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"HIV merupakan penyakit yang sering terjadi bersamaan dengan penyakit lain. Keberadaan penyakit penyerta memerlukan terapi bersama dengan obat ARV. Hal ini memungkinkan terjadinya interaksi antar obat yang berpotensi menyebabkan penurunan atau peningkatan kadar obat dalam darah, yang bisa menimbulkan kegagalan terapi atau efek samping berupa toksisitas. Penelitian ini bertujuan melihat potensi interaksi yang penting secara klinis dari terapi ARV dengan obat komorbidnya. Penelitian ini adalah penelitian non eksperimental, pengambilan data dilakukan secara potong lintang pada pasien HIV dengan komorbid yang dirawat di rumah sakit Cipto Mangunkusumo dalam periode Januari 2016 sampai dengan Juli 2017. Data diambil dari electronic health record dan pusat rekam medis RSCM. Dari 224 pasien HIV yang masuk kedalam kriteria inklusi, terdapat 121 pasien yang memenuhi persyaratan dan diambil menjadi subjek penelitian. Potensi interaksi yang penting secara klinis didefinisikan sama dengan potensi interaksi mayor memerlukan modifikasi dosis, jangan diberikan bersamaan, kontraindikasi atau hindari . Hasil penelitian menunjukkan dari 121 pasien, potensi interaksi mayor terjadi pada 18 pasien 14,99 dengan potensi interaksi yang menurunkan kadar ARV pada 14 pasien 11,57 . Kejadian potensi interaksi mayor yang paling banyak terjadi yaitu antara nevirapin dan rifampisin 3,53 . Komorbid terbanyak adalah Tuberkulosis Paru 12,92 . Diperlukan penelitian prospektif pengukuran kadar obat dan efek terapi akibat interaksi obat ARV dengan obat komorbidnya.

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HIV is a disease commonly presents with other comorbidities which need concomitant treatments with ARV. Drug-drug interaction is an unavoidable consequence which may potentially lead to an increase or a decrease of affected drug and ultimately resulted in therapeutic failure or otherwise, toxicity.This study was aimed to look at the potential of clinically significant drug-drug interactions between ARV and other treatments. This was a non experimental cross sectional study conducted on HIV patients with comorbids treated at the Cipto Mangunkusumo hospital from January 2016 to Juli 2017. Data were taken from the electronic health record and Cipto Mangunkusumo hospital medical record. From 224 HIV patients who meet the criteria of inclusion, there are 121 patients that rsquo;s fulfilled the conditions and was taken to be the subjects of research. The potential of clinically significant drug-drug interactions are definitioned as potential for major interaction requiring dose modification, do not coadminister, contraindicated or avoid . The results showed that potential for mayor interactions occurred in 18 out of 121 patients 14.99 . Potential decrease of blood ARV level was found in 14 patients 11.57 . The occurance of potential for major interaction mostly happened between nevirapin and rifampisin 3,35 . The most comorbid is pneumonia tuberculosis 12.92 . Prospective study is required to measure drugs level and the effect of therapy consequence ARV drugs interaction with comorbid drugs"

"Latar belakang: Tuberkulosis (TB) adalah penyebab kematian kesembilan paling banyak di dunia. Indonesia merupakan negara kedua dengan jumlah penderita TB paling banyak di dunia dengan persentase penderita sebanyak 8%. Kasus TB kambuh merupakan kasus dengan morbiditas yang tinggi dengan pengobatan yang lebih sulit. Karakteristik pasien TB kambuh belum banyak diteliti di Indonesia, padahal kasus TB kambuh sangat memperberat beban biaya penatalaksanaan TB di Indonesia. Tujuan dari penelitian ini adalah meneliti faktor-faktor yang memengaruhi terjadinya TB kambuh di Indonesia.Metode: Penelitian ini merupakan penelitian potong lintang yang dilakukan di Rumah Sakit Penyakit Infeksi Prof. Dr. Sulianti Saroso, 1 Januari 2014 hingga 31 Desember 2018. Seluruh pasien TB kambuh dimasukkan dalam penelitian, dan pasien TB tidak kambuh dengan jumlah sama pada periode yang sama dengan cara consecutive sampling. Kemudian dilakukan analisis terhadap karakteristik klinik kedua kelompok tersebut.Hasil: Didapatkan hasil bahwa ada 2.322 pasien TB selama periode penelitian, dengan persentase keberhasilan terapi sebesar 78,1%, tidak sembuh 21,9% dan pindah 5%. Diambil 94 kasus TB kambuh (sesuai perhitungan jumlah sampel) yang memenuhi kriteria inklusi dan eksklusi. Didapatkan bahwa faktor yang berpengaruh terhadap kejadian TB kambuh pada pasien adalah status kepatuhan mengambil obat pasien (p = 0,007, odds ratio 0,38 (IK 95% = 0,19-0,76)) dan gambaran lesi kavitas pada foto thorax awal (p < 0,001, odds ratio 0,08 (IK 95% = 0,03-0,20)).Kesimpulan: Terdapat hubungan antara dengan kejadian TB kambuh dengan status kepatuhan mengambil obat pasien, dan gambaran lesi kavitas pada foto torak awal.

