perbulan selama 90 hari. Dilakukan analisis dengan uji anova untuk melihat perbedaan tekanan darah pada ketiga kelompok setelah intervensi dengan prinsip analisis per protocol.HasilHasil randomisasi pada ketiga kelompok, didapatkan 182 subyek yang sesuai kriteria penelitian dan mengikuti penelitian sampai akhir, masing-masing terdiri dari 60 subyek pada kelompok I, 61 subyek pada kelompok II dan 61 subyek pada kelompok III. Pada akhir pengamatan, TDS kelompok I turun menjadi 130 (90- 179) mmHg, TDS kelompok II turun menjadi 135(80-174) mmHg, sedangkan TDS kelompok III turun menjadi 133 (102-209) mmHg (p=0,04). TDD kelompok I turun menjadi 70 (48-100) mmHg, TDD kelompok II turun menjadi 74 (45-103) mmHg, sedangkan TDD kelompok III turun menjadi 78 (60-102) mmHg (p<0,001).SimpulanEdukasi terstruktur memiliki pengaruh bermakna terhadap penurunan tekanan darah sistolik dan diastolik pada kelompok hipertensi usia lanjut. Kepatuhan minum obat antihipertensi dalam bentuk checklist tidak memiliki pengaruh bermakna terhadap penurunan tekanan darah sistolik dan diastolik pada kelompok hipertensi usia lanjut.

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Background

Hypertension is one of the important problems in elderly due to high impact of cardiovascular complications. Education and antihypertensive medications adherence in elderly hypertensive patients are factors that influenced treatment effect in a holistic and comprehensive way.

Objectives

To determine the effect of structured education and antihypertensive medications adherence in decreasing blood pressure as part of the hypertension treatment in elderly patients.

Methods

A randomized clinical trial was conducted since October 2012 until February 2013 on 188 elderly patients with hypertension at clinics in Jakarta Indonesia Cipto Mangunkusumo. Subjects were divided into groups that received structured education and checklist (group I), structured education group (group II) and the group with no structured education but received checklist (group III). Structured education was given 3 times per month for 90 days. Systolic and Diastolic Blood pressure (SBP and DBP) were measured on day-1 and day-90. Analysis with anova test to see the difference of blood pressure among all three groups after intervention was conducted based on per protocol analysis.

Results

Among 188 subjects who met the initial criteria after randomization in all three groups, we received 182 subjects who fit the study criteria and completed the study, each consisting of 60 subjects in group I, 61 subjects in group II and 61 subjects in group III. The three groups were comparable in all important prognostic factors. At the end of the observation, SBP of group I reduced to 130 (90-179) mmHg, group II to 135 (80-174) mmHg, while group III to 133 (102-209) mmHg (p=0.04). DBP of group I reduced to 70 (48-100) mmHg, group II to 74 (45-103) mmHg, while group III to 78 (60-102) mmHg (p <0.001 ).

Conclusion

Structured education significantly decrease systolic and diastolic blood pressure in elderly hypertensive patients. Adherence to antihypertensive medication wasn?t significantly decrease systolic and diastolic blood pressure in elderly hypertensive patients."

"Pengantar: Batu saluran kencing adalah salah satu penyebab yang paling sering dari nyeri kolik yang muncul pada layanan kesehatan primer. Penanganan dari kasus batu saluran kemih dibagi menjadi beberapa kelompok yaitu operatif dan juga konservatif. Cystone adalah salah satu terapi tambahan yang dapat ditambahkan pada regimen penanganan konservatif untuk ukuran batu dan memudahkan pengeluaran batu saluran kemih. Penelitian ini bertujuan untuk melihat keamanan dan efektivitas dari pemberian Cystone ini pasca tindakan ESWL. Metodologi : Penelitian ini dilakukan antara bulan Mei 2014-November 2015, jumlah sampel yang berpartisipasi dalam penelitian ini adalah 81 sampel, 42 berada pada grup cystone dan 39 dalam grup placebo. Setelah dilakukan ESWL, satu grup diberikan tablet cystone 2 x 2 setiap hari selama 4 minggu, grup lain diberikan placebo. Penanganan lanjutan seperti KUB radiografi, CT urografi dan juga pemeriksaan USG dilakukan setelah mengkonsumsi obat-obatan ini.Hasil: Dari 84 sampel yang berpartisipasi dalam penelitian ini, karkteristik demografik dan baseline antara grup tatalaksana dan grup placebo mirip satu sama lain. Tidak ada perbedaan statistic yang signifikan antara besar batu sebelum dan sesudah konsumsi cystone baik pada grup cystone ataupun placebo. Satu kejadian efek samping yang serius dilaporkan pada grup cystone, tidak ada kejadian efek samping yang berat terlihat pada grup placebo. Diskusi: Penelitian sebelumnya memperlihatkan bahwa cystone ini secara signifikan dapat memperkecil besar batu ginjal dan mengubah komposisi batu ginjal. Hasil yang berbeda ini kemungkinan disebabkan oleh perbedaan besar batu ginjal baik pada riset ini maupun literature-literatur sebelumnya. Berdasarkan penelitian ini, kami tidak merekomendasikan penggunaan cystone sebagai terapi adjunctive- management conservative dari batu ginjal ini.

