Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar belakang: Pasien NMOSD cenderung menunjukkan progresifitas/perburukan defisit neurologis pada setiap relaps. Pemberian terapi rumatan pada NMOSD bisa mencegah relaps dan mempertahankan remisi. Hingga saat ini belum ada studi yang meneliti mengenai kepatuhan pengobatan pasien NMOSD. Tujuan dari penelitian ini adalah untuk menilai tingkat kepatuhan pengobatan pasien NMOSD, mengetahui karakteristik serta faktor-faktor yang memengaruhi kepatuhan pengobatan.Metode: Penelitian ini merupakan studi potong-lintang dengan populasi seluruh pasien NMOSD yang berobat di RSCM sejak tahun 2019 hingga Mei 2023. Sampel diambil dengan cara consecutive sampling. Kriteria inklusi yaitu pasien dengan diagnosis NMOSD sesuai kriteria diagnosis IPND tahun 2015, usia ≥ 18 tahun, konsumsi obat untuk NMOSD minimal selama 1 bulan. Kriteria eksklusi yaitu tidak bersedia ikut serta dalam penelitian. Kepatuhan berobat dinilai dengan kuesioner Morisky Medication Adherence Scale 8 versi Bahasa Indonesia (MMAS-8), depresi dinilai dengan kuesioner Beck Depression Inventory versi Bahasa Indonesia (BDI-II), kognitif dinilai dengan kuesioner Montreal Cognitive Assesmenet versi Bahasa Indonesia (Moca-INA), dan persepsi terhadap penyakit dinilai dengan kuesioner Beck Depression Inventory versi Bahasa Indonesia (B-IPQ. Data karakteristik demografi, pengobatan, dan klinis didapatkan dari rekam medis/anamnesis. Hasil: Subjek penelitian ini sebanyak 42 orang dengan rasio pria:wanita= 1: 13. Pasien yang terkategori patuh berobat sebesar 57,1%. Kepatuhan berobat berhubungan dengan status pernikahan (p=0,037), jenis obat saat ini (p=0,033), nilai EDSS (p=0,035), depresi (p=0,018), dan gangguan kognitif (p=0,029). Hasil analisis multivariat mendapatkan bahwa subjek yang tidak depresi 4,60 kali (IK 95% 1,03-20,4) lebih patuh dibandingkan depresi dan setiap kenaikan 1 poin EDSS (perburukan klinis) dapat 1,33 kali meningkatkan kepatuhan pengobatan (IK95% 1,02-1,76). Simpulan: Pada penelitian ini, sebagian besar pasien NMOSD patuh pengobatan. Faktor independen yang mempengaruhi kepatuhan pengobatan pasien NMOSD di RSCM adalah depresi dan derajat disabilitas.

---

Background: NMOSD patients tend to show progressive/worsening neurologic deficits in each relapse. Maintenance therapy for NMOSD can prevent relapse and maintain remission. Until now there have been no studies that examined the medication adherence of NMOSD patients. The aim of this study was to assess the level of medication adherence of NMOSD patients, to find out the characteristics and factors that influence treatment adherence.

Methods: We conducted a cross sectional study on NMOSD patients who came to RSCM from 2019 to May 2023. Samples were taken by consecutive sampling. The inclusion criteria were patients with a diagnosis of NMOSD according to the 2015 IPND diagnosis criteria, age ≥ 18 years, consumption of drugs for NMOSD for at least 1 month. Exclusion criteria were not willing to participate in the study. Medication adherence was assessed by the Indonesian version of the Morisky Medication Adherence Scale 8 questionnaire (MMAS-8), depression was assessed by the Indonesian version of the Beck Depression Inventory questionnaire (BDI-II), cognitive was assessed by the Indonesian version of the Montreal Cognitive Assessment questionnaire (Moca-INA), and perceptions of illness were assessed by the questionnaire Beck Depression Inventory Indonesian version (B-IPQ). Data on demographic, treatment, and clinical characteristics were obtained from medical records/anamnesis.

Results: There were 42 subjects in this study with a male:female ratio = 1: 13. Patients who were categorized as adherent to medication were 57.1%. Medication adherence was related to marital status (p=0.037), current type of medication (p=0.033), EDSS score (p=0.035), depression (p=0.018), and cognitive impairment (p=0.029). The results of multivariate analysis found that subjects who were not depressed were 4.60 times (95% CI 1.03-20.4) more adherent than depressed subjects and for every 1 point increase in EDSS (clinical worsening) could be 1.33 times increased medication adherence (95% CI). 1.02-1.76).

Conclusion: In this study, the majority of NMOSD patients adhered to treatment. Independent factors that influence NMOSD patient medication adherence at RSCM are depression and the degree of disorder."

