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Neusa Oliveira Texeira L

Evaluasi pengobatan Tuberkulosis Multi Drug Resisten (Cohort Review Six Month) selama enam bulan di penampungan Klibur Domin Timur Leste dan Rumah Sakit Umum Pusat Persahabatan Jakarta Indonesia = Cohort Review Tuberculosis Multi Drug Resistans six months in penampungan Klibur Domin Timur Laste and Persahabatan Hospital Jakarta Indonesia

"[ABSTRAK

Latar belakang : Insidens Multi-drug resistant pulmonary tuberculosis (TB-MDR) meningkat hampir 2% tiap tahun sedangkan prevalensinya di dunia 4,3%. WHO melaporkan bahwa kasus TB-MDR tahun 2008 di Indonesia terjadi 6427 kasus.

Tujuan : Penelitian ini bertujuan untuk menentukan identifikasi TB-MDR di Rumah sakit Umum Pusat Persahabatan dan Klibur Domin Timur laste dengan melakukan evaluasi selama enam bulan.

Metode : Penelitian dilakukan dengan kohor retrospektif November 2014 dari rekam medis pasien TB-MDR di RSUP Persahabatan Jakarta dan Penampungan Klibur Domin Timoe Leste. Pemilihan sampel di RSUP Persahabatan dengan cluster random sampling sedangkan di Klibur Domin dengan total sampling.

Hasil : Total sampel 49 yaitu 32 pasien di RSUP Persahabatan Jakarta dan 17 pasien di penampungan Klibur Domin Timor Leste yang memenuhi kriteria inklusi. Jenis kelamin laki-laki paling banyak ditemukan baik di RSUP Persahabatan Jakarta (75%) maupun di Penampungan klibur Domin Timor Leste (94,1%) dengan usia produktif (35-44 tahun). Dari karakteristik dasar pengobatan ditemukan riwayat pengobatan ulang kategori II 37,5% paling banyak di RSUP Persahabatan dan di Klibur Domin 82,3% .Hasil pemeriksaan mikroskopis positif di RSUP Persahabatan 65,6% sedangkan di Klibur Domin 100%. Dari pola diagnostik di RSUP Persahabatan ditemukan pemeriksaan gabungan kultur+GenXpert yang terbanyak yaitu 50% sedangkan di Klibur Domin cenderung hanya mendapat diagnosis TB-MDR dari satu pemeriksaan yaitu kultur 64,7% dan Genxpert 18,8%. diterapi.Berdasarkan pola resistensi masing-masing di RSUP Persahabatan yaitu resisten R,H,E,S (56,2%) dan Klibur Domin resisten R,H (70,5%). Kesimpulan : Penelitian ini menunjukkan bahwa betapa pentingnya mengetahui faktor-faktor yang mempengaruhi terjadinya TB-MDR, perlunya pemantauan yang terus menerus dan pengobatan yang segera dan tepat. Pada penelitian ini dapat diketahui bahwa tidak terdapat perbedaan yang menonjol dalam penegakan diagnosis, pemantauan dan pengobatan pasien TB-MDR di RSUP Persahabatan dan Timur Laste.;