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Background: Tuberculosis (TB) infection is the most prevalent cause of deaths in the world. Indonesia is the second country in the world with the highest number of tuberculosis patients with a prevalence of 8%. Recurrent tuberculosis is a case with a high morbidity with more complicated medication. Recurrent tuberculosis patients characteristics are rarely studied in Indonesia, despite ubiquitous recurrent tuberculosis cases in Indonesia further worsening the burden of disease. The aim of this study is to study factors affecting recurrence of tuberculosis in Indonesia.

Method: This is a cross sectional study which done in Prof. Dr. Sulianti Saroso Infection Disease Hospital, January 2014-December 2018. All samples with recurrent tuberculosis were included in the study, while samples with successful treatment in the same period were chosen by consecutive sampling. Statistical analysis of clinical characteristics was done to both study groups.

Result: There were 2.322 tuberculosis patients obtained during the course of study with 78,1% successful treatment rate, 21,9% was not cured, and 5% switched to another health center. Ninety four cases of recurrent TB meeting inclusion and exclusion criteria were obtained. It was known that factors affecting recurrence of TB were medication compliance (p = 0.007, odds ratio 0.38 (IC 95% = 0.19-0.76)) and appearance of cavity lesion in the first thorax x-ray examination (p < 0.001, odds ratio 0.08 (IC 95% = 0.03-0.20)).

Conclusion: There was a relationship between recurrent TB and medication compliance and appearance of cavity lesion in the first thorax x-ray examination."

"Indonesia memiliki keanekaragaman lebah terbesar di seluruh Asia, dimana hingga tahun 2018 tercatat terdapat 46 spesies lebah tanpa sengat (stingless bee) yang ditemukan di Indonesia. Profil kimia dari propolis sangat bervariasi tergantung pada sumber vegetasi dan asal geografisnya, hal ini menimbulkan kesulitan untuk standarisasi. Oleh karena itu tujuan dari penelitian ini adalah untuk menemukan gambaran standarisasi yang dilihat dari rentang kandungan fenolik dan flavonoid totalnya, profil kimia, klasterisasi, dan senyawa yang berpotensi sebagai marker pada propolis Indonesia menggunakan pendekatan metabolomik dengan instrumen KCKUT-SM/SM. Penelitian dilakukan terhadap 19 sampel dari wilayah Sumatera, Jawa, Kalimantan, Nusa Tenggara Barat, dan Sulawesi. Hasil analisis KCKUT-SM/SM kemudian dikombinasikan dengan analisis statistik multivariat Principal Component Analysis (PCA). Hasil dari penelitian ini menunjukkan  terdapat perbedaan profil kimia dari sampel propolis Indonesia, dimana jumlah dan jenis senyawa yang terdeteksi bervariasi antar sampel, tidak terdapat pengelompokkan tertentu pada sampel propolis Indonesia dikarenakan banyaknya variasi kandungan kimia dari seluruh sampel propolis yang digunakan, dan ditemukan 3 senyawa yang berpotensi sebagai penciri, yaitu Choline, DL-Stachydrine, dan Betaine. Standar kandungan fenolik dan flavonoid propolis Indonesia berada pada rentang 7,06+ 2,77 mg GAE/g hingga 120,32+ 13,61 mg GAE/g dan 1,34 + 0,01 mg QE/g hingga 36,45 + 3,55 mg QE/g.

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Indonesia has the largest distribution of bees in all of Asia, until 2018 there were 46 species of stingless bees found in Indonesia. The chemical profile of propolis varies greatly depending on its vegetative source and geographic origin, making the standardization difficult. Therefore the aim of this study was to find a standardization seen from the range of total phenolic and flavonoid contents, chemical profiles, clusterization, and compounds that have the potential as markers in Indonesian propolis using a metabolomics approach with the UHPLC-MS/MS instrument. The study was conducted on 19 samples from Sumatra, Java, Kalimantan, West Nusa Tenggara and Sulawesi. The results of the UHPLC-MS/MS analysis were then combined with the Principal Component Analysis (PCA) multivariate statistical analysis. The results of this study indicated that there were differences in the chemical profile of the Indonesian propolis samples, where the number and types of compounds detected varied between samples, there were no specific groupings in the Indonesian propolis samples due to the large variation in chemical content of all the propolis samples used, and found 3 different compounds potential as markers, namely Choline, DL-Stachydrine, and Betaine. The standards for Indonesian propolis phenolic and flavonoid content ranges from 7,06 + 2,77 mg GAE/g to 120,32 + 13,61 mg GAE/g and 1,34 + 0,01 mg QE/g up to 36,45 + 3,55 mg QE/g."

