Analisis Efektivitas Pemberian Konseling Dan Leaflet Terhadap Tingkat Kepatuhan Minum Obat Dalam Mengontrol Tekanan Darah Pada Pasien Hipertensi Di RSUD Dr. Adjidarmo Kabupaten Lebak

Ketidak patuhan terapi hipertensi dapat menimbulkan komplikasi kronis. Konseling dan leaflet adalah bentuk edukasi yang dapat diberikan pada pasien hipertensi. Penelitian ini bertujuan untuk mengevaluasi efektivitas pemberian konseling dan leaflet terhadap tingkat kepatuhan melalui penurunan nilai tekanan darah sistole dan diastole dan penurunan skor kuesioner Morisky Medication Adherence Scale (MMAS-8) pada pasien hipertensi. Penelitian merupakan pre-experimental yang dilaksanakan secara prospektif mulai dari bulan April sampai Juni 2014 dan dilaksanakan di RSUD dr. Adjidarmo. Sampel penelitian adalah pasien hipertensi berjumlah 30 orang yang masuk kriteria inklusi dan eksklusi dan diberikan intervensi konseling dan leaflet. Kepatuhan diukur terhadap skor MMAS-8 dan nilai tekanan darah sistole dan diastolesebelum dan sesudah 30 hari pemberian intervensi. Hasil pengukuran dianalisis dengan menggunakan uji Wilcoxon untuk MMAS-8 dan Nilai tekanan darah sistole dan diastole. Hasil analisis menunjukkan ada perbedaan yang signifikan (

Formulasi Sediaan Gel Antijerawat Ekstrak Herba Meniran (Phylanthus niruri L) Dan Ekstrak Daun Sirsak (Annoni muricata L).

ABSTRAKHerba meniran dan daun sirsak mengandung senyawa flavonoid, triterpenoid, saponin, polifenol dan metabolit sekunder lainnya. Secara tradisional herba meniran dan daun sirsak tanaman yang berkhasiat sebagai Obat jerawat. Tujuan penelitian ini dilakukan dengan cara uji aktifitas antibakteri dari kombinasi ekstrak herba meniran dan daun sirsak sebagai antibakteri penyebab jerawat agar didapatkan efek sinergi sehingga bisa memperkuat kerja antibakteri dan memformulasi sediaan gel obat jerawat dengan bahan aktif kombinasi ekstrak herba meniran dan daun sirsak yang efektif sebagai antijerawat terhadap bakteri P.acne dan S.aureus. Metode Penelitian dilakukan dengan menentukan aktifitas antijerawat dari ekstrak meniran dan daun sirsak menggunakan bakteri P.acne dan S.aureus, dilanjutkan dengan pembuatan gel kombinasi ekstrak meniran dan daun sirsak. Evaluasi terhadap sediaan gel meliputi uji organoleptik, homogenitas, pH, viskositas, daya sebar, iritasi dan aktifitas antibakteri sediaan gel. Sediaan gel kombinasi ektrak daun sirsak dan meniran  (3% : 4,5%) memiliki aktivitas menghambat pertumbuhan bakteri P.acne dan S.aureus terbaik dengan nilai DDH P.acne sebesar 32 mm dengan kategori aktivitas sangat kuat dan S.aureus  21 mm dengan kategori aktivitas sangat kuat.  Sediaan gel ekstrak daun sirsak dan meniran dapat memenuhi parameter fisika dan kimia sediaan gel serta stabil selama 12 minggu pada suhu penyimpanan 4oC, suhu 27oC dan suhu 40oC. Sediaan gel kombinasi ekstrak meniran dan daun sirsak memiliki indeks iritasi primer sebesar 0,40 dan termasuk kategori respon iritasi sangat ringan.  Kata kunci : Daun sirsak; Gel antijerawat; Jerawat; Meniran. ABSTRACTMeniran herbs and soursop leaves contain flavonoids, triterpenoids, saponins, polyphenols and other secondary metabolites. Meniran herbs and soursop leaves were traditionally used as an acne medication. This study aimed to formulate carried out by testing the antibacterial activity of a combination of extracts from meniran herbs and soursop leaves as an antibacterial that causes acne with the aim of getting a synergistic effect so that it can strengthen antibacterial work and antiacne  gel formulation containing the active ingredients of a combination of meniran herb and soursop leaf extract which is effective as an anti-acne against P.acne and S.aureus bacteria. The research method was conducted by determining the antibacterial activity of extract to P.acne and S.aureus, followed by formulate a gel combination of meniran and soursop leaf extract. The evaluation of gel formulation included organoleptic tests, homogeneity, pH, viscosity, spreadability, irritation and antibacterial activity. The gel preparation of the combination of soursop leaf extract and meniran (3%: 4.5%) had the best activity inhibiting the growth of P.acne and S.aureus bacteria with a DDH value of P.acne of 32 mm with very strong activity category and S.aureus 21 mm with a very strong activity category. The gel formulations we meet to the physical and chemical parameters of the gel formulation and were stable for 12 weeks at storage temperature of 4oC, temperature of 27oC and temperature of 40oC. The gel formulation had a primary irritation index of 0.40 and was included in the very mild irritation response category. Keywords : Acne; Antiacne gel; Meniran; Soursop leaf.