ABSTRACT

Introduction : Multi-drug resistant with pulmonary tuberculosis (TB-MDR) incidence rise to 2% every year, meanwhile prevalence of TB-MDR in the world is 4.3%. WHO report estimated that at 2008 cases of TB MDR in Indonesia were 6427. Objective : The aim of this study is to determine identification of TB-MDR at Persahabatan hospital and Klibur Domin Timur Leste with six months cohort review approach. Methods : This retrospective cohort study was conducted November 2014 from the medical records of TB-MDR patients at Persahabatan Jakarta hospital and Klibur Domin Care of Timor Leste. The sample selection at Persahabatan hospital was with cluster random sampling and Klibur Domin care was with total sampling. Results. Out of a total of 49 patients, 32 patients at Persahabatan Jakarta hospital and 17 patients at Klibur Domin Care Timor Leste, all include inclusion criteria. Male most commonly found in Persahabatan hospital (75%) and Klibur Domin care of Timor Leste (94.1%) with the productive age (35-44 years). From basic characteristics of the history of anti tuberculosis drugs found, category II was most common at Persahabatan hospital (37.5%) and Klibur Domin care was also found to have category II most common (82,3%). Acid fast bacilli positive in Persahabatan hospital was 65.6% and Klibur Domin Timor Leste 100%. Resistance respectively at Persahabatan hospital was R,H,E,S resistant (56.2%) and Klibur Domin care was R,H resistant (70,5%). Conclusion. This study shows the importance of knowing the factors that influence occurance of TB-MDR, the need of countinues monitoring, immediate and appropiate treatment. In this study can be seen that there is no significant difference at diagnosis, monitoring and treatment of TB-MDR at Persahabatan Hospital and Klibur Domin shelter at East Timor.;Introduction : Multi-drug resistant with pulmonary tuberculosis (TB-MDR) incidence rise to 2% every year, meanwhile prevalence of TB-MDR in the world is 4.3%. WHO report estimated that at 2008 cases of TB MDR in Indonesia were 6427. Objective : The aim of this study is to determine identification of TB-MDR at Persahabatan hospital and Klibur Domin Timur Leste with six months cohort review approach. Methods : This retrospective cohort study was conducted November 2014 from the medical records of TB-MDR patients at Persahabatan Jakarta hospital and Klibur Domin Care of Timor Leste. The sample selection at Persahabatan hospital was with cluster random sampling and Klibur Domin care was with total sampling. Results. Out of a total of 49 patients, 32 patients at Persahabatan Jakarta hospital and 17 patients at Klibur Domin Care Timor Leste, all include inclusion criteria. Male most commonly found in Persahabatan hospital (75%) and Klibur Domin care of Timor Leste (94.1%) with the productive age (35-44 years). From basic characteristics of the history of anti tuberculosis drugs found, category II was most common at Persahabatan hospital (37.5%) and Klibur Domin care was also found to have category II most common (82,3%). Acid fast bacilli positive in Persahabatan hospital was 65.6% and Klibur Domin Timor Leste 100%. Resistance respectively at Persahabatan hospital was R,H,E,S resistant (56.2%) and Klibur Domin care was R,H resistant (70,5%). Conclusion. This study shows the importance of knowing the factors that influence occurance of TB-MDR, the need of countinues monitoring, immediate and appropiate treatment. In this study can be seen that there is no significant difference at diagnosis, monitoring and treatment of TB-MDR at Persahabatan Hospital and Klibur Domin shelter at East Timor., Introduction : Multi-drug resistant with pulmonary tuberculosis (TB-MDR) incidence rise to 2% every year, meanwhile prevalence of TB-MDR in the world is 4.3%. WHO report estimated that at 2008 cases of TB MDR in Indonesia were 6427. Objective : The aim of this study is to determine identification of TB-MDR at Persahabatan hospital and Klibur Domin Timur Leste with six months cohort review approach. Methods : This retrospective cohort study was conducted November 2014 from the medical records of TB-MDR patients at Persahabatan Jakarta hospital and Klibur Domin Care of Timor Leste. The sample selection at Persahabatan hospital was with cluster random sampling and Klibur Domin care was with total sampling. Results. Out of a total of 49 patients, 32 patients at Persahabatan Jakarta hospital and 17 patients at Klibur Domin Care Timor Leste, all include inclusion criteria. Male most commonly found in Persahabatan hospital (75%) and Klibur Domin care of Timor Leste (94.1%) with the productive age (35-44 years). From basic characteristics of the history of anti tuberculosis drugs found, category II was most common at Persahabatan hospital (37.5%) and Klibur Domin care was also found to have category II most common (82,3%). Acid fast bacilli positive in Persahabatan hospital was 65.6% and Klibur Domin Timor Leste 100%. Resistance respectively at Persahabatan hospital was R,H,E,S resistant (56.2%) and Klibur Domin care was R,H resistant (70,5%). Conclusion. This study shows the importance of knowing the factors that influence occurance of TB-MDR, the need of countinues monitoring, immediate and appropiate treatment. In this study can be seen that there is no significant difference at diagnosis, monitoring and treatment of TB-MDR at Persahabatan Hospital and Klibur Domin shelter at East Timor.]"

2015

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UI - Tugas Akhir Universitas Indonesia Library

Titi Sekarindah

Pengaruh pemberian Vitamin A terhadap profil imun pasien Tuberkulosis Paru dengan terapi obat anti Tuberkulosis = The effect of vitamin A supplementation on the immune profile of pulmonary Tb patient during oral anti tuberculosis treatment

"ABSTRAK

Ruang Lingkup dan Cara Penelitian : Penyakit tuberkulosis paru masih merupakan masalah di negara berkembang termasuk Indonesia. Tuberkulosis menduduki urutan ke 2 sebagai penyebab kematian menurut hasil survey nasional 1992. Dari kepustakaan diketahui bahwa pada penderita tuberkulosis didapati kelainan imunitas seluler, sehingga untuk penyembuhan penyakit tuberkulosis diperlukan pengaktifan sistem imun testa imunitas seluler. Vitamin A sudah lama dikenal sebagai imunomodulator. Dari penelitian terdahulu pemberian retinoid dapat meningkatkan respon imun seluler antara lain kenaikan sel T penolong dan T penolong/supresor. Pada penelitian ini diharapkan pemberian vitamin A sejumlah 2x 200000IU pada penderita TB paru dengan OAT dapat meningkatkan imunitas seluler. Tujuan penelitian ini adalah menilai pengaruh pemberian vitamin A pada penderita tuberkulosis paru yang sedang mendapat OAT terhadap jumlah limfosit total, limfosit T total, sub populasi limfosit T, kadar retinol plasma, dan keadaan klink penderita. Vitamin A 200.000 IU diberikan pada awal penelitian dan setelah 4 minggu. Penelitan dilakukan secara uji klinik tersamar ganda pada 40 penderita TB paru. Penderita dibagi dalam 2 kelompok masing-masing 20 orang yang diberi vitamin A dan placebo. Pada akhir penelitian yaitu setelah 8 minggu, ada 5 orang drop out.