"Pendahuluan: Kadar obat yang rendah dalam darah pasien TB paru diduga berhubungan dengan respon pengobatan yang buruk seperti kegagalan konversi sputum mikroskopis, yang merupakan risiko terjadinya kegagalan pengobatan. Namun berbagai penelitian menunjukan hasil kontroversial, sebagian menunjukan terdapat hubungan antara kadar obat dengan konversi sputum akhir intensif, sebagian lagi menunjukan respon terapi yang sama baiknya untuk kadar normal maupun kadar rendah. Faktor yang diduga menyebabkan perbedaan hasil ini adalah perbedaan MIC rifampisin dan isoniazid terhadap Mycobacterium tuberculosis (MTB) pada pasien-pasien TB di setiap wilayah. Penelitian ini bertujuan mengetahui hubungan kadar rifampisin dan isoniazid darah dengan konversi, serta hubungan rasio kadar puncak rifampisin dan isoniazid darah terhadap MIC (Cmax/MIC) dengan konversi sputum pasien TB paru di akhir fase intensif. Metode: Desain penelitian adalah kasus kontrol dengan jumlah sampel sebanyak 40 orang, yang terbagi dalam kelompok kasus (tidak konversi, n=20) dan kelompok kontrol (konversi, n=20). Kadar rifampisin dan isoniazid darah diukur pada dua jam setelah minum obat yang merupakan perkiraan kadar puncak rifampisin dan isoniazid, menggunakan metode LC/MS-MS. Data MIC diambil dari 20 isolat kultur MTB sputum pasien TB paru kasus baru di RSP dr. H.A Rotinsulu Bandung menggunakan metode MGIT. Hasil: Dari 40 pasien didapatkan rerata kadar rifampisin 5,58±2,41 mg/L dengan 36 pasien (90%) diantaranya memiliki kadar puncak di bawah normal. Untuk isoniazid didapatkan median kadar 1,46 (0,40-6,10) mg/L dengan 32 pasien (80%) diantaranya memiliki kadar puncak isoniazid di bawah normal. Pada penelitian ini didapatkan MIC rifampisin 0,25 mg/L dan MIC isoniazid 0,05 mg/L, lebih rendah dibanding kadar kritis masing-masing obat.

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Introduction: Low plasma drug concentration in pulmonary TB patients are thought to be associated with poor treatment outcomes such as microscopic sputum conversion failure, which is a risk of treatment failure. However, various studies showed controversial results, some showed that there was an association between drug concentration with sputum conversion at the end of intensive phase, while others showed the same good outcome for normal and low concentrations. Factors thought to cause these controversial in results are the differences in the MIC of rifampicin and isoniazid against Mycobacterium tuberculosis in TB patients in each region. This study aims to determine the association between blood rifampicin and isoniazid concentratiom with sputum conversion, as well as the association between the ratio of peak blood concentration of rifampicin and isoniazid to MIC (Cmax/MIC) with sputum conversion of pulmonary TB patients at the end of the intensive phase.

Methods: The study design was a case-control study with a sample size of 40 subjects, which were divided into a case group (non-conversion, n=20) and a control group (conversion, n=20). The blood concentration of rifampicin and isoniazid were measured two hours after taking the drug which is an estimate of the peak concentrations of rifampicin and isoniazid, using the LC/MS-MS method. MIC data were taken from 20 MTB sputum culture isolates from new cases of pulmonary TB patients at RSP dr. H.A Rotinsulu Bandung using the MGIT method.

Results: Of the 40 patients, the mean concentration of rifampicin was 5.58 ± 2.41 mg/L with 36 patients (90%) of whom had peak concentrations below normal. For isoniazid, the median concentration was 1.46 (0.40-6.10) mg/L with 32 patients (80%) of whom had peak concentration of isoniazid below normal. In this study, the MIC of rifampicin 0.25 mg/L and MIC of isoniazid 0.05 mg/L were lower than the critical concentration of each drug. There was no association between blood rifampicin concentration (OR: 11.18; 95% CI: 0.20-223.00, p= 0.106), blood isoniazid concentration (OR: 3.86; 95% CI: 0.67-22 .22, p= 0.235), and the Cmax/MIC ratio of rifampicin (OR: 0.474; 95% CI: 0.039-5.688, p=1.00) with intensive final sputum conversion. However, there was an association between low concentration of both drugs simultaneously (OR: 6.00; 95% CI: 1.08-33.27, p = 0.028), and the Cmax/MIC ratio of isoniazid (OR: 4.333; 95% CI: 1.150). -16,323, p= 0.027) with sputum conversion at the end of the intensive phase.

Conclusion: There was no association between blood rifampicin concentration, blood isoniazid concentration, and the Cmax/MIC ratio of rifampicin with microscopic sputum conversion at the end of the intensive phase. However, there was an association between low concentration of both drugs and the Cmax/MIC ratio of isoniazid and sputum conversion at the end of the intensive phase."