Coronavirus: Penyakit Lama, Virus Lama, Kemasan Baru

Abstract— Covid -19, a virus strain and a member of family with known member as Severe Acute Respiratory Disease (SARS) or Middle East Respiratory Syndrome (MERS), but having a potentially lethal differences in not readily recognized by our immunity. Classified as betacoronavirus, with incubation period up to 14 days, the sign and symptoms can be highly variable, from asymptomatic to mild to criticalin the form of severe pneumonia. Almost half the persons infected did not show any symptoms, but in cases of people with comorbidities such as advanced age, pregnancy, obesity or other certain diseases, could increase the likelihood of morbidity and even potentially fatal. Covid-19 has spread globally, including Indonesia, with a potentially increased number of cases, prevention in covid-19 protocol is a necessity. Keywords: Covid-19, SARS, symptoms, variable, prevention Abstrak— Covid-19, yang sebelumnya dikenal sebagai virus strain dari kelompok family yang sama dengan Severe Acute Respiratory Disease (SARS) atau Middle East Respiratory Syndrome (MERS), tapi memiliki fatalitas yang secara potensial lebih tinggi, karena bersiafat novel bagi sistem imunitas kita. Termasuk betacoronavirus, dengan masa inkubasi sampai dengan 14 hari, tanda dan gejala penyakit bisa sangat bervariasi, mulai dari asimtomatik, ringan sampai berat, dalam bentuk pneumonia berat. Hamper separuh penderita yang terinfeksi tidak menunjukkan gejala sama sekali, tapi pada penderita dengan komorbiditas seperti usia lanjut, kehamilan, obesitas atau penyakit kronis tertentu, resiko moribiditas dan mortalitas dapat meningkat. Covid-19 saat ini sudah menyebar ke seluruh dunia, termasuk Indonesia, dengan adanya potensi kenaikan kasus lebih banyak, pencegahan dalam bentuk protocol covid-19 bersifat mutlak diperlukan. Kata kunci: Covid-19, SARS, gejala, bervariasi, pencegaha

Drug Interactions in Diabetic Ulcer Patients in an Indonesian Private Hospital

Diabetic ulcers can progress into tissue death, or gangrene, which create a risk for amputation. Measures for preventing other complications and accelerating wound healing in diabetic ulcers include blood sugar level control, diet adjustment, wound care, antidiabetic drug administration, and comorbid therapy. This leads to the use of various drugs that can potentially trigger drug interactions. This study aimed to identify possible drug interactions in the therapeutic management of diabetic ulcer patients treated in Husada Utama Hospital Surabaya, Indonesia, from January 2020–June 2022. This was a descriptive observational study using retrospective data from medical records. Results showed that 103 types of drugs were administered to 48 research samples with 41 of them experienced drug interactions (n=263 cases). Based on the severity of drug interactions, 31 cases were categorized as major cases (11.79%), with drug-class antibiotic-antiemetic interactions as the most frequent interactions. This study proves that it is essential for doctors and pharmacists

Profil Penggunaan Antibiotik Dan Peta Kuman Di Ruang Rawat RS Husada Utama Surabaya