Hasil dan kesimpulan : Dari 40 orang peserta penelitian 10% kadar retinol plasma rendah (<20pg/dl), 30%normal, rendah(20-30pg/d.l), 60% normal. Pada pemeriksaan imunitas seluler 53,85% ada gangguan dan 46,15% normal. Nilai rata rata hitung (X) retinal plasma kelompok placebo dan perlakuan sebelum pemberian vit. .A/placebo berturut-turut adalah 30,24 ± 7,51 µg/dl dan 30,82 ±7,31 µg/dl. Setelah pemberian adalah 36,85 ± 9,74 µg/dl dan 38,02 ± 8,29 µg/dl. Pada uji t berpasangan dari kelompok perbkkan kenaikannya bermakna (p

ABSTRACT
Scope and Method of Study : Pulmonary tuberculosis is still a major health problem in the developing countries including Indonesia. Tuberculosis is number 2 as cause of death (National Survey's data, 1992). According to literature study tuberculosis patients are suffering from an immune defect. To recover from the disease the immune response especially the cellular immune response needs to be activated, because mycobacterium TB are living intracellular. Vitamin A is known as an immunomodulator. From earlier research it is known that retinoid could enhance cellular immune response, ie. increasing T helper cells and the ratio Thelperffsupresor. The hypothesis is that supplementation of vitamin A 2x2000001U to pulmonary TB patients could increase the cellular immunity. The aim of this study was to asses the vitamin A supplementation on the immune?s profile of pulmonary TB patient who are on oral anti tuberculosis treatment. Plasma retinot, nutrients intake, BMI, clinical findings were examined. Vitamin A 200.000M was given twice, in the beginning of the study and after 4 weeks. The design of the study was a randomized double blind clinical trial. Forty patients were selected and divided into 2 groups, a placebo and treatment (vitamin A) group. At the end of the study (after the 8th week), 5 patients dropped out.
Findings and Conclusions : Among 40 patients 10% showed plasma ret noK20 p g/dl), 30% normal low (20-30pgldl) and 60% normal. (03011g041). The cellular immunity was 53,85% abnormal and 46,15% normal The means (X) of plasma retinol of the placebo and study group before supplementation were 30.24 ± 7,51 µg/dl and 30.82 ± 7.31µg/dl respectively; after supplementation 36.85±9.74µg/dl and 38.02 ± 8.29µgldl respectively. Statistical analysis using paired t test showed that the study group was increasing s' 0,05), however there was no Significant difference between the 2 groups. The mean (X) of total lymphocyte before supplementation of the placebo and study group were 22.61 ± 6.51% and 22.63 ± 8,62%; after supplementation 38.09 ± 19.91% and 35.20 + 10.71%. Both were increasing significant; however there was no significant difference between the 2 groups. The T lymphocyte, T helper and ratio Thelper CT supresor were decreasing. T helper more in the placebo group 5.75% 2.29% but there was no significant difference. This study concluded that although vitamin A supplementation 2 X 200.000 IU could increase the plasma retinol but could not yet improve the immune response and clinical status significantly."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 1996

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UI - Tesis Membership Universitas Indonesia Library

Lela Dwi Sary

Polimorfisme gen n-asetiltransferase-2 pada pasien tuberkulosis dengan kegagalan pengobatan di Puskesmas Kecamatan Pademangan Jakarta Utara = Polymorphisms of n acetyltransferase 2 gene in tuberculosis patient with treatment failure at pademangan district primary health care North Jakarta / Lela Dwi Sary

"Pendahuluan: Polimorfisme gen N-asetiltransferase 2 NAT2 dapat mempengaruhi hasil pengobatan infeksi tuberkulosis TB dan risiko terjadinya efek samping kerusakan hati imbas obat anti tuberkulosis. Penelitian ini bertujuan untuk mengetahui distribusi polimorfisme gen NAT2 pada pasien TB naif yang mengalami kegagalan konversi sputum pada pengobatan dengan rejimen OAT standar dan untuk mengetahui apakah polimorfisme gen NAT2 berpengaruh terhadap toleransi dan keberhasilan terapi TB paru dengan INH.

Metode: Analisis polimorfisme gen NAT2 dilakukan pada 54 pasien TB naif Puskesmas Kecamatan Pademangan, Jakarta Utara, menggunakan teknik polymerase chain reactions PCR dan dilanjutkan dengan sekuensing. Lima puluh empat pasien TB dikelompokkan menjadi dua kelompok observasi; 26 kelompok gagal konversi dan 28 pasien berhasil konversi.

Hasil: Diantara 54 pasien TB, 11,2 adalah gen prediktor asetilator lambat membawa dua alel mutan; NAT2 5, NAT2 6, NAT2 dan 88,8 adalah gen prediktor asetilator cepat membawa satu atau dua alel NAT2 4, NAT2 12, NAT2 13 . Frekuensi asetilator cepat lebih banyak ditemukan pada penelitian ini. Sebanyak 92 pasien yang gagal konversi dan 83 pasien yang gagal pengobatan akhir mempunyai gen asetilator cepat. Tidak ditemukan hubungan yang bermakna antara gen NAT2 dengan kegagalan konversi p=0,423 dan kegagalan pengobatan p=0,415. Tidak ditemukan satupun kejadian kerusakan hati imbas obat antituberkulosis AT-DILI pada 6 pasien asetilator lambat.

Kesimpulan: Tidak ditemukan hubungan antara jenis asetilator dengan kegagalan konversi sputum, kegagalan pengobatan dan terjadinya AT-DILI.