Analisis Ketersediaan Obat dengan Pemberlakuan E Catalogue di Dinas Kesehatan Kabupaten/Kota Provinsi Lampung Tahun 2018

Dalam upaya pelayanan kesehatan, ketersediaan obat dalam jenis yang lengkap, jumlah yang cukup, terjamin khasiatnya, aman, efektif dan bermutu, dengan harga terjangkau serta mudah diakses adalah sasaran yang harus dicapai.  Pada era Jaminan Kesehatan Nasional (JKN), Menteri Kesehatan melakukan pengendalian dan pengawasan dengan Pengadaan obat melalui e-katalog secara on-line.  Tujuan penelitian ini adalah untuk mengetahui pemanfaatan pengadaan obat berdasarkan e-catalogue dan pengaruhnya terhadap ketersediaan obat. Penelitian ini merupakan penelitian deskriptik-analitik yang dilakukan di 6 Kabupaten/Kota (Kabupaten Lampung Barat, Kabupaten Pesisir Barat, Kabupaten Tulang Bawang Barat, Kabupaten Lampung Utara, Kabupaten Lampung Timur, dan Kabupaten Pesawaran). Data yang dikumpulkan berupa data kualitatif melalui wawancara mendalam dengan 5 responden di masing-masing kabupaten dan data kuantitatif berupa pengkajian data Rencana Kebutuhan Obat (RKO) dari masing-masing kabupaten, data pengadaan obat yang dilakukan melalui e-Catalogue dan dokumen lain yang sudah diarsipkan oleh Dinas Kesehatan Kabupaten.  Penelitian dilakukan dari bulan April sampai Juli 2019.  Hasil penelitian menunjukkan bahwa dalam pelaksanaan pengadaan obat dengan e catalogue masih ditemukan hambatan/kendala yaitu masih ada 4 kabupaten yang belum bisa memenuhi kebutuhan obatnya sesuai dengan nilai obat yang ada dalam Rencana Kebutuhan Obat (RKO) dan ada 7 item obat yang dipesan oleh 6 Dinas Kesehatan Kabupaten di Provinsi Lampung yang tidak dapat dipenuhi oleh penyedia (cutoff). Namun secara keseluruhan berdasarkan hasil wawancara mendalam terhadap responden penelitian maka dapat disimpulkan bahwa penerapan pengadaan obat berdasarkan e catalogue di 6 kabupaten di Provinsi Lampung dapat menjamin transparansi/keterbukaan, efektifitas dan efisiensi proses pengadaan obat karena daerah akan mendapatkan obat dengan pilihan terbaik, efisien dari segi biaya dan waktu, lebih aman dan mempermudah pelaksanaan kegiatan pengadaan.&nbsp