Latar belakang: peresepan antibiotik yang tinggi merupakan salah satu faktor pemicu peningkatan kejadian resistensi. Resistensi antibiotik adalah kemampuan bakteri untuk bertahan hidup terhadap efek antibiotik sehingga tidak efektif dalam penggunaan klinis, bakteri yang semula peka terhadap suatu antimikroba dapat berubah sifat genetiknya menjadi tidak peka (resisten) atau kurang peka Tujuan: penelitian ini bertujuan untuk mengetahui profil penggunaan antibiotik dan peta kuman pada pasien rawat inap di RS Husada Utama Surabaya. Metode: data penggunaan antibiotik diperoleh dari database instalasi farmasi RS dan hasil pemeriksaan kultur bakteri pasien pada bulan Oktober-Desember 2016. Data dari instalasi farmasi dihitung dan dinyatakan dalam DDD/100 hari rawat, dan data hasil pemeriksaan kultur bakteri dihitung persentase sensitifitasnya terhadap antibiotik. Hasil penelitian: terdapat 45 jenis antibiotik pada periode Oktober-Desember 2016 dengan total DDD/100 hari rawat pada bulan Oktober adalah 94,3 DDD/100 hari rawat, bulan November 79,4 DDD/100 hari rawat, dan bulan Desember 102,7 DDD/100 hari rawat. Antibiotik dengan nilai DDD/100 hari rawat tertinggi pada bulan Oktober-Desember 2016 relatif sama yaitu seftriakson, sefiksim, dan levofloksasin. Terdapat 14 jenis antibiotik pada periode Oktober-Desember 2016 yang masuk dalam segmen 90% penggunaan antibiotik yaitu seftriakson, sefiksim, levofloksasin, meropenem,amoksisilin, kombinasi amoksisilin + kalium klavulanat, sefepim, siprofloksasin, metronidazol parenteral, sefditoren, metronidazol oral, etambutol, rifampisin, dan moksifloksasin. Terdapat 15 jenis bakteri dengan frekuensi kemunculan terbanyak pada bulan Oktober- Desember 2016 terdiri dari bakteri Gram positif yaitu Staphylococcus haemolyticus, Enterococcus faecalis, Staphylococcus epidermidis dan bakteri Gram negatif yaitu Acinetobacter baumannii. Sensitivitas antibiotik dengan nilai DDD/100 hari tertinggi (seftriakson, sefiksim, dan levofloksasin) yang diujikan pada bakteri dengan kemunculan terbanyak Staphylococcus haemolyticus bulan Oktober-Desember 2016 adalah 0% sensitif. Sensitivitas antibiotik Cefixime pada semua kultur bakteri telah resisten terhadap bakteri Staphylococcus haemolyticus, Staphylococcus epidermidis, dan Staphylococcusaureus. Kesimpulan: antibiotik terbanyak yang digunakan setiap bulannya adalah seftriakson, sefiksim, dan levofloksasin dimana bakteri yang ditemukan masih sensitif terhadap ketiga antibiotik tersebu

Pengaruh Edukasi Perubahan Gaya Hidup Sehat terhadap Clinical Outcome pada Pasien di Rumah Diabetes Universitas Surabaya

Prevalensi diabetes melitus yang semakin meningkat setiap tahunnya cenderung meningkatkan risiko komplikasi dan kematian akibat diabetes melitus itu sendiri. Tujuan penelitian ini adalah untuk mengetahui pengaruh edukasi perubahan gaya hidup sehat terhadap clinical outcome (parameter klinis) pada pasien di Rumah Diabetes Universitas Surabaya. Rancangan penelitian menggunakan one group pretest-posttest yang diikuti oleh 27 subjek diabetes melitus di Rumah Diabetes Universitas Surabaya. Seluruh subjek diberikan edukasi (intervensi) dengan perangkat piring sehat dengan durasi 4 minggu. Pengukuran clinical outcome dilakukan terhadap gula darah puasa, indeks massa tubuh (IMT), lingkar perut, dan tekanan darah. Uji statistika yang digunakan adalah Wilcoxon signed rank test dan paired t-test. Hasil penelitian menunjukkan bahwa edukasi perubahan gaya hidup sehat berpengaruh signifikan terhadap penurunan gula darah puasa (p<0,001), indeks massa tubuh (p=0,005), lingkar perut (p=0,005), tekanan darah sistolik (p=0,013), namun tidak signifikan terhadap tekanan darah diastolik (p=0,247). Dapat disimpulkan bahwa edukasi perubahan gaya hidup sehat berpengaruh terhadap gula darah puasa, indeks massa tubuh, lingkar perut, dan tekanan darah sistolik. Keterbatasan dalam penelitian ini adalah keikutsertaan penderita diabetes melitus yang sedikit serta tidak adanya kelompok kontrol sebagai pembanding

Pengaruh Persepsi Masyarakat Terhadap Covid-19 Dan Perilaku Penerapan Protokol Kesehatan Berdasarkan Health Belief Model