Introduction: Polymorphisms of N acetyltransferase 2 NAT2 gene might affect the outcome of TB infection treatment and the risks of developing hepatic adverse event, known as antituberculosis drug induced liver injury AT DILI. The purpose of this study was to find the distribution of NAT2 gene polymorphisms in the naive TB patients, who experienced sputum conversion failure after conventional standard regimen and to clarify whether the NAT2 gene polymorphisms could affect the tolerability and the efficacy of multidrug therapy with INH for pulmonary tuberculosis.
Methods: Polymorphisms of NAT2 gene were studied in 54 TB naive patients in Pademangan District Primary Health Care, North Jakarta. Twenty six patients were assigned to the sputum conversion failure group and 28 to the conversion group. Analysis was done using polymerase chain reactions PCR followed by direct sequencing.
Results: Fifty four TB patients slow acetylators, 11,2 rapid acetylators, 88,8 were enrolled in this study. Two mutant alleles NAT2 5, NAT2 6, NAT2 7 were found in slow acetylator genes and NAT2 4, NAT2 12, NAT2 13 in fast acetylator genes. Among 92 patients who experienced sputum conversion failure and 83 patients who undergone treatment failure have fast acetylator genotypes. There were no significance association between NAT2 genotypes analysis associated to sputum conversion failure p 0,423 and treatment failure p 0,415. None of the six slow acetylators experienced AT DILI.
Conclusion: Among patients with sputum conversion failure and treatment failure evaluated in this study, fast acetylator genotypes were more common and no relationship was found between the acetylator genotypes with antituberculosis treatment failure and the occurrence of antituberculosis drug induced liver injury."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017

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UI - Tesis Membership Universitas Indonesia Library

Nabiilah Risa Widaad

Gambaran Implementasi Sistem Manajemen Logistik Program Penanggulangan Tuberkulosis di Kota Depok = Overview of the Implementation of the Logistics Management System for the Tuberculosis Control Program in Depok City

"Penyakit tuberkulosis masih menjadi masalah kesehatan yang cukup serius dimana Indonesia merupakan negara kedua dengan beban tuberkulosis tertinggi. Strategi penanggulangan penyakit tuberkulosis dapat dilakukan dengan memperkuat sistem manajemen pengelolaan obat tuberkulosis. Pengelolaan logistik yang baik dapat menjamin ketersediaan logistik yang sesuai dengan kebutuhan. Oleh karena itu, tujuan dari penelitian ini untuk mengetahui gambaran implementasi sistem manajemen logistik program penanggulangan tuberkulosis di Kota Depok. Penelitian ini dilakukan menggunakan pendekatan kualitatif dengan metode pengambilan data wawancara mendalam, observasi, FGD, dan telaah dokumen. Validasi data yang digunakan yaitu triangulasi sumber dan triangulasi metode. Hasil penelitian menunjukkan bahwa terjadi kekosongan logistik yaitu pada OAT kategori anak dan pot dahak akibat tidak tersedianya stok di tingkat provinsi. Selain itu, terjadi kelebihan stok pada cartridge TCM akibat keterlambatan distribusi dari provinsi berada di waktu yang berdekatan dengan pengadaan UPTD Farmasi Kota Depok. Proses pengelolaan logistik telah dilakukan sesuai panduan. Namun, kondisi ruang penyimpanan belum sepenuhnya baik di tingkat fasilitas pelayanan kesehatan dan penggunaan SITB belum maksimal. Saran yang dapat peneliti berikan yaitu dengan melakukan upgrade pada sistem informasi, menguatkan monitoring dan evaluasi ketersediaan logistik, melakukan observasi pada ruang penyimpanan obat secara berkala, memperbaiki kondisi ruang penyimpanan obat, dan melakukan penguatan jaringan internet.

Tuberculosis is still become a serious health problem, where Indonesia is the second country with the highest burden of tuberculosis. Tuberculosis control strategies can be implemented by strengthening the management of tuberculosis drugs. Therefore, the purpose of this study is to discover ther overview of the implementation logistics management of the tuberculosis control program in Depok City. This research was conducted using a qualitative approach with in-depth interviews, observation, focus group discussion, and document review as the data collection methods. Validation of the data used is triangulation of sources and triangulation of methods. The results in this study indicate that there was a logistical stock out in tuberculosis drugs for children and sputum pots due to unavailability of stock at the provincial level. In addition, there was excess stock in the TCM cartridge due to delays in distribution from the province and the procurement of the Depok City Regional Pharmacy Technical Implementation Unit at the adjacent time. The logistics management process has been carried out in accordance with the guidelines. However, the condition of storage space at the level of health service facilities and the use of information systems are not entirely ideal. Suggestions that researchers can give are upgrading the information system, strengthening monitoring and evaluation of logistics availability, making periodic observations of drug storage rooms, improving drug storage room conditions, and strengthening the internet network."

Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2023

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UI - Skripsi Membership Universitas Indonesia Library

Fiona Natania Kurniadi

Evaluasi hasil terapi pengobatan Tuberkulosis (TB) Kategori I Dosis Intermiten di Puskesmas Kecamatan Cengkareng Periode Maret 2022 - Mei 2023 = Evaluation of Intermittent Dose Category I tuberculosis treatment at Puskesmas Kecamatan Cengkareng from March 2022 - May 2023

"Tuberkulosis (TB) hingga saat ini menjadi salah satu masalah kesehatan masyarakat dunia. Di Indonesia, prevalensi infeksi TB mencapai 8,5% dan merupakan angka prevalensi TB terbesar kedua di dunia pada tahun 2019. Dalam rangka mendukung keberhasilan program penanggulangan TB nasional, dilaksanakan upaya pemantauan dan evaluasi keberhasilan program penanggulangan TB di Indonesia. Sejak bulan Maret 2022 – Mei 2023, puskesmas kecamatan cengkareng telah melayani 166 pasien dewasa TB Sensitif Obat (TB-SO) dosis intermiten. Dalam rangka menilai keberhasilan program tersebut, dilakukan evaluasi hasil pengobatan periode Maret 2022 – April 2023 serta dilakukan penyusun leaflet sebagai sarana edukasi pengobatan TB-SO dosis intermiten. Evaluasi pengobatan dilaksanakan melalui pengelolahan data retrospektif menggunakan perangkat lunak Microsoft excel dari data sekunder hasil rekapitulasi pengobatan OAT 2HRZE/4H3R3 sejak bulan Maret 2022 – Mei 2023. Sedangkan, pembuatan leaflet dilakukan berdasarkan studi literatur dari pustaka tahun 2009 – 2021 dan ditulis secara ringkas dan menarik. Berdasarkan hasil evaluasi, dari 166 pasien dewasa TB-SO dosis intermiten; 48,80% pasien sembuh; 13,25% pasien dirujuk ke fasilitas kesehatan lain; 9,64% pasien Loss to Follow Up; 0,6% pasien meninggal; 21,08% pasien menjalankan terapi fase awal; dan 6,63% pasien menjalankan terapi fase lanjutan. Selain itu, telah dibuat leaflet pengobatan TB dosis 4HRZE/2H3R3 sebagai media edukasi bagi pasien TB.

Tuberculosis (TB) has become one of the world's public health problems. In Indonesia, the prevalence of TB infection reached 8.5% and was the second highest TB prevalence in the world in 2019. To support the success of the national TB program, evaluation, and monitoring of TB programs in Indonesia were carried out. From March 2022 – May 2023, Puskesmas kecamatan cengkareng has treated 166 adult patients with drug-sensitive TB (SO-TB). To assess the success of the program, an evaluation of the treatment was carried out and the leaflet was compiled as an educational media. The evaluation was carried out retrospectively using secondary data from the recapitulation of OAT 2HRZE/4H3R3 treatment from March 2022 – May 2023, all the data were processed using Microsoft Excel software. Meanwhile, the leaflet was created based on literature studies from the 2009 – 2021 literature. Based on the evaluation results, from 166 adult patients with intermittent dose TB-SO; 48.80% of the patients recovered; 13.25% of patients were referred to other health facilities; 9.64% of patients were Loss to Follow Up; 0.6% of patients died; 21.08% of patients underwent intensive phase therapy; and 6.63% of patients underwent continuous phase therapy. In addition, the leaflet for drug-sensitive TB has been made as educational media for TB patients."

Depok: Fakultas Farmasi Universitas Indonesia, 2023

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UI - Tugas Akhir Universitas Indonesia Library

Dewinta Rahma Astika

Praktik Kerja di Apotek Roxy Biak Periode 11 Januari - 6 Februari 2021 "Analisis Pola Peresepan Obat Anti Tuberkulosis Apotek Roxy Biak Periode Januari 2021" = Field Practice at Roxy Biak Pharmacy on January 11st - February 6th 2021 "Analysis of the Prescription Patterns of Tuberculosis Drugs at Roxy Biak Pharmacy in January 2021"

"Tuberkulosis (TBC) merupakan penyakit infeksi pernapasan menular dengan persentase kasus kematian yang tinggi di Indonesia. Provinsi DKI Jakarta masuk dalam wilayah zona merah kasus TBC disebabkan oleh beberapa faktor, salah satunya yaitu terkait pemberian Obat Anti Tuberkulosis (OAT) kepada pasien penderita TBC. OAT diresepkan oleh dokter terhadap pasien penderita TBC dan tidak menutup kemungkinan terjadi kesalahan pengobatan. Kesalahan pengobatan kepada pasien dapat menyebabkan resistensi hingga kematian. Tugas akhir ini ditulis untuk meninjau resep OAT dari dokter yang diterima oleh Apotek Roxy Biak dengan mengkaji resep OAT pada bulan Januari 2021 secara administratif, farmasetik, dan klinis. Penulis berharap tugas akhir yang telah disusun dapat menunjukkan kesesuaian resep OAT yang diterima oleh Apotek Roxy Biak terhadap kaidah penulisan resep sesuai dengan aturan yang berlaku.

Tuberculosis (TB) is an infectious respiratory disease with a high percentage of deaths in Indonesia. DKI Jakarta Province is included in the red zone of TB cases due to several factors, one of which is related to the administration of Anti Tuberculosis Drugs (OAT) to patients with TB. OAT is prescribed by doctors to patients with TB and does not rule out the possibility of medication errors. Medication errors to patients can lead to resistance or even death. This final project was written to review OAT prescriptions from doctors received by Roxy Biak Pharmacy by reviewing OAT prescriptions in January 2021 administratively, pharmaceutically, and clinically. The author hopes that the final project that has been written can show the suitability of the OAT prescription received by the Roxy Biak Pharmacy to the prescription writing rules in accordance with the regulations."

