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"This volume covers all aspects of the antibiotic discovery and development process through Phase II/III. The contributors, a group of highly experienced individuals in both academics and industry, include chapters on the need for new antibiotic compounds, strategies for screening for new antibiotics, sources of novel synthetic and natural antibiotics, discovery phases of lead development and optimization, and candidate compound nominations into development. Beyond discovery , the handbook will cover all of the studies to prepare for IND submission : phase I (safety and dose ranging), progression to phase II (efficacy), and phase III (capturing desired initial indications). This book walks the reader through all aspects of the process, which has never been done before in a single reference. With the rise of antibiotic resistance and the increasing view that a crisis may be looming in infectious diseases, there are strong signs of renewed emphasis in antibiotic research. The purpose of the handbook is to offer a detailed overview of all aspects of the problem posed by antibiotic discovery and development."

"ABSTRACTWorldwide it is estimated that 1400 million episodes of diarrhea occur annually in children under the age of 5 years. In 1990, over 3 million of such children died. Up to 70% of diarrhea episodes could be due to pathogens transmitted through food (Motarjemi, et. al., 1993). A prospective cohort study was conducted in Kelurahan Kapuk, West Jakarta. The purpose was to identify relationship between food contamination, diarrhea, and nutritional status of children age 6 months to 2 years. Food samples such as drinking water (DW), rice mixture (RH), and milk formula (ME) consumed by 99 children were tested for contamination of Escherichia coli, total coliform, and total aerobic bacteria (APO). Diarrhea occurrence during 2-weekperiod were noted along with measurements of weight and height. The results were as follow: 6% DW, 18% RM, and 7% MF were contaminated by faecal coliform; 29% DW, 26% RM, and 46% MF had total coliform below the recommenced guideline values of Health Department and WHO (Depkes, RI 1990, Depkes, RI 1991 & WHO, 1985); as well as 74% DW, 43% RM, and 12% MF for APC. However, no statistical significant relationship was found between food contamination and diarrhea. Seventeen children suffered diarrhea during the 2-week study period; ranging from 1-6 days with average of 3 days. No persistent diarrhea was found. About half (53%) of the diarrhea children had mild dehydration problem. Mean x-scores of weight-for-height for the diarrhea children at food sampling and 7 day afterward were (-1.39±1.03) and (-0.62+2 90). Six children were wasted at food sampling day, but only 5 were still wasted at 7th day visit. No statistical significant relationship was found between diarrhea and nutritional status after the disease."

"lnfected ascites is one of the complication happened in liver cirrhotic patient in ascites. There are 5 infected ascites classifications i. e. Spontaneous Ascites Infection Consist of Spontaneous Bacterial Peritonitis, Monomicrobial Non Neurocytic Bacteriascites, Culture Negative Neurovytic Ascites, Secondary Bacterial Peritonitis and Iantrogenic Polimicrobial Bacterascites. Spontaneous Bacterial Peritonitis (SBP) is the infection in ascites without unrecognized intra abdominal infection source. The normal floras in the gastrointestinal, respiratory or urinal tract are the important infection source in SBP. As we know that normal ascites has ability to kill micro organism through phagocitosis function, opsonization, but when infected occurs; phagocitosis function, opsanization, and MPS could be worst so that the possibility of being SBP increased. The commoon frequently sign and symtom of SBP are fever, abdominal pain, consciousness assault,tenderness, diarrhea, paralytic ileus, hypotension and hypothermia. Some of the invasive actions like endoscopy, variceal sclerothrerapy and ligation may cause intestine flora translocation to mesenteric gland bacterimia and infected ascites also made transmural passage intestine micro organism to ascites may cause infected ascites. Cefotaxime is the antibiotic that more frequently studied to SBP patient. The close of cefotaxirne to SBP patient show that 2 grant/6 hours and 2 grain/I2 hours injected produce SBP resolution and the same survival, besides that 2 gram/8 hours injected for 5 and 10 days also show the same effectively. The antibiotic prophylaxis such as quinolon group show the effective result in liver cirrhotic with the gastroentestinal tract bleeding and lout total protein (<1 graim/dl ) or has the SBP experience patients."