"Latar belakang: Autism Spectrum Disorder (ASD) adalah suatu kondisi heterogen dengan gejala yang bervariasi disebabkan berbagai etiologi, dan komorbiditas yang berdampak pada defisit komunikasi sosial, gangguan perilaku berulang dan minat terbatas. Sudah banyak penelitian yang mengaitkan ASD dengan variasi gambaran pemanjangan masa laten gelombang dan antar gelombang pada Brainstem Evoked Response Audiometry (BERA). Beberapa penelitian menghubungkan BERA dengan derajat keparahan ASD berdasarkan The Childhood Autism Rating Scale (CARS), namun masih kontroversi. Tujuan: Penelitian ini bertujuan untuk mengetahui apakah ada hubungan antara masa laten gelombang III dan V serta masa laten antar gelombang III-V BERA Click dengan derajat keparahan ASD berdasarkan skoring CARS anak usia 3-8 tahun dengan pendengaran normal. Metode: Studi potong lintang ini terdiri dari 26 subjek ASD yang memenuhi kriteria inklusi dan eksklusi. Penilaian derajat keparahan subjek dilakukan menggunakan skoring CARS dan pemeriksaan BERA. Pengolahan data dilakukan dengan analisis uji korelasi masa laten absolut dan masa laten antar gelombang BERA dan CARS. Hasil: Tidak ditemukan hubungan yang bermakna antara masa laten absolut gelombang III dan V serta masa laten antar gelombang III-V BERA Click dengan CARS (r<0,3 dan p>0,05). Namun berdasarkan analisis deskriptif, terdapat pemanjangan masa laten gelombang III dan V serta masa laten antar gelombang I-III pada anak ASD dengan pendengaran perifer normal. Kesimpulan: Anak ASD dengan pendengaran perifer normal menunjukkan karakteristik BERA abnormal. Hal ini menunjukkan potensi BERA sebagai alat objektif untuk mengevaluasi perkembangan ASD di masa depan namun diperlukan penelitian lebih lanjut.

---

Background: Autism Spectrum Disorder (ASD) is a heterogeneous condition with variable symptoms due to various etiologies, and comorbidities that result in social communication deficits, repetitive behavioral disorders and restricted interests. Many studies have linked ASD to variations in the latent wave and inter-wave lengthening images on Brainstem Evoked Response Audiometry (BERA). Some studies have linked BERA to ASD severity based on The Childhood Autism Rating Scale (CARS), but it is still controversial. Aim: This study aims to determine whether there is a correlation between latencies of waves III and V, as well as interpeak latencies of waves III-V BERA Click and ASD severity based on CARS scoring in children aged 3-8 years with normal hearing. Methods: This cross-sectional study consisted of 26 subjects with ASD met the inclusion and exclusion criteria. Subjects were assessed for severity using CARS scoring and BERA examination. Data processing was done by correlation test analysis between latencies of waves III and V BERA and CARS waves. Results: There was no significant relationship between the latencies of waves III and V and interpeak latencies of waves III-V and interpeak latencies of waves III-V BERA Click with CARS (r < 0.3 and p>0.05). However, based on descriptive analysis, there was a lengthening of the latency of waves III and V and interpeak latency of waves I-III in ASD children with normal peripheral hearing. Conclusion Children with ASD display abnormal ABR characteristics. This shows the potential of BERA as an objective tool to evaluate ASD development in the future but further research is needed"

"Latar belakang: Prevalensi ketidakpatuhan pasien pada pengobatan epilepsi cukup besar. Penyebab ketidakpatuhan terdiri dari banyak faktor, yang dapat diklasifikasikan menjadi intensional ataupun non intensional. Perilaku kepatuhan pasien dibentuk oleh bagaimana pasien melakukan representasi terhadap penyakit yang dideritanya, sehingga pengetahuan, sikap, dan perilaku (PSP) pasien epilepsi dinilai dapat berhubungan dengan kepatuhan pasien. Penelitian ini dilakukan untuk menilai hubungan tersebut.Metode penelitian: Penelitian ini dilakukan dengan desain potong lintang. Populasinya adalah pasien epilepsi yang berobat ke poli neurologi RSUPNCM bulan Agustus – September 2022. Sampel diambil dengan cara consecutive sampling. Analisis statistik menggunakan regresi logistik.Hasil: Rerata nilai pengetahuan sebesar 15,41+/-3,827 dengan rentang 7-35 (nilai 7 mengindikasikan ukuran pengetahuan paling baik). Median nilai sikap adalah 18 (10-27)dengan rentang 8-40 (nilai 8 mengindikasikan sikap paling baik). Median nilai perilaku adalah 10 (5-20), dengan rentang 5-25 (nilai 5 menunjukkan perilaku paling baik). Nilai kepatuhan pasien pada penelitian ini adalah 55,7%. Analisis multivariat menunjukkan bahwa semakin buruk nilai pengetahuan maka akan meningkatkan probabilitas terjadinya ketidakpatuhan sebesar 1,271 kali.Kesimpulan: Pengetahuan mengenai epilepsi memiliki hubungan dengan kepatuhan pengobatan, sedangkan sikap dan perilaku pasien epilepsi tidak memiliki hubungan dengan kepatuhan pengobatan

---

Background: There was a high prevalence of patient’s non-adherence to anti-seizure medication (ASM). It caused by many factors and classified as intentional or non intentional. Patient’s adherence was formed when they represent their ilness, so knowledge, attitudes, and behavior of patient with epilepsy (PWE) are considered to be related to their adherence. This study was aimed to assess this relationship.

Methods: We conducted a cross sectional study on PWE who came to RSUPNCM Neurology outpatient clinic from August to September 2022. All consecutive patients were asked to complete the given questionnaire. We used a logistic regression for statistical analysis.

Results: The mean score of knowledge was 15,41+/-3,827 (range, 7-35), with score of 7 indicated the best knowledge. The median score of attitudes was 18, interquartile range (IQR) 10-27 (range, 8-40), with score of 8 indicated the best attitudes. The median score of behavior was 10, IQR 5-20 (range, 5-25), with score of 5 indicated the best behavior. Fifty-five-point seven percent were estimated to be adherent. The multivariate analysis showed that with the worse score of knowledge, the probability of non-adherence will increase by 1,271 times.