Depok: Fakultas Farmasi Universitas Indonesia, 2021

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UI - Tugas Akhir Universitas Indonesia Library

Marcella

Peran Pemberian Obat Anti Tuberkulosis Pascabedah Terhadap Komplikasi Pascaoperasi Kasus Sekuel Tuberkulosis = Role of Postsurgical Antituberculous Chemotherapy in Complications after Surgery of TB Sequelae

"Latar belakang : Sekuel Tuberkulosis (TB) adalah deformitas permanen sebagai gejala sisa pada pasien yang telah menjalani pengobatan TB lengkap atau sudah dinayatakan sembuh. Pembedahan merupakan tata laksana efektif sekuel TB, meski tidak terbebas dari komplikasi. Penelitian ini ditujukan melakukan evaluasi peran pemberian OAT terhadap komplikasi pascabedah, dan menilai pengaruh riwayat Diabetes mellitus (DM), merokok dan status gizi kurang terhadap kejadian komplikasi pascabedah kasus sekuel TB.

Metode : Dilakukan suatu studi kohort retrospektif pada pasien pasien yang menjalani operasi sekuel TB di Rumah Sakit Umum Pusat Persahabatan dalam periode 1 Januari 2016 hingga 31 Desember 2019. Faktor pemberian OAT, riwayat DM, kebiasaan merokok dan status gizi kurang serta pengaruhnya pada komplikasi pascabedah merupakan variabel penelitian. Dilakukan uji statistik dengan kemaknaan p<0,05.

Hasil : Sebanyak 58 subjek dilibatkan sebagai sampel penelitian. Komplikasi pascabedah terjadi pada 36 (62,1%) subjek. OAT diberikan pada 26 (44,8%) subjek. Pemberian OAT menurunkan odds kejadian komplikasi yang bermakna secara statistik rasio odds 0,06 (0,01-0,24); p < 0,001

Simpulan : Pemberian OAT pascabedah menurunkan kejadian komplikasi pascabedah secara bermakna. Komplikasi pascabedah lebih banyak terjadi pada pasien yang tidak menerima OAT pascabedah

Introduction: Tuberculosis (TB) sequelae are permanent deformities identified as residual signs after completion of TB treatment or cured TB cases. Surgery has been demonstrated to be an effective treatment of TB sequelae albeit with possible post-surgical complications. This study aimed to assess the role of antituberculosis chemotherapy in postoperative complications and to evaluate the impact of diabetes mellitus (DM), smoking and nutritional status on the incidence of postoperative complications.
Method: A retrospective cohort trial was conducted on patients who underwent surgery of TB sequelae at the Rumah Sakit Umum Pusat Persahabatan from January 1, 2016 to December 31, 2019. Administration of antituberculosis chemotherapy, diabetes mellitus (DM), smoking habits, nutritional status and their effects on postoperative complications were evaluated. Statistical analysis concluded to be significant if p<0.05.
Results: A total of 58 subjects were included in the study. Postoperative complications were observed in 36 (62.1%) subjects. Antituberculosis chemotherapy was administered to 26 (44.8%) subjects. Post-surgical administration of antituberculosis drug reduced the likelihood of complications [OR 0.06, 95% CI 0.01-0.24, p <0.001).
Conclusion: Antituberculosis chemotherapy significantly reduced the occurence of postoperative complications. Patient who encountered postoperative complication tend not to receive antituberculous chemotherapy"

Depok: Fakultas Kedokteran Universitas Indonesia, 2020

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Mei Riasanti

Hubungan Ekspresi mRNA Type 1 Interferon Stimulated Genes (Isgs) dan Protein C1q dengan Perbaikan Klinis Okular pada Pasien Uveitis Idiopatik IGRA Positif pada Awal Terapi Obat Anti Tuberkulosis = Correlation of type 1 stimulated interferon gene mRNA expression and C1q protein with ocular clinical improvement in idiopathic uveitis IGRA positive patients in the early phase of anti-tuberculosis treatment

"Pasien uveitis tanpa etiologi yang jelas (idiopatik) dengan kriteria klinis peradangan yang tidak spesifik namun memiliki status IGRA positif kerap menyebabkan dilema dalam pengobatan. Kelompok pasien tersebut diterapi sebagai kelompok suspek ekstrapulmonari TB dan mendapatkan pengobatan Obat Anti Tuberkulosis (OAT). Berbagai penelitian menunjukan bahwa profil ekspresi transkriptomik Interferon-stimulated Genes (ISG) tipe 1 ditemukan meningkat pada pasien aktif TB dan diketahui berpotensi sebagai biomarker diagnosa dan monitoring efikasi terapi. Selain itu level protein C1q ditemukan meningkat pada pasien TB aktif dibandingkan kelompok kontrol sehat serta kadarnnya menurun signifikan seiring dengan durasi pengobatan OAT. Pada penelitian ini dilakukan pemeriksaan ekspresi mRNA menggunakan RT-qPCR terhadap Interferon Stimulated Genes (ISG) tipe 1 (MyD88, FCG1R1B, IL1B, IFIT2, GBP1, IRF7, TLR8, STAT1, SERPING1, UBE2L6) dan protein C1q menggunakan ELISA pada pasien uveitis idiopatik dengan IGRA positif dari 20 pasien dengan time-point follow up pada minggu ke-0 (M0) dan minggu ke-2 (M2). Ekspresi gen GBP1 (p=0,001), UBE2L6 (p=0,0012) dan SERPING1 (p=0,03) berbeda bermakna pada kelompok perbaikan okular, dengan 8/10 gen menunjukan tren penurunan ekspresi pada M2. Hanya GBP1 (p=0,03) yang ekspresinya berbeda bermakna pada kelompok tanpa perbaikan okular, dengan 9/10 menunjukan tren peningkatan ekspresi gen pada M2. Perubahan ekspresi gen (M0-M2) MyD88, FCGR1B, GBP1, TLR8, STAT1 berkorelasi dengan outcome okular. Perubahan ekspresi gen GBP1 dan TLR8 berbeda bermakna sebagai biomarker diagnosis dengan AUC 88,1% dan 90,5%. Pada penelitian ini, level C1q sebelum dan setelah pengobatan ditemukan tidak berbeda bermakna (p=0,87) dan tidak terdapat hubungan berbeda bermakna antara perubahan klinis okular dengan level C1q.