Evaluasi Pelayanan Pemantauan Terapi Obat di Rumah Sakit X Tangerang

Therapeutic Drug Monitoring (TDM) is a clinical practice to increase the effectiveness of therapy and minimize the risk of adverse drug reactions (ADR). The purpose of this study is to describe the implementation of TDM, and whether it is in accordance with the Regulation of the Minister of Health of the Republic of Indonesia (Permenkes) Number 72 of 2016 concerning pharmaceutical service standards at hospitals and the evaluation of TDM services conducted by pharmacists on inpatients. This research covers a descriptive study with a collection of retrospective data from TDM documents of inpatients during the period of January–May 2016 at X Hospital, Tangerang. The implementation of TDM by pharmacists based on the standards was 73%. The number of patients who met the inclusion criteria were 50 patients. Based on the diagnosis of the disease, patients with the potential of receiving TDM were patients with hypertension (10 patients; 20%), congestive heart failure (9 patients; 18%), and diabetes mellitus (8 patients; 16%). Whereas patients with both potential drug interaction and prescribed with more than 10 drugs was 29 patients (58%), patients with both potential drug interaction and diagnosed with three types of diseases was 19 patients (38%). The implementation of TDM in accordance with pharmaceutical service standards requires the competence of clinical pharmacist pharmacists with 2 years work experience. Potential drug interactions can be controlled by prioritizing TDM based on the number of drugs, complications of the disease and type of disease.Pemantauan terapi obat (PTO) merupakan suatu kegiatan untuk meningkatkan efektivitas terapi dan meminimalkan risiko Reaksi Obat yang Tidak Dikehendaki (ROTD). Tujuan penelitian ini untuk menggambarkan kesesuaian pelaksanaan PTO dengan Peraturan Menteri Kesehatan Republik Indonesia (Permenkes) Nomor 72 Tahun 2016 tentang Standar Pelayanan Kefarmasian di Rumah Sakit dan mengevaluasi pelaksanaan PTO yang dilakukan apoteker terhadap pasien rawat inap. Penelitian ini merupakan penelitian deskriptif dengan pengambilan data secara retrospektif menggunakan dokumen PTO pasien rawat inap selama periode Januari – Mei 2016 di rumah sakit X Tangerang. Hasil penelitian menunjukkan kesesuaian pelaksanaan PTO oleh apoteker berdasarkan standar adalah 73%. Jumlah pasien yang memenuhi kriteria inklusi sebanyak 50 pasien. Profil potensi pasien yang mendapatkan PTO berdasarkan diagnosis penyakit adalah hipertensi 10 pasien (20%), gagal jantung kongestif 9 pasien (18%) dan diabetes mellitus 8 pasien (16%). Profil potensi terjadinya interaksi obat berdasarkan resep dengan jumlah obat lebih dari sepuluh adalah 29 pasien (58%). Profil potensi terjadinya interaksi obat pada pasien yang terdiagnosis lebih dari tiga macam penyakit adalah 19 pasien (38%). Pelaksanaan PTO sesuai standar pelayanan kefarmasian membutuhkan kompetensi apoteker farmasi klinik dengan pengalaman 2 tahun kerja. Potensi interaksi obat dapat dikontrol dengan melakukan prioritas PTO berdasarkan jumlah obat, komplikasi penyakit dan jenis penyakit

Risk factors and costs of household perspectives in hemodialysis patients on Hospital Of Bhayangkara Tk. I. R. Said Sukanto

The incidence and prevalence of chronic kidney disease (CKD) patients in Indonesia is increasing every year. In the promotion of health promotion and prevention efforts, data related to risk factors and cost analysis are needed from the perspective of patients and / or families related to CKD treatment that requires replacement therapy for kidney function (Hemodialysis / HD). CKD patients undergo HD therapy generally twice a week, making it a relatively large burden on them. This study aims to determine the risk factors for CKD in hemodialysis patients at Bhayangkara Hospital Tk. I R. Said Sukanto and the impact of the cost of HD therapy from a household perspective. In an observational study with this case control method. Primary data was taken through interviews using a structured questionnaire with 100 HD patients (cases) and 100 patients from other poly (control), cross sectional. Risk factor analysis was carried out by logistic regression (p Rp. 6,000,000. In terms of biophysiology, hypertension, diabetes and anemia had a risk of 516 times, 54 times and 272 times the effect of CKD. The habit of consuming Chinese and Western herbs increases the risk of developing CKD up to 10.9 times. The cost of the household perspective issued by the patient includes a meal cost of Rp360,000, transportation costs Rp.320,000 and drugs and multivitamins Rp250,000. The potential loss of productivity reaches Rp1,241,904 per patient per month

Evaluating the Use of Warfarin Using the HAS-BLED Score and INR on Atrial Fibrillation Patients at Harapan Kita National Heart Center

Patients with atrial fibrillation are associated with a 4-5-fold risk of having a stroke. The most effective treatment for atrial fibrillation is to prevent the formation of blood clots by administering anticoagulant drugs. Warfarin is an anticoagulant drug that has a narrow therapeutic index with side effects of the risk of bleeding; hence it needs supervision in its use. In this study, the HAS-BLED score was used to measure major bleeding risk and as a value representing each risk factor for bleeding. The bleeding risk can be prevented by maintaining a warfarin response in the therapeutic range with an INR (International Normalized Ratio) measurement 2-3. This study was an observational study conducted with retrospective data collection through medical records of patients with a primary diagnosis of atrial fibrillation who received oral warfarin anticoagulant therapy at Harapan Kita National Heart Center in the period of January-December 2017. Using a sample of 40 patients who met the inclusion criteria. According to the data, found that atrial fibrillation patients who received oral warfarin therapy 55% were male patients, while 45% were female patients. Patients with atrial fibrillation who got the most oral warfarin therapy were patients who were over 40 years old with 90% of the total sample, with the highest group in patients aged 50-54 years with 22.5%. The HAS-BLED values arranged from 0-9, the percentage of patients who had HAS-BLED values of 0, 1, 2 respectively at 7.5%, 42.5%, 30%. The HAS-BLED score ≥ 3 showed patients classified as at high risk of bleeding by 20%. The most risk factors based on HAS-BLED score from all study samples were 18 patients with abnormal kidney or 45%. The average INR score in patients at high risk of bleeding showed that 37.5% had an average INR score in the target ratio score of INR 2-3