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Introduction: Urinary stone is one of the most common cause of colicky pain in primary care. Management of urinary stone is divided into operative management and conservative management. Cystone is one of the traditional adjunctive therapy that may added to conservative management regiment to reduce kidney stone size and speed-up the stone passing. This study aims to see the efficacy and safety of Cystone after Extracorporeal Shock Wave Lithotripsy. Methods : This clinical trial was conducted from May 2014-November 2015, the total sample for this research are 81 samples, 42 in cystone group and 39 in placebo group. After undergoing ESWL procedure, one group were given 2 x 2 cystone tables daily for 4 weeks, and the other were given placebo. Further examination such as KUB radiography, CT urography, USG examination were conducted after consumption of the drugs. Results : Among 84 subjects that participated in this research, demographic charcteristics and baseline disease were comparable. No statistically significant changes on the stone size in both cystone and placebo group. One serious adverse event appeared in cystone group compared to none in the placebo group. Discussion: Previous research showed that cystone made significant changes on the renal stone size and composition. This differing results may be caused by different stone sizes in both this research and previous literature. Based on this research’s result we do not recommend using cystone as an adjunctive conservative management of renal stone"

"Latar Belakang: Pajanan nyeri menimbulkan efek merugikan baik pada neonatus kurang bulan maupun neonatus cukup bulan. Efek analgesik sukrosa pada penyuntikan intramuskular masih kontroversial. Efektivitas sukrosa untuk mengatasi nyeris saat vaksinasi hepatitis B pada neonatus cukup bulan belum pernah diteliti di Indonesia. Tujuan: untuk mengetahui efek analgesik pemberian sukrosa disertai empeng saat vaksinasi hepatitis B pada neonatus cukup bulan. Metode: penelitian ini menggunakan metode uji klinis acak tersamar ganda. Subjek secara random dibagi menjadi kelompok intervensi yang mendapatkan 2 mL sukrosa 24% disertai empeng, serta kelompok kontrol yang mendapatkan 2 mL aquabidestilata disertai empeng. Rasa nyeri yang dirasakan subjek dievaluasi dengan skor nyeri premature infant pain profile (PIPP). Hasil: median skor PIPP pada kelompok yang diberikan sukrosa lebih rendah dibandingkan kelompok kontrol (6 (2-15) vs 11 (2-15), p <0,0001). Lama tangis subjek pada kelompok yang mendapat sukrosa lebih singkat dibandingkan kelompok kontrol (11 (0-33) detik vs 19 (0-100) detik, p <0,0001). Pemberian empeng tidak memberikan efek sinergis dalam menurunkan skor nyeri maupun lama tangis subjek. Pada penelitian ini ditemukan satu subjek yang mengalami desaturasi hingga saturasi oksigen <88% saat pemberian sukrosa, namun efek samping ini tidak memerlukan terapi khusus. Simpulan: sukrosa secara statistik menurunkan skor nyeri PIPP dan lama tangis saat vaksinasi hepatitis B pada neonatus cukup bulan.

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Background: Pain causes adverse effect for preterm and also term newborn. Analgesic effect of sucrose during intramuscular injection is still a controversy. Sucrose effectivity in reducing pain in term newborn during hepatitis B vaccination has not been studied in Indonesia.

Objective: to examine analgesic effect of sucrose with pacifier during hepatitis B vaccination in term newborn.

Method: we used consecutive sampling to reach 70 subjects. Subject was randomised into intervension group receiving 2 mL of 24% sucrose solution with pacifier, and control group receiving 2 mL aquadest with pacifier. Pain was evaluated with the premature infant pain profile (PIPP) scoring system.

Result: median PIPP score in intervension group was significantly lower than control group (6 (2-15) vs 11 (2-15), p <0,0001). Cry duration in intervension group was significantly shorter than control group (11 (0-33) second vs 19 (0-100) second, p <0,0001). Pacifier had no synergistic effect in lowering PIPP score and cry duration. Decreased oxygen saturation below 88% was found in one subject receiving sucrose but additional therapy was not needed.

Conclusion: Sucrose was statistically significant in reducing pain score and cry duration during hepatitis B vaccination in term newborn."