Informasi Obat pada Pasien Diabetes Mellitus Rawat Jalan di RSUD X Surabaya: Apa yang diberikan dan apa yang diketahui?

The prevalence of Diabetes Mellitus (DM) in Indonesia has increased 0.5% in the last five years. This study aimed to evaluate information provided and level of knowledge among DM patients on their treatment at the outpatient clinic at the X Public Hospital (Rumah Sakit Umum Daerah, RSUD), Surabaya, Indonesia. This was a cross-sectional study using a checklist developed by The Food And Drug Supervisory Agency which consists of 11 types of information. The data were analysed descriptively; to test the relationship between the amount of information provided and the patient's level of knowledge, Spearman correlation analysis was used. A total of 110 patients were included in this study (response rate 90.91%). The mean of information provided and understood by patients was 6.48/11±0.73 and 7.48/11±0.90, respectively. There was a significant relationship between information provided to and known by patients (p=0.001). Characteristic factors such as age (p=0.001), education level (p=0.001), and sources of information related to DM (p=0.014) were shown to influence DM patients' knowledge of their treatment. This study indicated the importance of providing clear and complete drug information, especially for patients on long-term therapy, to improve their knowledge, thus potentially increasing adherence and optimizing therapy outcomes.Prevalensi Diabetes Mellitus (DM) di Indonesia mengalami peningkatan sebanyak 0,5% dalam lima tahun terakhir. Tujuan dari penelitian ini adalah untuk melihat informasi yang diberikan dan tingkat pengetahuan pasien DM terkait pengobatan yang diterima di klinik rawat jalan di Rumah Sakit Umum Daerah (RSUD) X, Surabaya, Indonesia. Penelitian ini merupakan penelitian cross-sectional dengan menggunakan checklist yang dikembangkan dari Badan Pengawas Obat dan Makanan (BPOM) dimana terdiri dari 11 jenis informasi. Data dianalisis secara deskriptif, dan untuk melihat hubungan antara informasi yang diberikan dan tingkat pengetahuan pasien digunakan analisis korelasi Spearman. Terdapat 110 pasien yang bersedia berpartisipasi di dalam penelitian ini (response rate 90,91%). Ratarata jumlah informasi yang diberikan dan dipahami adalah 6,48/11±0,73 dan 7,48/11±0,90. Terdapat hubungan yang signifikan antara jumlah informasi yang diberikan dan yang diketahui pasien (p=0,001). Faktor karakteristik seperti usia (nilai p=0,001), tingkat pendidikan (nilai p=0,001), dan sumber informasi terkait DM (nilai p=0,014) dapat mempengaruhi pengetahuan pasien DM terhadap pengobatannya. Penelitian ini menunjukkan pentingnya pemberian informasi yang jelas dan lengkap terutama pada pasien yang menjalani pengobatan jangka panjang karena dapat meningkatkan pengetahuan, sehingga diharapkan dapat meningkatkan kepatuhan dan mengoptimalkan keberhasilan terapi

The Attitude Changes Of Local Farmers Toward The Introduction Of Artificial Insemination In The Extensive Of Cattle Raising In The Seram Bagian Barat District, Maluku Province, Indonesia