Conclusion: Knowledge about epilepsy has a relationship with ASM adherence, while attitude and behavior of PWE has no relationship with ASM adherence"

"[ABSTRAKLatar belakang dan tujuan: Akne vulgaris (AV) adalah penyakit peradangan menahun unit pilosebasea yang bersifat swasirna, ditandai dengan lesi pleomorfik berupa papul, komedo, pustul, dan nodul. Pengobatan AV memerlukan waktu yang cukup lama. Penyakit menahun dengan waktu pengobatan yang lama, berdampak terhadap kepatuhan pasien. Kepatuhan pengobatan topikal lebih rendah daripada sistemik. Hanya akne vulgaris ringan (AVR) yang diterapi menggunakan obat-obatan topikal saja. Layanan pesan singkat merupakan salah satu cara yang praktis dan efisien dalam upaya meningkatkan kepatuhan pengobatan AV, dengan pertimbangan prevalensi AV lebih banyak pada usia remaja dan dewasa muda yang merupakan pengguna terbanyak layanan tersebut. Dengan layanan ini, diharapkan pasien tidak lupa menggunakan obat topikal pada AVR. Penelitian ini dilakukan untuk mengetahui efektivitas penggunaan pesan singkat elektronik terhadap kepatuhan pengobatan AVR.Metode: Studi eksperimen dengan desain randomized controlled trial (RCT) terhadap pasien AVR usia 15-25 tahun yang berobat ke Poliklinik Ilmu Kesehatan Kulit dan Kelamin (IKKK) Rumah Sakit dr. Cipto Mangunkusumo (RSCM). Penelitian ini melibatkan 2 kelompok, yaitu: kelompok intervensi yang mendapat pesan singkat elektronik dan kelompok kontrol. Kedua kelompok diberi pengobatan tretinoin krim 0,05% dan/atau klindamisin gel 1,2% selama 6 minggu.Hasil: Tidak terdapat perbedaan bermakna antara kepatuhan pengobatan AVR kelompok kontrol dengan kelompok intervensi pada minggu kedua (p=0,376) dan keempat (p=0,432). Namun pada minggu keenam, kelompok intervensi secara bermakna lebih patuh daripada kelompok kontrol (p=0,032).Kesimpulan: Pesan singkat elektronik meningkatkan kepatuhan pengobatan AVR terutama pada minggu keenam di Poliklinik IKKK RSCM.

---

ABSTRACTBackground and objectives: Acne vulgaris (AV) is a self limited, chronic inflammatory disease of pilosebaceous unit, characterized by pleomorphic lesions consist of papules, comedones, pustules, and nodules. Acne vulgaris requires a long duration of treatment. Chronic disease with a long duration of therapy usually has an impact on adherence. Topical therapy adherence is lower than systemic. Only mild AV is treated with topical medications. Electronic text messaging is a practical and efficient method in order to improve adherence to AV therapy, with a consideration of the AV prevalence are more on teens and young adults who are the majority users of electronic text messaging service. With this method, patients are expected not to forget the use of medication. This study was conducted to determine the effectiveness of electronic text messaging to improve adherence of mild AV therapy.Methods: Experimental study, randomized controlled trial (RCT) to mild AV patients, age 15-25 years old who came to Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital. This study involved two groups: intervention group who received electronic text messaging, and the contrary is the control group. Both groups were prescribed tretinoin 0,05% cream and/or clindamycin 1,2% gel for six weeks.Results: There were no significant differences in adherence of mild AV therapy between both groups in the second (p = 0.376) and fourth week (p = 0.432). The intervention group was significantly higher in terms of adherence than the control group in the sixth week (p = 0.032).Conclusions: Electronic text messaging improve adherence of mild AV therapy especially in the sixth week at Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital.;Background and objectives: Acne vulgaris (AV) is a self limited, chronicinflammatory disease of pilosebaceous unit, characterized by pleomorphic lesionsconsist of papules, comedones, pustules, and nodules. Acne vulgaris requires along duration of treatment. Chronic disease with a long duration of therapyusually has an impact on adherence. Topical therapy adherence is lower thansystemic. Only mild AV is treated with topical medications. Electronic textmessaging is a practical and efficient method in order to improve adherence toAV therapy, with a consideration of the AV prevalence are more on teens andyoung adults who are the majority users of electronic text messaging service.With this method, patients are expected not to forget the use of medication. Thisstudy was conducted to determine the effectiveness of electronic text messagingto improve adherence of mild AV therapy.Methods: Experimental study, randomized controlled trial (RCT) to mild AVpatients, age 15-25 years old who came to Dermatology and Venereology Clinicdr. Cipto Mangunkusumo Hospital. This study involved two groups: interventiongroup who received electronic text messaging, and the contrary is the controlgroup. Both groups were prescribed tretinoin 0,05% cream and/or clindamycin1,2% gel for six weeks. Results: There were no significant differences in adherence of mild AV therapybetween both groups in the second (p = 0.376) and fourth week (p = 0.432). Theintervention group was significantly higher in terms of adherence than the controlgroup in the sixth week (p = 0.032). Conclusions: Electronic text messaging improve adherence of mild AV therapy especially in the sixth week at Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital.;Background and objectives: Acne vulgaris (AV) is a self limited, chronicinflammatory disease of pilosebaceous unit, characterized by pleomorphic lesionsconsist of papules, comedones, pustules, and nodules. Acne vulgaris requires along duration of treatment. Chronic disease with a long duration of therapyusually has an impact on adherence. Topical therapy adherence is lower thansystemic. Only mild AV is treated with topical medications. Electronic textmessaging is a practical and efficient method in order to improve adherence toAV therapy, with a consideration of the AV prevalence are more on teens andyoung adults who are the majority users of electronic text messaging service.With this method, patients are expected not to forget the use of medication. Thisstudy was conducted to determine the effectiveness of electronic text messagingto improve adherence of mild AV therapy.Methods: Experimental study, randomized controlled trial (RCT) to mild AVpatients, age 15-25 years old who came to Dermatology and Venereology Clinicdr. Cipto Mangunkusumo Hospital. This study involved two groups: interventiongroup who received electronic text messaging, and the contrary is the controlgroup. Both groups were prescribed tretinoin 0,05% cream and/or clindamycin1,2% gel for six weeks. Results: There were no significant differences in adherence of mild AV therapybetween both groups in the second (p = 0.376) and fourth week (p = 0.432). Theintervention group was significantly higher in terms of adherence than the controlgroup in the sixth week (p = 0.032). Conclusions: Electronic text messaging improve adherence of mild AV therapy especially in the sixth week at Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital., Background and objectives: Acne vulgaris (AV) is a self limited, chronicinflammatory disease of pilosebaceous unit, characterized by pleomorphic lesionsconsist of papules, comedones, pustules, and nodules. Acne vulgaris requires along duration of treatment. Chronic disease with a long duration of therapyusually has an impact on adherence. Topical therapy adherence is lower thansystemic. Only mild AV is treated with topical medications. Electronic textmessaging is a practical and efficient method in order to improve adherence toAV therapy, with a consideration of the AV prevalence are more on teens andyoung adults who are the majority users of electronic text messaging service.With this method, patients are expected not to forget the use of medication. Thisstudy was conducted to determine the effectiveness of electronic text messagingto improve adherence of mild AV therapy.Methods: Experimental study, randomized controlled trial (RCT) to mild AVpatients, age 15-25 years old who came to Dermatology and Venereology Clinicdr. Cipto Mangunkusumo Hospital. This study involved two groups: interventiongroup who received electronic text messaging, and the contrary is the controlgroup. Both groups were prescribed tretinoin 0,05% cream and/or clindamycin1,2% gel for six weeks. Results: There were no significant differences in adherence of mild AV therapybetween both groups in the second (p = 0.376) and fourth week (p = 0.432). Theintervention group was significantly higher in terms of adherence than the controlgroup in the sixth week (p = 0.032). Conclusions: Electronic text messaging improve adherence of mild AV therapy especially in the sixth week at Dermatology and Venereology Clinic dr. Cipto Mangunkusumo Hospital.]"