Uveitis patients without a clear etiology (idiopathic) with non-specific inflammation clinical criteria but who have a positive IGRA status often cause dilemmas in treatment. This group of patients was treated as a group of suspected extrapulmonary TB and received anti-tuberculosis drug (ATT) treatment. Various studies have shown that the transcriptomic expression profile of type 1 Interferon Stimulated Genes (ISG) was found to be increased in active TB patients and is known to have potential as a diagnostic biomarker and monitoring of therapy efficacy. In addition, the C1q protein level was found to be increased in active TB patients compared to the healthy control group and its levels decreased significantly with the duration of OAT treatment. In this study, mRNA expression was examined using RT-qPCR on Interferon Stimulated Genes (ISG) type 1 (MyD88, FCG1R1B, IL1B, IFIT2, GBP1, IRF7, TLR8, STAT1, SERPING1, UBE2L6) and C1q protein using ELISA in idiopathic uveitis patients. with positive IGRA of 20 patients with time-point follow-up at week 0 (W0) and week 2 (W2). GBP1 (p=0.001), UBE2L6 (p=0.0012), and SERPING1 (p=0.03) genes differentially expressed significantly in the group with ocular improvement, which 8/10 genes were downregulated in W2. In the non-improvement ocular group, only the GBP1 gene was significantly expressed differentially (p=0.03), with 9/10 genes expression upregulated in W2. Changes in expression of the MyD88, FCGR1B, GBP1, TLR8, and STAT1 genes correlated with ocular improvement. Changes in GBP1 and TLR8 gene expression were significantly different as a biomarker diagnosis with AUC of 88.1% and 90.5%. In this study, C1q levels before and after treatment were not significantly different (p=0.87) and there was no significant correlation between ocular clinical changes and C1q levels."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023

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UI - Tesis Membership Universitas Indonesia Library

Nikko Yendi Sutrisno

Reaksi obat yang tidak dikehendaki pada pasien tuberkulosis paru rawat jalan di RSUD Kota Depok periode Desember 2013-April 2014 = Adverse drug reactions on tuberculosis pulmonary outpatients at RSUD Kota Depok in December 2013 April 2014 period

"Tuberkulosis (TB) merupakan masalah kesehatan yang umum di dunia, bahkan tergolong mematikan. Pengobatan TB menggunakan obat anti Tuberkulosis (OAT) berupa isoniazid, rifampisin, pirazinamid, dan etambutol. Penggunaan OAT dapat menimbulkan Reaksi Obat yang Tidak Dikehendaki (ROTD) sehingga perlu mendapatkan perhatian khusus. Penelitian ini bertujuan untuk mengevaluasi ROTD yang dialami pasien pengguna OAT beserta faktor-faktor yang mempengaruhinya pada pasien TB paru rawat jalan di RSUD Kota Depok periode Desember 2013 ? April 2014. Metode penelitian yang digunakan adalah deskriptif dengan pengambilan data secara prospektif menggunakan data kuesioner hasil wawancara dengan pasien dan data resep pasien. Sampel adalah pasien yang mendapatkan OAT dengan lama penggunaan ≤ 3 bulan. Jumlah sampel yang didapat selama penelitian sebanyak 33 orang. Penderita baru TB paru di RSUD Kota Depok sebagian besar adalah wanita (58%), berada pada usia produktif 15-54 tahun (76%), serta merupakan keturunan Jawa, Sunda, dan Betawi. Pasien yang mengalami ROTD sebesar 85%, 65% di antaranya mengalami lebih dari 1 ROTD. ROTD yang dialami yaitu gatal, mual, muntah, pusing, dan kesemutan. Pasien dengan jenis kelamin wanita, berusia lansia (> 54 tahun), memiliki riwayat penyakit lain, dan menggunakan obat non Kombipak/FDC, memiliki persentase lebih besar untuk mengalami ROTD. Sebanyak 71% pasien yang menggunakan OAT merasakan timbulnya ROTD beberapa jam atau pada hari yang sama setelah minum OAT. Usia, jenis kelamin, riwayat penyakit lain, asal suku pasien, dan jenis obat merupakan faktor yang mempengaruhi terjadinya ROTD.