COVID-19 is a disease caused by SARS CoV-2, which causes many deaths. The government launched the 5M health protocol to reduce morbidity and mortality from COVID-19. Awareness of implementing health protocols is influenced by various factors besides knowledge. Theory Health Belief Model (HBM) focuses on individual perceptions and beliefs about the COVID-19 which includes which perceived susceptibility, perceived severity, perceived benefits, and perceived barriers, can be used in predicting public awareness in carrying out the behavior of implementing the COVID-19 health protocol. This study aims to determine the relationship between perceived vulnerability, perceived severity, perceived benefits and perceived obstacles with adherence to implementing the COVID-19 health protocol. This research is an analytic observational study, the data was taken by cross-sectional use google form. Correlation test was performed with Rank Spearman test use SPSS version 25. Results: There were 40 respondents, 21 (53.5%) female, 19 (47.5%) male, 17 to 70 yo. There is a significant relationship between perceived severity (p = 0.003), perceived benefits (p = 0.000) and perceived barriers (p = 0.004) to the behavior of implementing health protocols, but no relations was found between perceived susceptibility (p =0.216) and behavior of implementing protocols health. Perceived severity, perceived benefits, and perceived barriers are related to the behavior of implementing health protocol

Profil Penggunaan Antibiotik Profilaksis pada Pasien Bedah di Salah Satu RS Swasta Kota Surabaya

Latar belakang: Masalah resistensi bakteri terhadap antibiotik telah menjadi masalah internasional, jika tidak segera ditangani maka dapat merugikan masyarakat di seluruh dunia dari segi kesehatan dan ekonomi Data Antimicrobial Resistant in Indonesia (AMRIN) memperkirakan pada tahun 2018 kematian akibat Antimicrobial Resistant (AMR) sekitar 700.000 jiwa dan diperkirakan juga pada tahun 2050, AMR menyebabkan kematian 10 juta jiwa/tahun. Penelitian ini bertujuan untuk mengetahui profil kuantitas penggunaan antibiotik berdasarkan metode DDD/100 patient-days dan profil Infeksi Daerah Operasi (IDO) pada pasien bedah di salah satu RS Swasta Kota Surabaya periode Januari-Juni 2019. Metode: Penelitian ini menggunakan desain penelitian deskriptif dengan pengambilan data secara retrospektif terhadap data rekam medik sampel penelitian. Subyek penelitian adalah pasien bedah periode Januari-Juni 2019 yang memenuhi kriteria inklusi yaitu sebanyak 241 sampel penelitian, lalu dihitung dengan menggunakan metode DDD/100 patient-days. Hasil: Hasil yang diperoleh dari penelitian ini yaitu kuantitas penggunaan antibiotik periode Januari-Juni 2019 didominasi oleh antibiotik ceftriaxone (J01DD04) dengan nilai total DDD/100 patient-days pada pre operasi yaitu 17,95, on operasi 23,57, dan post operasi 23,22. Simpulan: Konsumsi antibiotik terbanyak pada pre, on, dan post bedah didapatkan pada antibiotik ceftriaxone

Lesson Learned from COVID-19 Critically Ill Patients

Background: Pandemics such as Spanish flu, SARS, and COVID-19 have occurred and are likely to happen in the future. This study evaluates critically ill patient characteristics and their medications. Methods: The study collected medical records of severe to critically ill COVID patients in the ICU from five hospitals. Data gathered included gender, age, severity, length of stay, and comorbidities. Data on drug use was collected, including type, dose, frequency, and duration were analyzed descriptively. The study investigated the effectiveness of antibiotics and antivirals using a mixed-logit regression model at a significance level of 5%. Results: Among 244 COVID-19 patients, 181 were over 45 years old, and 124 were critically ill. Antibiotics, antivirals, and steroids were the most drugs used for COVID-19 treatment. Some commonly used drugs include levofloxacin, moxifloxacin, azithromycin, remdesivir, mefenamic acid, ceftazidime, dexamethasone, and favipiravir. Meropenem, a broad-spectrum antibiotic, was also used as a treatment for COVID-19 patients (0.7-41.2 DDD per 100 bed days). Dexamethasone increases the likelihood of patient recovery with an odds ratio of 3.95 [1.81-8.68]. Conclusions: Antibiotic overuse contributes to resistance despite limited evidence. Remdesivir is preferred over Favipiravir for severe COVID-19. Studies show mixed results for antiviral benefits in patient outcomes. It is necessary to conduct further research on an appropriate therapy, develop neither new drug nor repurposing drug, for the flu virus