"ABSTRAKLatar belakang. Multipel Sklerosis MS dan Neuromyelitis Optica Spectrum Disorder NMOSD adalah penyakit autoimun yang mengakibatkan lesi inflamasi dan demielinisasi pada sistem saraf pusat. Salah satu manifestasi klinis yang paling menonjol pada kedua penyakit ini adalah neuritis optik NO . Penelitian ini bertujuan untuk mengetahui perbedaan struktur dan fungsi nervus optikus pada pasien MS dan NMOSD serta melihat hubungannya dengan derajat disabilitas yang dinilai dengan EDSS, durasi penyakit, dan jumlah relaps. Metode. Penelitian ini menggunakan desain potong lintang dengan jumlah sampel 30 mata MS dan 15 mata NMOSD di Rumah Sakit Cipto Mangunkusumo RSCM , tanpa riwayat neuritis optik dalam 6 bulan terakhir. Penelitian dilakukan pada bulan Desember 2017. Struktur nervus optikus dinilai dengan menggunakan optical coherence tomography yang menilai ketebalan GCL-IPL ganglion cell layer-inner plexiform layer dan RNFL retinal nerve fiber layer serta foto fundus. Sedangkan fungsi nervus optikus dinilai dengan ketajaman penglihatan logmar , sensitivitas kontras, dan latensi P100. Hasil. Rerata usia MS 30 6 tahun tahun dan NMOSD 23,19 7,25 tahun. Hanya terdapat satu orang laki-laki pada kelompok MS, sedangkan subjek NMOSD keseluruhannya adalah perempuan. Kelompok NMOSD memiliki ketebalan lapisan GCL-IPL, RNFL serta ketajaman penglihatan yang lebih rendah dibandingkan MS. Pada kelompok ini juga didapatkan korelasi positif antara nilai EDSS dengan ketajaman penglihatan r=0,74 dan korelasi negatif dengan rerata ketebalan lapisan GCL-IPL r=-0,67 dan RNFL r=-0,46 . Pada kelompok MS, subjek dengan nilai EDSS yang tinggi cenderung memiliki lapisan GCL-IPL yang lebih tipis. Korelasi negatif antara durasi penyakit dengan ketajaman penglihatan r=0,65 dan ketebalan lapisan GCL-IPL r=-0,63 terlihat pada kelompok NMOSD. Sedangkan pada MS didapatkan korelasi negatif antara durasi penyakit dengan sensitivitas kontras r=-0,42 serta ketebalan lapisan GCL-IPL r=-0,40 dan RNFL r=-0,38 . Jumlah relaps berkorelasi negatif dengan ketebalan lapisan RNFL r=-0,63 pada kelompok NMOSD. Pada kelompok MS, jumlah relaps tidak berkorelasi dengan parameter struktur dan fungsi nervus optikus. Kesimpulan. Ketebalan lapisan GCL-IPL dan RNFL lebih tipis pada kelompok NMOSD. Fungsi nervus optikus pada NMOSD juga lebih inferior dibandingkan MS. Derajat disabilitas dan durasi penyakit berkorelasi dengan parameter struktur dan fungsi nervus optikus pada pasien MS dan NMOSD. Sedangkan korelasi dengan jumlah relaps hanya didapatkan pada kelompok NMOSD.