"Latar Belakang: Kondisi dekompensata tanpa infeksi bakteri pada pasien sirosis hati dapat meningkatkan kadar prokalsitonin (PCT). Belum ada penelitian yang secara khusus membandingkan kadar PCT berdasarkan kompensasi hati dan ada tidaknya infeksi bakteri. Tujuan: Mengetahui peran PCT dalam membantu menegakkan diagnosis infeksi bakteri pada pasien sirosis hati. Metode: Studi potong lintang dilakukan terhadap pasien sirosis hati yang berobat jalan dan dirawat inap di RSUPNCM Jakarta dari April sampai Mei 2016. Pada pasien dilakukan pemeriksaan PCT dan penentuan ada tidaknya infeksi bakteri berdasarkan pemeriksaan standar sesuai jenis infeksi yang dicurigai. Dilakukan analisis untuk mengetahui perbedaan rerata kadar PCT pada pasien sirosis hati yang tidak terinfeksi bakteri dan yang terinfeksi bakteri, serta pencarian nilai titik potong PCT untuk mendiagnosis infeksi bakteri pada sirosis hati dekompensata dengan menggunakan receiver operating curve (ROC). Hasil: Didapatkan 55 pasien sirosis hati, pria sebanyak 65,5%, dengan rerata usia 55,34±1,308 tahun. Sebanyak 38 (69,1%) pasien sirosis hati dekompensata yang 22 (57,9%) diantaranya tidak terinfeksi bakteri dan 16 (42,1%) terinfeksi bakteri. Pada pasien yang tidak terinfeksi bakteri terdapat perbedaan rerata kadar PCT yang bermakna antara pasien dekompensata (0,738ng/mL±1,185) dibandingkan dengan 17 pasien kompensata (0,065ng/mL±0,022). Rerata kadar PCT pasien dekompensata yang terinfeksi bakteri (3,607ng/mL±0,643) lebih tinggi bermakna dibandingkan dengan yang tidak terinfeksi bakteri(0,738ng/mL±1,185). Dari kurva ROC, kadar PCT pada pasien sirosis hati dekompensata didapatkan area under curve (AUC) 0,933 (IK 0,853-1,014) untuk diagnosis infeksi bakteri. Nilai titik potong kadar PCT untuk mendiagnosis infeksi bakteri pada pasien sirosis hati dekompensata adalah 2,79ng/mL dengan sensitivitas 87,5% dan spesifisitas 86,4%. Kesimpulan: Pada pasien sirosis hati yang tidak terinfeksi bakteri, kadar PCT pasien dekompensata lebih tinggi dibandingkan dengan yang kompensata. Kadar PCT pasien sirosis hati dekompensata yang terinfeksi bakteri lebih tinggi dibandingkan dengan yang tidak terinfeksi bakteri. Sementara nilai titik potong kadar PCT untuk mendiagnosis infeksi bakteri pada pasien sirosis hati dekompensata adalah 2,79ng/mL.

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Background: Liver decompensated without bacterial infection may increase procalcitonin (PCT) level in liver cirrhosis patients. Previous studies did not provide conclusive results about the differences of PCT level due to specific liver compensation and bacterial infection.

Objective: To examine the role of PCT in assisting the diagnosis of bacterial infection in liver cirrhosis patients.

Methods: A cross sectional study was conducted in liver cirrhosis patients who were outpatients and admitted to Cipto Mangunkusumo Hospital, Jakarta between April and May 2016. Procalcitonin were examined and bacterial infection were identified using standard criteria for each type of infection being suspected. Analysis were performed to determine differences in the level of PCT among liver cirrhosis patients without bacterial infection and with bacterial infection, also to get cut off point of PCT for bacterial infection diagnosis in decompensated liver cirrhosis patients using receiver operating curve (ROC).

Results: There were 55 patients with liver cirrhosis, 65,5% male, with mean of age 55,34±1,308 years. A total of 38 (69,1%) patients had decompensated liver cirrhosis, while 22 (57,9%) of them without bacterial infection and 16 (42,1%) with bacterial infection. In the absence of bacterial infection, there was significant difference between PCT level in decompensated patients (0,738ng/mL±1,185) and 17 compensated patients(0,065ng/mL±0,022). Decompensated patients with bacterial infection (3,607ng/mL±0,643) had significantly higher PCT levels than those without bacterial infection(0,738ng/mL±1,185). From ROC, level of PCT for bacterial infection in decompensated liver cirrhosis was area under curve (AUC) 0,933 (IK 0,853-1,014). Cut off point of PCT for bacterial infection diagnosis in decompensated liver cirrhosis patients was 2,79ng/mL with a sensitivity of 87.5% and specificity of 86,4%.