The Tuberculosis (TB) is a popular enough problem of health in the world, in many cases and even can cause the death. The Tuberculosis medication using the anti-Tuberculosis drugs, such as isoniazid, rifampicin, pyrazinamide, and ethambutol. The use of anti-Tuberculosis drugs can cause The Adverse Drug Reactions (ADR) that need to get a special attention. The aims of this research were to evaluate ADR that could happen on the TB pulmonary outpatients who are using the anti-Tuberculosis drugs and the factors which affect it on the patients at RSUD Kota Depok in December 2013 – April 2014 period. The research method that was used is descriptive with the prospective datas collecting method use data questionnaires from interviewed the patients and patient’s data recipes. The sample is the patients who used the anti-Tuberculosis drugs for ≤ 3 months. The samples were gotten during the research are 33 peoples. New patients of TB pulmonary in RSUD Kota Depok are mostly women (58%), in productive ages 15-54 years old (76%), and also from javanese, sundanese, and betawi tribe. The prevalence of patients that feel the ADR is 85%, which 65% patients feel more than 1 ADR. The ADR which was felt is itchy, queasy, vomit, dizzy, and numb. There are 71% patients who consume anti-tuberculosis drugs feel the ADR several hours or in the same day after they have consumed the drugs. The ages, gender, history of other disease, patient’s tribe, and kinds of drugs are the factors that affect the incidence of ADR."

Depok: Fakultas Farmasi Universitas Indonesia, 2014

S56182

UI - Skripsi Membership Universitas Indonesia Library

Shellinna Kurniawati

Analisis pola peresepan obat tuberkulosis sensitif obat (TB SO) di Rumah Sakit Universitas Indonesia periode Januari - Maret 2023 = Analysis of sensitive Drug-Susceptible tuberculosis prescription pattern at the Universitas Indonesia Hospital in January-March 2023

"Rumah Sakit (RS) merupakan institusi pelayanan kesehatan yang menyelenggarakan pelayanan kesehatan perorangan secara paripurna yang menyediakan pelayanan rawat inap, rawat jalan, dan gawat darurat dimana di dalamnya terdapat Instalasi Farmasi (IF) sebagai sebuah unit yang menyelenggarakan seluruh kegiatan pelayanan kefarmasian di Rumah Sakit. Tuberkulosis (TB) adalah penyakit menular yang disebabkan oleh bakteri Mycobacterium tuberculosis yang menyerang organ tubuh, terutama paru-paru, tetapi juga dapat menyerang organ lain seperti tulang, kelenjar getah bening, ginjal, dan otak. Indonesia adalah salah satu negara dengan beban TB tertinggi di dunia dengan prevalensi sekitar 214 kasus per 100.000 penduduk. Pemerintah terus berupaya meningkatkan kesadaran, pencegahan, diagnosis dini, pengobatan, dan pemantauan TB melalui program-program yang lebih efektif. Oleh sebab itu, dilakukan analisis terhadap pola peresepan obat pasien tuberkulosis sensitif obat (TB SO) di Rumah Sakit Universitas Indonesia (RSUI) periode Januari – Maret 2023. Dari 107 pasien TB SO, terdapat 57 pasien laki-laki dan 52 pasien perempuan. Berdasarkan kategori usia, terdapat 18 pasien anak dan 91 pasien dewasa. Jumlah minimum obat sebagai titik pemesanan kembali untuk paket OAT kategori I pasien dewasa 4 KDT adalah 404 tablet dan 2 KDT saat stok tersisa 705 tablet. Sedangkan stok minimum untuk paket OAT anak 3 KDT adalah 38 tablet dan 2 KDT sebanyak 127 tablet. Jumlah maksimum obat untuk paket OAT kategori I pasien dewasa 4 KDT adalah saat stok mencapai 6.455 tablet dan 2 KDT saat stok mencapai 11.277 tablet. Sedangkan stok maksimum untuk paket OAT anak 3 KDT adalah 606 tablet dan 2 KDT sebanyak 2.027 tablet.

Hospital is a health service institution that provides complete individual health services including inpatient, outpatient, and emergency services with a pharmacy installation as a unit that organizes all pharmaceutical service at the hospital. Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis which attacks organs, especially the lungs, and also other organs such as bones, lymph nodes, kidneys, and brain. Indonesia is one of the countries with the highest TB patients in the world with a prevalence of around 214 cases per 100,000 population. The government continues to increase awareness, prevention, early diagnosis, treatment, and monitoring of TB through more effective programs. Thus, an analysis was carried out on the pattern of drug prescribing in patients with sensitive drug-susceptible tuberculosis (TB SO) at the University of Indonesia Hospital during January - March 2023. Of the 107 TB SO patients, there were 57 male patients and 52 female patients. Based on age, there were 18 pediatric patients and 91 adult patients. The minimum number of drugs as the reorder point for category I OAT for adult patients with 4 KDT is 404 tablets and 2 KDT is 705 tablets. Meanwhile, the minimum stock for OAT packages for children with 3 KDT is 38 tablets and 2 KDT is 127 tablets. The maximum number of drugs for category I OAT packages for adult patients 4 KDT is 6,455 tablets and 2 KDT is 11,277 tablets. Meanwhile, OAT packages for 3 KDT children is 606 tablets and 2 KDT is 2,027 tablets."

Depok: Fakultas Farmasi Universitas Indonesia, 2023

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