---

ABSTRACT<>br>Background. Multiple Sclerosis MS and Neuromyelitis Optica Spectrum Disorder NMOSD is an autoimmune disease that results in inflammatory lesions and demyelinization of the central nervous system. One of the most prominent clinical manifestations in both diseases is optic neuritis ON . This study aims to determine the differences in structure and function of the optic nerve in MS and NMOSD patients and to see its relationship with the degree of disability assessed by EDSS, duration of disease, and number of relapse. Method. This study used cross sectional design with 30 MS eyes 15 NMOSD eyes at Cipto Mangunkusumo Hospital RSCM , with no history of optic neuritis in the last 6 months. The study was conducted in December 2017. The optic nerve structure was assessed using optical coherence tomography by measuring the thickness of GCL IPL ganglion cell layer inner plexiform layer and RNFL retinal nerve fiber layer and fundus photography. While optic nerve function is assessed with visual acuity, contrast sensitivity, and P100 latency. Results. Mean age of MS subjects were 30 6 years and NMOSD 23.19 7.25 years. There is only one male in the MS group, while the entire NMOSD subject is female. The NMOSD group has lower GCL IPL and RNFL thickness and also lower visual acuity than MS. In this group there was also a positive correlation between EDSS value with visual acuity r 0.74 and negative correlation with mean GCL IPL r 0.67 and RNFL thickness r 0.46 . In the MS group, subjects with high EDSS values tend to have thinner GCL IPL. The positive correlation between disease duration and visual acuity r 0.65 and negative correlation with GCL IPL layer thickness r 0.63 was seen in the NMOSD group. While in MS, there was a negative correlation between duration of disease with contrast sensitivity r 0.42 and mean GCL IPL r 0.40 and RNFL thickness r 0.38 . The number of relapse were negatively correlated with mean RNFL thickness r 0.63 in the NMOSD group. In the MS group, the number of relapse was not correlated with the structural and functional parameters of the optic nerve. Conclusion. The thickness of the GCL IPL and RNFL is thinner in the NMOSD group. The optic nerve function in NMOSD is also inferior to MS. The degree of disability and duration of disease correlates with the structural and functional parameters of the optic nerve in MS and NMOSD patients. While the correlation with the number of relapse is only found in the NMOSD group."

"Latar Belakang: Ketidaktaatan pengobatan pada orang dengan skizofrenia merupakan masalah di seluruh dunia dan merupakan aspek paling menantang dalam menangani pasien dengan skizofrenia. Ketaatan pengobatan merupakan faktor penting untuk memberikan luaran yang baik pada pasien dengan skizofrenia. Terdapat beberapa perbedaan hasil dari berbagai penelitian terhadap faktor yang menyebabkan ketidaktaan pengobatan, namun ketidaktaatan pengobatan tetap merupakan masalah yang konsisten dalam pengobatan skizofrenia. kasus di RSUP Nasional dr. Cipto Mangunkusumo cenderung kompleks. Sehingga penelitian ini dilakukan untuk mengetahui faktor terkait yang menyebabkan ketidaktaatan pengobatan di RSUP Nasional dr. Cipto Mangunkusumo. Metode: Penelitian dilakukan secara potong lintang. Sebanyak 1440 subjek berasal dari pasien rawat jalan dengan skizofrenia di poliklinik psikiatri RS dr. Cipto Mangunkusumo. yang ditentukan dengan cluster konsekutif. Pengambilan data dilakukan dengan wawancara terstruktur menggunakan Positive and Negative Symptom of Schizophrenia (PANSS). Penilaian efek samping ekstrapiramidal mengunakan extrapyramidal symptom rating scale (ESRS). Data ketidaktaatan pengobatan diambil dengan menggunakan instrumen self-report medication adherence rating scale (MARS) data yang diperoleh kemdian dilakukan analisis dengan metode regresi logistik. Hasil: Ditemukan proporsi ketidaktaatan pengobatan pada pasien dengan skizofrenia di RSUPN dr. Cipto Mangunkusumo sebesar 21,4%. Tilikan, fungsi kognitif, status ekonomi, keparahan gejala, gejala depresi, efektivitas pengobatan ditemukan memengaruhi ketidaktaan pengobatan. Melalui analisis multivariat hanya tilikan (p 0,003 ; OR = 5,437 ; CI95% 1,752-16,868) dan fungsi kognitif (p = 0.035 ; OR = 3,294 ; CI95% 1,089-9,967) yang menunjukkan pengaruh bermaknak terhadap ketidaktaatan pengobatan.

---

Introduction: Medication non-adherence in people with schizophrenia is a worldwide problem and is the most challenging aspect of managing patients with schizophrenia. Adherence to medication is an important factor to provide a good outcome in patients with schizophrenia. There are differences in the results of various studies on the factors that lead to medication non-adherence, but medication adherence remains a consistent problem in the treatment of schizophrenia. the case at dr. Cipto Mangunkusumo General Hospital tends to be more complex. So this research was conducted to determine the related factors that led to medication non-adherence at dr. Cipto Mangunkusumo General Hospital.