Quantity and quality profiles of antibiotics pre, on, and post surgery in a hospital setting

Background Providing proper antibiotics is undoubtedly crucial to prevent infections during surgery. Objective This study set out to evaluate the medication administration in antibiotic prophylaxis using both quantitative and qualitative methods. Setting The study employed a retrospective design and observed patients who underwent surgical procedures during hospitalization at a private hospital in Indonesia within the period of January–June 2019. Methods The data obtained were evaluated quantitatively and qualitatively; and analyzed descriptively. The quantitative evaluation used the defined daily dose (DDD) per 100 bed-days. The qualitative evaluation was expressed as the percentage of antibiotic suitability based on antibiotic administration, i.e. (1) type; (2) timing; (3) dosage; (4) duration; and (5) route. Main outcome measure Suitability of antibiotic prophylaxis in a hospital setting. Results There were 164 prescriptions recorded from 20 types of surgical procedures, of which the most common was cholecystectomy (23 patients, 14%). Most antibiotics were administered 61–120 min before the incision time (55 patients, 37%), and had a duration of more than 24 h (119 patients, 80%). The total DDD per 100 bed-days for pre-, on-, and post-surgery antibiotic use were 44.2, 33.3, and 66.7 respectively. The suitability profiles of the antibiotics used according to the Antibiotic Use Guideline for Hospital (2018) were as follows: 26.3% right type, 52.9% right time, 24.8% right dosage, 19.1% right duration, 91.8% right route, while according to American Society of Health-System Pharmacists Therapeutic Guidelines (2014) there were 17.6% right type, 53.4% right time, 16.4% right dosage, 19.1% right duration, and 96.6% right route. Conclusion Ceftriaxone was the first-choice prophylactic antibiotic administered in this Indonesian hospital. The data indicate a considerable non-compliance with local and international guidelines

Drug Interactions in Diabetic Ulcer Patients in an Indonesian Private Hospital

Diabetic ulcers can progress into tissue death, or gangrene, which create a risk for amputation. Measures for preventing other complications and accelerating wound healing in diabetic ulcers include blood sugar level control, diet adjustment, wound care, antidiabetic drug administration, and comorbid therapy. This leads to the use of various drugs that can potentially trigger drug interactions. This study aimed to identify possible drug interactions in the therapeutic management of diabetic ulcer patients treated in Husada Utama Hospital Surabaya, Indonesia, from January 2020–June 2022. This was a descriptive observational study using retrospective data from medical records. Results showed that 103 types of drugs were administered to 48 research samples with 41 of them experienced drug interactions (n=263 cases). Based on the severity of drug interactions, 31 cases were categorized as major cases (11.79%), with drug-class antibiotic-antiemetic interactions as the most frequent interactions. This study proves that it is essential for doctors and pharmacists

Healthcare collaboration intervention: Pre-post study

Background: Effective interprofessional collaboration between health professionals is correlated with improving the quality of health services and patient safety, for example, Program Pengendalian Resistensi Antibiotik (PPRA). Objective: This research aims to determine the effect of educational PPRA on the knowledge and motivation of healthcare professionals in interprofessional collaboration practices. Methods: The research is quasi-experimental, with one group pre-post using a knowledge questionnaire (questionnaire 1) and a motivation questionnaire (questionnaire 2). The respondents were health professionals at Husada Utama Hospital. This research involved 74 respondents: two doctors, three pharmacists, 41 nurses, five midwives, ten pharmacist assistants, and 13 laboratory assistants. Results: The analysis of the effect of providing education on health professionals’ knowledge level showed a significant improvement in good categories before and after education, with 55.4% before and 73% after (Sig. = 0.025, p 0.05). Conclusion: This research concluded that PPRA education's effect on health workers' knowledge and motivation in interprofessional collaboration at Husada Utama Hospital has increased knowledge and motivation