Special efforts for cow must be pregnant  (Upsus Siwab)  is a program for the achievement of meat adequacy in 2022 through the optimization strategy of implementing Artificial Insemination (AI) in 34 provinces including Maluku Province. One of them is Seram Bagian Barat District. The type of cattle that are kept are Bali with extensive management. Maluku Province is The AI introduction area, so there are many challenges to meet the targets set. The purpose of this paper is to know the performance of AI introductions and the effect toward farmer attitudes in the SBB District during the 3 years of assistance. The method of this research was a survey, interviews with farmers, field officers, and district officers. Data with the Ishiknas format for 3 years was collected from the Agriculture services of SBB District. Data was tabulated and analyzed descriptively. The basic problems related to the application of AI are (1) it is difficult to detect the oestrus because all cattle are released, (2) the habits of mating cattle naturally, (3) there is no interest in participating of AI, and (4) the knowledge of oestrus is very minimal. The strategy to solved the problem was introduction the hormone of Oestrus Synchronization (SE). The strategy was quite successful, in 2017, the realization of AI was 85%. Realization in 2018 and 2019 were more than 100%. The S/C score was 1.13 times indicates that the cows have very good reproductive performance. There were 15 variations in gestational age with the range of 8 months 4 days - 9 months 17 days. The most average were 9 months 10 days (16.6%) and 9 months 11 days (16.6%). The pregnancy rates of AI was 10 -311 cows/month with an average of 108.8 cows, while in natural marriages 0 - 32 cows/month with an average of 12.5 cows. The birth weights of AI with Bali bulls straw ranged from 17 to 23 kg (an average of 19.6 kg), while the natural mating was an average of 16 kg. Another results, the birth weight of AI with Ongole bulls straw on male was an average of 32.2 kg and 30 kg on female. In 2017, the implementation of the AI was all done in combination with the SE because no farmers wanted to report the oestrus of cows. In 2018 there were reports from farmers and in 2019, all AI implementations were based on normal oestrus reports. The change in attitudes of farmers regarding adoption of AI was caused by the calves had a higher birth weight and a higher selling price. Implementation of AI in the District of SBB has good prospects for increasing the quantity and quality of cattle and also increasing the income of farmer

a Kajian Naratif Pengukuran Kualitas Peresepan Pasien Diabetes Mellitus Lanjut Usia

The aging populations has increased worldwide, resulting in higher prevalences of non-communicable diseases, including Diabetes Mellitus (DM). Elderly with DM requires long-term prescribing which warrants special considerations. Hence, this narrative review aims to identify quality measurement tools and quality prescribing in elderly patients with DM. This review included literature searching in three databases [i.e., Pubmed (MEDLINE), Science Direct, and CINAHL] with combination of keywords: (Diabetes) AND (Elderly OR older OR geriatric) AND (“Potentially inappropriate medication” OR “potentially inappropriate prescribing” OR “inappropriate prescribing” OR “quality prescription” OR “rational prescribing”). The searching resulted in 1059 articles; and after the selection process, 10 articles were included in this study. The extracted data indicated that tools with explicit criteria (such as Beer's Criteria) were more commonly used to measure quality prescribing in elderly patients with DM compared to those with implicit criteria (i.e., Prescribing Quality Assessment Checklist) (9 articles versus 1 article, respectively). Varying quality prescribing were reported dependent on the tools used. The percentage of Potentially Inappropriate Medication (PIM) measured using explicit tools ranged from 22,7% to 68,1%; glibenclamide or glyburide were among the most common PIM. Whereas, 83.2% of precriptions measured with the implicit criteria in one article indicated poor quality. This finding demonstrated the needs of strategy to improve the quality of prescribing in elderly patients with DM.Peningkatan jumlah pasien lanjut usia di seluruh dunia mengakibatkan peningkatkan jumlah penyakit tidak menular, termasuk Diabetes Mellitus (DM). Pasien lanjut usia dengan DM memerlukan pengobatan dalam jangka panjang sehingga membutuhkan perhatian khusus. Kajian naratif ini dibuat dengan tujuan untuk melihat instrumen yang digunakan untuk mengukur kualitas peresepan dan kualitas peresepan itu sendiri pada pasien lanjut usia dengan DM. Kajian ini melibatkan pencarian di tiga basis data [yaitu: Pubmed (MEDLINE), Science Direct, dan CINAHL], dengan menggunakan kombinasi kata kunci: (Diabetes) AND (Elderly OR older OR geriatric) AND (“Potentially inappropriate medication” OR “potentially inappropriate prescribing” OR “inappropriate prescribing” OR “quality prescription” OR “rational prescribing”). Berdasarkan hasil pencarian didapatkan 1059 artikel; dan setelah dilakukan proses seleksi, didapatkan 10 artikel yang diikutsertakan didalam penelitian ini. Hasil kajian ini menunjukkan bahwa instrumen eksplisit (seperti Beer’s Criteria) lebih banyak digunakan jika dibandingkan dengan instrumen implisit (yaitu, Prescribing Quality Assessment Checklist) (9 banding 1 artikel secara berurutan). Kualitas peresepan pada pasien lanjut usia dengan DM menunjukkan perbedaan hasil yang bervariasi sesuai dengan instrumen yang digunakan. Persentase Potentially Inappropriate Medication (PIM) dengan menggunakan instrumen eksplisit memiliki rentang antara 22,7-68,1%, dimana penggunaan glibenklamid atau gliburid termasuk PIM yang paling sering ditemukan. Sedangkan pengukuran kualitas dengan menggunakan instrumen implisit pada satu artikel menunjukkan peresepan dengan kualitas buruk sebesar 83,2%. Hasil kajian ini mengindikasikan perlunya strategi untuk meningkatkan kualitas peresepan pada pasien lanjut usia dengan DM