Methods: we conducted in a cross-sectional research. The sample size was 140 subjects from outpatients with schizophrenia in psychiatric polyclinic at dr. Cipto Mangunkusumo hospital and selected by consecutive clusters. Data were collected by structured interviews using Positive and Negative Symptoms of Schizophrenia (PANSS). Extrapyramidal side effect assessment using extrapyramidal symptom rating scale (ESRS). Medication adherence data were taken using the instrument self-report medication adherence rating scale (MARS). The data obtained were analyzed using logistic regression methods.

Results: The Proportion of medication non-adherence in patients with schizophrenia of 21.4% was found at dr. Cipto Mangunkusumo General Hospital. Insight, cognitive function, economic status, symptom severity, depressive symptoms, and effectiveness of treatment were found to be significant related to medication non-adherence. Multivariate analysis shown only insight (p 0.003; OR = 5.437; 95% CI 1.752-16.868) and cognitive function (p = 0.035; OR = 3.294; 95% CI 1.089-9.967) were found were found significant related to medication non-adherence."

"[ABSTRAKPendahuluanHipertensi merupakan masalah kesehatan dunia karena jumlah penderita yangbanyak serta komplikasi yang diakibatkannya. Pengendalian tekanan darah padapada pasien hipertensi masih belum adekuat. Penyebab utama kegagalanpengendalian tekanan darah pada pasien hipertensi adalah ketidak-patuhan berobat,adanya therapeutic inertia dan penyakit yang resisten.TujuanMengetahui proporsi therapeutic inertia pada pasien dengan tekanan darah tidakterkontrol, tingkat medication adherence dan proporsi pengendalian tekanan darahpada pasien hipertensi yang telah berobat lebih dari enam bulan dengan melakukanpengisian kuesioner mengenai kepatuhan berobat dan evaluasi dari rekam medismengenai tatalaksana hipertensi.MetodeTelah dilakukan penelitian potong lintang pada bulan April 2015 sampai Mei 2015terhadap 126 pasien dengan hipertensi dan telah berobat lebih dari enam bulan dipoliklinik Ginjal-Hipertensi RSCM Jakarta-Indonesia. Subjek dilakukanwawancara terstruktur dan pengukuran tekanan darah dan diminta untuk mengisikuesioner 8-item Morisky Medication Adherence Score (MMAS-8) untuk menilaikepatuhan berobat serta evaluasi rekam medis pasien untuk menilai tatalaksanahipertensi yang diterima, serta tekanan darah selama berobat.HasilDidapatkan 113 subjek yang sesuai dengan kriteria penelitian. Dari hasil penelitiandidapatkan pengendalian tekanan darah adalah sebesar 69,3% dari seluruhkunjungan pada pasien dengan tekanan darah tinggi, dari 30,7% pasien dengantekanan darah tidak terkontrol, tingkat therapeutic inertia mencapai 84,1%.Kepatuhan berobat yang baik didapatkan pada 85,8% pasien dengan hipertensiSimpulanTingkat pengendalian tekanan darah pada pasien hipertensi sudah cukup baik.Kepatuhan berobat pasien dengan hipertensi sudah baik. Tingkat therapeuticinertia pada pasien hipertensi dengan tekanan darah tidak terkontrol masih tinggi.

---

ABSTRACTBackgroundHypertension is a worldwide medical problem because of huge amount ofhypertensive patient and complication tha follows. The blood pressure control ofhypertensive patients is inadequate. The main reason failure in controlling bloodpressure of hypertensive patient are medication inadherent, therapeutic inertia andresistant disease.ObjectivesTo determine the proportion of therapeutic inertia in hypertensive patient withuncontrolled blood pressure, medication adherence level and blood pressurecontrol rate in hypertensive patient who has been on medication for over than sixmonth by filling questionnaire on medication adherence and evaluation of medicalrecord on hypertension therapy.MethodA cross-sectional study was conducted in April 2015 through May 2015 on 126hypertensive patient and has been on hypertension medication for over than sixmonth at Nephrology-Hypertension clinic Cipto Mangunkusumo Hospital, Jakarta-Indonesia. We conducted structured interview and blood pressure measurement tothe subject, and requested to fill 8-item Morisky Medication Adherence Score(MMAS-8) to evaluate medication adherence and reveiw of medical record toevaluate hypertension therapy and blood pressure during ambulatory visit.ResultsThere were 113 subject that meet the study criteria. The blood pressure control ratewere 69.3% from all visit of hypertensive patient. From 30.7% visit withuncontrolled blood pressure, therapeutic inertia were 84,1%. Good medicationadherence were found in 85.8% hypertensive patient.ConclusionBlood pressure control rate in hypertensive patient is good. Medication adherencein hypertensive patient were also found good. We found that the theraputic inertialevel among hypertensive patient with uncontrolled blood pressure is high., BackgroundHypertension is a worldwide medical problem because of huge amount ofhypertensive patient and complication tha follows. The blood pressure control ofhypertensive patients is inadequate. The main reason failure in controlling bloodpressure of hypertensive patient are medication inadherent, therapeutic inertia andresistant disease.ObjectivesTo determine the proportion of therapeutic inertia in hypertensive patient withuncontrolled blood pressure, medication adherence level and blood pressurecontrol rate in hypertensive patient who has been on medication for over than sixmonth by filling questionnaire on medication adherence and evaluation of medicalrecord on hypertension therapy.MethodA cross-sectional study was conducted in April 2015 through May 2015 on 126hypertensive patient and has been on hypertension medication for over than sixmonth at Nephrology-Hypertension clinic Cipto Mangunkusumo Hospital, Jakarta-Indonesia. We conducted structured interview and blood pressure measurement tothe subject, and requested to fill 8-item Morisky Medication Adherence Score(MMAS-8) to evaluate medication adherence and reveiw of medical record toevaluate hypertension therapy and blood pressure during ambulatory visit.ResultsThere were 113 subject that meet the study criteria. The blood pressure control ratewere 69.3% from all visit of hypertensive patient. From 30.7% visit withuncontrolled blood pressure, therapeutic inertia were 84,1%. Good medicationadherence were found in 85.8% hypertensive patient.ConclusionBlood pressure control rate in hypertensive patient is good. Medication adherencein hypertensive patient were also found good. We found that the theraputic inertialevel among hypertensive patient with uncontrolled blood pressure is high.]"