Conclusion: In the absence of bacterial infection, PCT levels of decompensated patients was higher than compensated ones. Procalcitonin levels of decompensated liver cirrhosis patients with bacterial infection was higher than those without bacterial infection.Cut off point of PCT for bacterial infection diagnosis in decompensated liver cirrhosis patients was 2,79ng/mL."

"Latar belakang dan tujuan : Tuberkulosis saat ini masih menjadi masalah kesehatan masyarakat dunia dan Indonesia menempati urutan kedua kasus TB paru di seluruh dunia. Faktor risiko terpenting terinfeksi TB adalah malnutrisi. Keadaan ini mempengaruhi perjalananpenyakit sehingga menentukan prognosis pengobatan dan meningkatkan angka mortalitas. Malnutrition screening tools MST sebagai alat penapisan risiko malnutrisi banyak dipergunakan pada rawat inap dandiharapkan dapat menilai hubungan status gizi pasien dengan bacterial load di tingkat pelayanan primer/rawat jalan. Metode : penelitian mempergunakan desain potong lintang dengan 185 sampel yang diambil dengan cara stratified consecutive sampling di Puskesmas Rujukan mikroskopis PRM wilayah Kota bekasi pada penderita TB paru kasus baru yang belum mendapatkan terapi Obat anti tuberkulosis OAT. Hasil : Karakteristik subjek TB paru kasus baru di puskesmas menurut usia dengan nilai tengah 37 tahun IQR 25-51, laki-laki 61,6, perokok 44,3, Kontak serumah 27,6, IMT gizi kurang 56,8, hipoalbumin 18,4, anemia 54,6 kavitas 27 dan keluhan sebagian besar subjek batuk 2-3mgg, demam dan mudah lelah. Terdapat perbedaan bermakna kadar albumin, IMT, skor risiko MST, dan gejala klinis batuk berdahak, batuk kering, sesak napas, nafsu makan turun, berat badan turun dan keringat malam. Skor MST p=2 dan nafsu makan turun mempunyai risiko untuk menderita TB dengan bacterial load 1 ,2 dan 3 . Skor MST dapat dipergunakan sebagai prognosis derajat keparahan penderita TB paru kasus baru di pelayanan kesehatan primer.

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Background and aim: Currently tuberculosis still become global health problems and Indonesia is as the second number of tuberculosis globally. Most important risk factor of tuberculosis is malnutrition. This condition affects to pathogenesis of tuberculosis so it will be determining treatment prognosis and increasing mortality. Malnutrition Screening Tools MST often uses at hospitalized patients to decide malnutrition risk and hopefully it has correlation between nutritional status and bacterial load at primary health center outpatients.

Method: A cross sectional study was conducted among 185 samples new case without tuberculosis drug treatment and stratified consecutive sampling at microscopic reference community health center of Bekasi city.

Results: Data from total 185 participants with median age 37 years IQR 25 51, male 61,6, smokers 44,3, household contact 27,6, BMI underweight 56,8, Hipoalbumin 18,4, anemia 54,6, cavity 27 and most of clinical manifestations are prolong cough, fever and weak. There are correlation among variabels consist of albumin level, BMI, MST score, productive and dry cough, dyspnea, loss of appetite and weight and night sweat. MST score p "