A Review of CRISPR Cas9 for SCA: Treatment Strategies and Could Target β-globin Gene and BCL11A Gene using CRISPR Cas9 Prevent the Patient from Sickle Cell Anemia?

BACKGROUND: Sickle cell anemia is a hereditary globin chain condition that leads to hemolysis and persistent organ damage. Chronic hemolytic anemia, severe acute and chronic pain, and end-organ destruction occur throughout the lifespan of sickle cell anemia. SCD is associated with a higher risk of mortality. Genome editing with CRISPR-associated regularly interspersed short palindromic repeats (CRISPR/Cas9) have therapeutic potential for sickle cell anemia thala. AIM: This research aimed to see if using CRISPR/Cas9 to target β-globin gene is an effective therapeutic and if it has a long-term effect on Sickle Cell Anemia. METHODS: The method used in this study summarizes the article by looking for keywords that have been determined in the title and abstract. The authors used official guidelines from Science Direct, PubMed, Google Scholar, and Journal Molecular Biology to select full-text articles published within the last decade, prioritizing searches within the past 10 years. RESULTS: CRISPR/Cas9-mediated genome editing in clinical trials contributes to α-globin gene deletion correcting β-thalassemia through balanced α- and β-globin ratios and inhibiting disease progression. CONCLUSION: HBB and BCL11A targeting by CRISPR/Cas9 deletion effectively inactivate BCL11A, a repressor of fetal hemoglobin production. However, further research is needed to determine its side effects and safety

ASMA Pedoman Diagnosis dan Penatalaksanaan Di Indonesia Perhimpunan Dokter Paru Indonesia

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Efek Kualitas Pelabelan Terhadap Pengetahuan dan Kepatuhan Pasien Hipertensi di Mataram

Hipertensi merupakan penyakit kronis yang membutuhkan pengobatan jangka panjang, dengan kepatuhan menjadi suatu permasalahan utama. Label pada obat seringkali digunakan sebagai media informasi tertulis untuk mengoptimalkan penggunaan pengobatan dalam mencapai target terapi. Penelitian ini bertujuan untuk mengevaluasi efek perbaikan kualitas pelabelan obat terhadap pengetahuan dan kepatuhan pasien hipertensi di Kota Mataram. Penelitian ini menggunakan desain pre-/post-intervensi dengan perbaikan kualitas pelabelan (label dibuat sesuai dengan standar Good Dispensing Practice (GDP)—9 atribut) sebagai intervensinya. Uji statistik dilakukan untuk melihat perbedaan pengetahuan, kepatuhan, dan tekanan darah pre-/post-intervensi. Terdapat 132 pasien dari 11 Puskesmas di Kota Mataram yang menyelesaikan seluruh tahapan penelitian pada periode waktu Agustus sampai Oktober 2017. Baseline skor pelabelan adalah 3,6; dan setelah dilakukan perbaikan pada label maka didapatkan skor maksimum yaitu 9. Terdapat peningkatan pengetahuan pasien setelah dilakukan intervensi perbaikan pelabelan (median skor dari 2,0 menjadi 5,0; p=0,001). Demikian juga, terdapat peningkatan kepatuhan setelah intervensi pelabelan (median skor dari 1,0 menjadi 2,0; p=0,001). Perubahan yang signifikan terhadap tekanan darah sistolik/diastolik pada pre-/post-intervensi juga dilaporkan (p=0,001/0,026). Hasil penelitian ini memberikan data awal yang menunjukkan bahwa intervensi berupa perbaikan kualitas pelabelan potensial meningkatkan pengetahuan dan kepatuhan pasien hipertensi di Mataram. Hypertension is a chronic condition that requires long-term treatment, hence, adherence has been a major issue. The dispensed medication label has been commonly used to provide written information to optimize drug use in achieving treatment goals. Therefore, this study aimed to determine the effect of improved labeling quality on knowledge and adherence of hypertensive patients in Mataram. This is a pre-/post-intervention study with improved labeling quality (according to Good Dispensing Practice (GDP) standard–9 attributes) as the intervention. The differences in knowledge, adherence, and blood pressure pre-/post-intervention were statistically tested. A total of 132 patients from 11 Public Health Center in Mataram participated in this study from August to October 2017. The results showed a baseline labeling score of 3.6, and after the intervention (improved labeling), a maximum score of 9 was achieved. Knowledge was significantly increased through improved labeling (median score from 2.0 to 5.0; p=0.001). In addition, the intervention enhanced adherence (median score from 1.0 to 2.0; p=0.001). Significant changes were reported in systolic and diastolic blood pressure pre-/post-intervention (p=0.001 and 0.026, respectively). Therefore, preliminary data were provided on the potential of high-quality labeling to improve knowledge and adherence among hypertensive patients in Mataram