"ABSTRAKNama : MegawatiProgram Studi : EpidemiologiJudul : Kesintasan Pasien Kanker Payudara Berdasarkan Keterlambatan Pengobatandi Rumah Sakit Umum Cipto MangunkusumoPembimbing : Prof. Dr. dr. Bambang Sutrisna, MHSc Epidemiology AbstrakKanker payudara masih mendominasi penyakit kanker pada wanita di duniatermasuk di Indonesia. Rumah Sakit Cipto Mangunkusumo sebagai rumah sakitrujukan nasional dengan jumlah kasus terus meningkat setiap tahunnya.Sebagian besar kasus ditemukan pada stadium lanjut dan mengalamiketerlambatan pengobatan lebih dari 60 hari setelah didiagnosis. Keterlambatanpengobatan diduga berpengaruh terhadap kesintasan pasien kanker payudara.Oleh karena itu penelitian ini dilakukan untuk menilai hubungan keterlambatanpengobatan dengan kesintasan pasien kanker payudara di RSCM. Desain studipenelitian adalah kohort retrospektif dengan mengamati 584 pasien yangmemenuhi kriteria inklusi. Pengamatan dilakukan mulai dari 1 Januari 2011sampai Desember 2017. Data dianalisis secara univariat, bivariat dengan ujilogrank, dan multivariat dengan cox regresi. Hasil penelitian menunjukkan dari584 pasien yang dianalisis ditemukan besarnya risiko terjadinya kematiansebesar 1,27 kali lebih cepat pada pasien yang mengalami keterlambatanpengobatan lebih dari 60 hari dibandingkan dengan pasien yang mendapatkanpengobatan kurang dari 60 hari HR=1,27; 95 CI;0,99 ndash; 1,64 setelah dikontrolstadium klinis, status pernikahan, dan status hormon reseptor estrogen.Perbedaan kesintasan antara pasien yang terlambat lebih dari 60 hari setelahdidiagnosis adalah sebesar 7 pada tahun kelima. Berdasarkan penelitian inidapat disimpulkan bahwa keterlambatan pengobatan lebih dari 60 hari setelahdidiagnosis mempengaruhi kesintasan pasien kanker payudara sehinggapentingnya edukasi kepada pasien dan keluarga untuk tidak menundapengobatan setelah didiagnosis.Kata kunci: keterlambatan pengobatan; kesintasan; kanker payudara

---

ABSTRACTName MegawatiStudy Program EpidemiologiTitle Survival of Breast Cancer based on Delay treatment at CiptoMangunkusumo HospitalCounsellor Prof. Dr. dr. Bambang Sutrisna, MHSc Epidemiology Breast cancer still dominates cancer in women in the world including inIndonesia. Cipto Mangunkusumo Hospital as a national referral hospitalwith the number of cases continues to increase every year. Most of the caseswere found at an advanced stage and experienced treatment delays morethan 60 days after diagnosis. Treatment delays are thought to affect thesurvival of breast cancer patients. Therefore, this study was conducted toassess the relationship of delayed treatment with survival of breast cancerpatients at RSCM. The study design was a retrospective cohort by observing584 patients who met the inclusion criteria. Observations were done from 1January 2011 to December 2017. Data were analyzed univariat, bivariatewith logrank test, and multivariate with cox regression. The results of thestudy showed that the 584 patients analyzed found that the risk of death was1.27 times faster in patients who experienced treatment delay more than 60days compared with patients who received treatment less than 60 days HR 1.27 95 CI 0,99 1.92 after controlled marital status, hormonereceptor estrogen, and clinical stage. The difference in survival betweentheir patients who were late more than 60 days after the diagnosis was 7 in the fifth year. Based on this research, it can be concluded that the delayof treatment influences survival of breast cancer patients so that theimportance of education to the patient and family to immediately performtreatment after diagnosis.Keywords Delay treatment Survival Breast Cancer"