"Fanatisme terhadap sebuah produk tidak selalu berawal dari tingginya kualitas produk, Dari berbagai temuan riset maupun kajian terdahulu, terdapat temuan bahwa relasi antar konsumen dan produk yang dikonsumsinya, lebih sering membangun fanatisme terhadap brand. Salah satu bentuk relasinya terwujud sebagai komunitas brand online. Xiaomi dengan komunitas brand online, Mi Community Indonesia, merupakan salah satu contoh dari produk low-end market yang memiliki pengikut sangat loyal terhadap brandnya. Kesetiaan para fans Xiaomi ini telah terbukti di berbagai negara salah satunya adalah Indonesia. Mi Community Indonesia telah berdiri sejak 2017 dengan puluhan Mi Fans regional yang telah terbentuk secara organik semenjak Xiaomi masuk ke Indonesia. Untuk mendalami yang terjadi pada fenomena Xiaomi itulah, tesis ini bertujuan untuk mengkategorikan jenis keanggotaan yang terdapat pada Mi Community Indonesia dan bentuk prilaku pengkultusan brand dari setiap jenis anggota komunitas. Untuk mencapai tujuan dari penelitian, peneliti menggunakan metode kualitatif dengan metode studi netnografi melalui observasi netnografi dan wawancara mendalam dengan informan kunci. Penelitian ini menggunakan konsep komunitas brand online, termasuk didalamnya interaksi dan jenis keanggotaan komunitas brand dan pengkultusan brand. Jenis keanggotaan dan perilaku pengkultusan brand dianalisis melalui post, thread dan hasil wawancara dengan informan kunci. Dari hasil penelitian, ditemukan adanya enam jenis keanggotaan dalam Mi Community Indonesia yang terbagi menjadi the Learner, the Pragmatist, the Opinion Leader, the Activist, the Evangelist dan the Blindfold Cult. Bentuk perilaku pengkultusan brand ditemukan pada jenis keanggotaan the Evangelist dan the Blindfold Cult. Penelitian ini juga menemukan adanya bentuk pengkultusan brand yang dilakukan oleh anggota Mi Community Indonesia, dimana perilaku pengkultusan brand ini banyak terjadi pada interaksi yang didasarkan pada jenis impressions management dan community engagement. Pengkultusan brand yang terjadi pada anggota Mi Community Indonesia merupakan suatu bentuk unjuk diri kepada dunia luar menutupi realitas semu mereka terhadap produk Xiaomi itu sendiri.

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Fanaticism about a product does not always start from the high quality of the product itself. Based on previous research and studies, found out that there are a special relationship between consumers and the products they consume, more often builds fanaticism towards the brand. One form if its relationship is reflected as an online brand community. Xiaomi, with its well-known online brand community, Mi Community Indonesia, is the example of a low-end market product that have a very loyal brand followers. Their loyalty is proven in various country of Xiaomi target market in which Indonesia is one of them. Mi Community Indonesia formed since 2017 with dozens of regional Mi Fans that already formed organically since Xiaomi enter Indonesia smartphone’s market. This thesis objective is to determine the type of membership in Mi Community Indonesia and their form of brand cult towards Xiaomi as a brand of each type of membership in Mi Community Indonesia. This research is using qualitative approach with netnography study as its method. This research is using both netnography observations and in-depth interview with key informant. This research is using online brand community including the interaction within brand community and type of membership in brand community and brand cult as its concepts. In this research, type of membership and behaviour of brand cults are analysed by post, thread and online data system given by Mi Community Indonesia and interview result with key informant. The results of this research show that there are six types of membership in Mi Community Indonesia which divided into the Learner, the Pragmatist, the Opinion Leader, the Activist, and the Blindfold Cult. The brand cult behaviour is found in the Evangelist and the Blindfold Cult type of membership. This research also found behaviour of brand cult of members in Mi Community Indonesia, in which happens in interaction that based on impressions management and community engagement kind of interactions within the community. Brand cult behaviour that happens in Mi Community Indonesia is a form of rally to cover their false reality towards Xiaomi’s product."