UKPDS 20: Plasma Leptin, Obesity, and Plasma Insulin in Type 2 Diabetic Subjects

We measured plasma leptin and insulin concentrations across a spectrum of obesity in 829 white Caucasian, 154 Afro-Caribbean, and 204 Asian type 2 diabetic subjects. Although the leptin concentrations covered a large range, there were no subgroups of diabetic subjects with very high or low leptin levels that would suggest mutations in the leptin gene or leptin receptor gene comparable to the obese diabetic ob/ob and db/db mice models respectively. In all three ethnic groups, leptin concentrations correlated with body mass index (BMI) in a similar manner to nondiabetic patients and were higher in females than males after adjustment for BMI, with no difference between ethnic groups. In a multivariate regression analysis, plasma leptin was associated with gender and BMI, (both P&lt; 1 x 10-17) and with fasting plasma insulin concentrations (P = 5 x 10-9). Subjects treated with insulin had both raised insulin and leptin concentrations. When matched for different therapies, gender, and BMI, diabetic subjects with high leptin levels also had high insulin levels (P &lt; 0.0009). High leptin concentrations may in part be influenced by hyperinsulinemia or impaired insulin sensitivity.</p

DMD, RIPK3, and MLKL gene editing by CRISPR Cas9 as myofiber protection against dystrophin deficiency and necroptosis in Duchenne muscular dystrophy: A literature review

&nbsp; BACKGROUND: Duchenne muscular dystrophy is a neuromuscular disease caused by a deficiency of dystrophin, which causes the skeletal and cardiac muscles to degenerate. Targeted deletion of DMD, RIPK3, and MLKL has been shown in several studies to prevent dystrophin deficiency and necroptosis, a critical hypothesis in the etiology of Duchenne muscular dystrophy. AIM: This research aimed to see if using CRISPR/Cas9 to target DMD, RIPK3, and MLKL is an effective therapeutic and if it has a long-term effect on Duchenne muscular dystrophy. METHODS: Abstracts and titles of articles were searched for specific keywords to summarize them using the method used in this study. The researcher will look over the entire article to see if it is valuable and relevant to the topic. RESULTS: CRISPR/Cas9-mediated genome editing in MDX mice can improve the primary genetic lesions that cause muscular dystrophy (DMD) and prevent disease development. Furthermore, Ripk3/Mlk1 double knockout completely blocked necroptosis susceptibility in necroptosis-sensitive cell lines, each to an indistinguishable degree. CONCLUSION: DMD, RIPK3, and MLKL gene editing by CRISPR/Cas9 is effective dystrophin insufficiency, sarcolemma fragility, poor intracellular signaling, myocyte death, inflammatory infiltration, muscle replacement, and necroptosis. However, more research is needed to determine its side effects and safety. &nbsp