"Latar Belakang. Tuberkulosis (TB) adalah penyakit menular dan merupakan salah satu dari 10 penyebab kematian terbanyak di dunia. Selain paru, TB dapat juga menyerang ekstraparu. Tanpa terapi, mortalitas TB sangat tinggi. Data mengenai TB ekstraparu masih sedikit di Indonesia. Tatalaksana TB ekstraparu serta hasil pengobatannya juga masih jarang diteliti.Tujuan. Mengetahui hasil pengobatan TB ekstraparu di Rumah Sakit Cipto Mangunkusumo (RSCM) yang sudah menggunakan standar pengobatan TB ekstaparu di IndonesiaDesain Penelitian. Penelitian berdesain kohort retrospektif ini dilakukan menggunakan data sekunder dari rekam medik pasien tuberkulosis ekstraparu pada 1 Januari 2014 - 31 Desember 2017 di RSCM.Hasil Penelitian. Dari 78 subjek penelitian yang menderita TB ekstraparu, prevalensi terbanyak adalah TB kelenjar getah bening yakni 27 subjek (34,6%). Sebanyak 62 (79,5%) subjek dinyatakan mengalami keberhasilan pengobatan dan 58 (74,4%) subjek diantaranya diobati sesuai dengan panduan. Pada analisis multivariat terdapat hubungan bermakna antara jenis kelamin dengan keberhasilan pengobatan TB ekstra paru.Simpulan. Keberhasilan pengobatan TB ekstraparu di RSCM 79,5%. Pengobatan TB ekstraparu di RSCM sudah sesuai dengan panduan terapi TB ekstraparu di Indonesia 74,4%. Keberhasilan pengobatan TB Ekstraparu pada wanita lebih besar dibandingkan pria. Background. Tuberculosis (TB) is an infectious disease and also one of 10 prevalent causes of death worldwide. Apart from lungs, TB also affects extra-pumonar organs. Without treatment, TB mortality is very high. There are only limited data on extrapulmonary TB in Indonesia. Extrapulmonary TB treatment and the outcomes are also rarely studied.Objective. To evaluate the results of standardized extrapulmonary TB treatment in Cipto Mangunkusumo Hospital (RSCM) according to extrapulmonary TB standard treatment used in Indonesia.Methods. This is a retrospective cohort was carried out with secondary data from medical records of extrapulmonary tuberculosis patients in between January 1st 2014 - December 31st 2017 at RSCM.Results. Of the 78 subjects who suffered from extrapulmonary, the highest prevalence extrapumonary TB was lymphadenitis TB in 27 subjects (34,6%). A total of 62 subjects (79,5%) were declared cured and 58 (74,4%) subject treated according to the guidelines. There is related between gender to recovery.Conclusion. The success of extrapulmonary TB therapy at RSCM was 79,%. Extrapulmonary TB treatments at RSCM were in accordance with guidelines for extrapulmonary TB therapy in Indonesia 74,4%. The success of extrapulmonary TB treatment in women is greater than men"

"Anak merupakan populasi yang memiliki risiko lebih tinggi untuk terjadinya tuberkulosis ekstraparu (TBC-EP). Namun demikian, sampai saat ini data mengenai keberhasilan pengobatan TBC ekstraparu pada anak dan faktor yang memengaruhinya di Indonesia masih sangat terbatas. Penelitian ini bertujuan untuk mengetahui keberhasilan pengobatan TBC-EP pada anak dan mengidentifikasi faktor-faktor yang memengaruhinya. Pengambilan data dilakukan di Rumah Sakit Cipto Mangunkusumo Kiara dengan metode kohor retrospektif pada populasi anak terdiagnosis TBC ekstraparu. Dari 953 pasien anak usia 0 bulan-17 tahun yang terdiagnosis TBC, 458 (48%) anak mengalami TBC-EP dengan tiga bentuk yang paling sering bertutur-turut adalah TBC osteoartikular (21,7%), limfadenitis (21,1%) dan sistem saraf pusat (16,3%). Sebanyak 70,6% pasien TBC ekstraparu anak dinyatakan sembuh selama 2015-2021. Mayoritas pasien TBC-EP berusia 11-18 tahun (46%) dengan sebaran jenis kelamin yang seimbang, laki-laki (49,3%) dan perempuan (50,7%). Riwayat kontak dengan pasien TBC ditemukan pada 41,1% dan jaringan parut BCG ditemukan pada 34,7% kasus. Komorbiditas TBC ekstraparu dan TBC paru ditemukan pada 45,7% pasien. Analisis multivariat pada faktor prediktor keberhasilan pengobatan TBC ekstraparu mendapati hasil yang bermakna pada status gizi baik (RR 1,285, IK 95% 1,135-1,456) dan jenis TBC ekstraparu yang dialami bukanlah TBC ekstraparu berat (RR 1,330, IK 95% 1,094-1,616).

---

Children is highly susceptible to extrapulmonary tuberculosis (EPTB). However, knowledge about childhood EPTB in Indonesia and its treatment success is limited. This study aimed to determine treatment success rate of EPTB and factors affecting successful treatment outcome in children. We conducted a retrospective cohort study in Cipto-Mangunkusumo Kiara Hospital. A total of 953 pediatric patients below 18 years old were diagnosed with TBC. Extrapulmonary TB was found in 458 children (48%), with the most prevalent type: bone and joint (21.7%), lymph node (21.1%), and central nervous system (16.3%). There were 70.6% EPTB pediatric patients successfully treated during 2015-2021. The majority of patient with EPTB were in the age group of 11-18 years (46%) with balanced sex distribution, male (49.3%) and female (50.7%). Comorbidity of pulmonary TBC and EPTB was found in 45.7% patients. Multivariate analysis in factors predicting successful treatment outcome with significant results were good nutritional status (RR 1.285, 95% CI 1.135-1.456) and suffered from non-severe EPTB form (RR     1.330, 95% CI 1.094-1.616)."