"LATAR BELAKANG : Sirosis hati merupakan salah satu masalah kesehatan di Indonesia. Penyakit ini merupakan penyakit hati yang sering dijumpai selain hepatitis virus akut dan kanker hati. Komplikasi sirosis hati yang tersering adalah asites. Adanya asites merupakan prognosis yang buruk karena hanya sekitar 50% penderita sirosis hati dengan asites dapat bertahan hidup dalarn waktu 2 tahun. Asites juga merupakan faktor predisposisi terjadinya komplikasi berbahaya seperti Peritonitis Bakteri Spontan (PBS).BAHAN DAN METODE : 74 subyek penelitian penderita sirosis hati dengan asites. Pada cairan asites dilakukan biakan aerob-anaerob, pemeriksaan hitung leukosit dengan alat hitung sel otomatis Sysmex XT2000i®, hitung jenis leukosit dengan mikroskop dan uji leukosit esterase carik celup urin sedangkan pemeriksaan albumin, protein dan LDH dilakukan untuk serum dan cairan asites.HASIL : Pada penelitian ini didapatkan penderita PBS sebanyak 14 orang (18.92%). Pada kelompok PBS didapatkan netrositik asites sebanyak 12 orang (85.71%). Dari hasil biakan yang positif pads kelompok penderita PBS berhasil diisolasi dua jenis kuman golongan Enterobacteriaceae yaitu Escherichia call dan Enterobacter aerogenes. Kedua kuman ini diduga menghasilkan Extended Spectrum Beta Lactamase (ESBL). Dengan menggunakan cara perhitungan stastistik menurut Bland-Altman didapatkan bahwa hasil hitung jumlah leukosit pada cairan asites dengan menggunakan alat otomatis Sysmex XT2000P tidak berbeda bermakna dengan cara manual. Untuk memperkirakan jumlah PMN cairan asites ? 250 sellpL maka cut off point untuk MuitistixlOSG® adaiah pada skala trace sedangkan untuk Comburl4M® adalah pada skala positif-2. Sebagian besar cairan asites pada penderita PBS termasuk transudat berdasarkan kriteria Light (85.71 %). Pada 92.86 % penderita PBS mempunyai SAAG > 1.1 g/dL.KESIMPULAN : Pada penelitian ini diperoleh proporsi PBS sebesar 18.92 % dan proporsi netrositik asites sebesar 85.71%. Kedua jenis kuman batang Gram negatif diduga menghasilkan ESBL sehingga resisten terhadap Sefotaksim. Hitung leukosit cairan asites dapat dilakukan dengan alat penghitung sel otomatis Sysmex XT2000i. Leukosit esterase carik celup urin Multistixi OSG® dan Comburl0M@ dapat digunakan untuk memperkirakan jumlah PMN cairan asites > 250 sellpL. Cairan asites pada penderita PBS temasuk transudat menurut modifikasi kriteria Light. PBS tidak mempengaruhi SAAG.SARAN : Parasentesis diagnostik harus dilakukan sebelum pemberian antibiotik empirik. Leukosit esterase carik celup urin dapat digunakan sebagai salah satu cara untuk memdiagnosis PBS secara "bedside". Penelitian lanjutan untuk mendapatkan pola dan kepekaan antibiotika kuman penyebab PBS.

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Cirrhosis is identified as one of major health problems in Indonesia. It is found to be the most prevalent liver disease in addition to acute viral hepatitis and liver cancer. Ascites is the most common complication associated with cirrhosis. About 50% of patients with cirrhosis who develop ascites die within 2 years of diagnosis. Ascites also predisposes life-threatening complication such as Spontaneous Bacterial Peritonitis (SBP).

Materials and Methods. 74 cirrhosis patients who develop ascites were included in the study. The ascitic fluid was cultured in aerobic and anaerobic media. Leukocytes were evaluated for leukocytes count using Sysmex XT2000iT"" automatic cell counter, leukocytes differential count was observed under the microscope, and dip stick urine of leukocyte esterase test. Moreover, albumin, protein, and LDH level were assessed for both serum and ascitic fluid.

Results. Spontaneous Bacterial Peritonitis was diagnosed in 14 subjects (18.92%). Twelve subjects (85.71%) within this group developed neutrocytic ascites. Enterobacteriaceae pathogens, i.e. Eschericiiia coil and Enterobacter aerogerles, had been isolated from the ascitic fluid culture. These pathogens were suspected for producing Extended Spectrum Beta Lactamase (ESBL). Using Bland-Altman test, it was discovered that there were no significant differences in leukocytes count of ascitic fluid either measured with Sysmex XT2000iT"' automatic cell counter or conventional method. The cut-off point for MultistixlOSGTm was set on trace scale, whereas the ComburlOMTM was set on scale positive-2 to obtain a number of PMN leukocytes count of more than 250 cellslpL. Based on Light criteria, 85.71% of ascitic fluid from the SBP patients were considered as transudates. Meanwhile, 92.86% of SBP group showed an SHAG ? 1.lg/dL.

Conclusions. The study reveals that the proportion of SBP is 18.92% and neutrocytic ascites is 85.71%. Both of the Gram-negative bacteria are considered producing ESBL that induce resistance to Cefotaxime. Leukocytes count of ascitic fluid can be measured using Sysmex XT2000iTM automatic cell counter. To predict PMN leukocyte count of more than 250 cells/pL, the dip stick urine leukocytes esterase test using MultistixlOSGT"^ and ComburlOMTM are available. The ascitic fluid in SBP patients are classified as transudates, based on Light criteria. SBP has no effect against SAAG.

Suggestions. A diagnostic paracentesis should be performed prior to empirical antibiotics therapy. The dip stick urine leukocytes esterase test can be use as an alternative method to diagnose SBP along with the other bedside techniques. Further study is required to attain pattern and sensitivity of SBP pathogens."