ANTIBACTERIAL ACTIVITY OF ETHANOLIC EXTRACT OF JAVANESE TURMERIC RHIZOME ENTRAPPTED IN NANOPARTICLES: A NOVEL RULE OF CHITOSAN

Objective: The aim of this study was to compare the antibacterial activity of 96% (v/v) ethanolic extract of Javanese turmeric rhizome (Curcuma xanthorrhiza Roxb.) and nanoparticles containing the extract against 4 pathogenic bacteria.Methods: The synthesis of chitosan nanoparticles used ionic gelation method. The nanoparticles were evaluated for particle size, zeta potential and morphology. Dilution method was performed to determine minimum inhibitory concentration (MIC).Results: The nanoparticles showed particle size of 53.25 nm, polydispersity index of 0.442 and zeta potential value of+31.5 mv. The antibacterial activity results based on the broth dilution method demonstrated that both the extract and the nanoparticles could inhibit the growth of Staphylococcus aureus, Escherichia coli, Salmonella thypi, and Bacillus subtilis in a concentration of 500 µg/ml. The MIC of the extract against Staphylococcus aureus and Bacillus subtilis were 400 µg/ml and against Escherichia coli and Salmonella thypi in a concentration of 500 µg/ml. In addition, the MIC of the nanoparticles against Staphylococcus aureus was 300 µg/ml while against Bacillus subtilis and Salmonella thypi 400 µg/ml and against Escherichia coli 500 µg/ml.Conclusion: The nanoparticles have a promising strategy to formulate the extracts in order to decrease the MIC against Staphylococcus aureus and Salmonella thypi

Aktivitas Antibakteri Rebusan Secang (Caesalpinia sappan L.) terhadap Salmonella thypii Secara In Vivo

One of the plant that has been used emperically for treatment was Caesalpinia sappan L“secang”. The bark of this plant contains metabolites with strong and effective antibaterial activity, namely tannin and brasilin. Two methods, namely A and B, were employed to perform the in vivo antibacterial study of this plant. In every method, there were six groups (K1-K6) which each of the group consisted of five mice. K1-K3 were the control groups consisting of control using healthy mice (K1), positive control in the presence of chloramphenicol (K2) and negative control (K3).  The test groups were K4-K6, mice in these group were treated with different concentrations of “secang” water extract at 15%, 30% and 75%, respectively.  The Salmonella thypii bacterial suspension was injected to the mice via intraperitonium adminsitration. In A method, treatment was given 2 hours after infecting the mice with the bacterial suspension, while in the B method, the treatment was given to the mice after 24 hours of bacterial infection. After 3 days of treatment, the intraperitonium fluid of the mice was taken under anaesthetic condition followed by qualitative and quantitative analysis of the biological sample obtained. Quantitative analysis via A method demonstrated that a decreased of 16.54%, 25.29 % and 25.12% in bacterial colony number was observed in the samples collected from K4, K5 and K6 respectively when compared to the respective controls.  B method showed smalled decreased (3.37 %,  9.83 % and 20.48 %) in the colony number counted. The qualitative analysis demonstrated that the isolated bacterial strain was Salmonella typhi. In conclusion, boiled water extract of secang could act as effective antibacterial agent because it inhibit the growth of Salmonella thypii under in vivo study conditions.ABSTRAK Salah satu tanaman yang secara empiris banyak digunakan untuk pengobatan adalah Caesalpinia sappan L. (Secang). Batang dari tanaman secang mengandung tanin dan brasilin, yang berkhasiat sebagai antibakteri. Uji antibakteri rebusan secang dilakukan secara in vivo menggunakan 2 metode yaitu metode A dan metode B. Setiap metode terdiri dari 6 kelompok dan setiap kelompok terdiri dari 5 ekor mencit (mus musculus) putih jantan galur DDY. Masing-masing kelompok terdiri dari kontrol normal (K1), kontrol positif kloramfenikol (K2), kontrol negatif (K3) dan kelompok yang diberi rebusan secang konsentrasi 15 % (K4), 30 % (K5) dan 75 % (K6). Suspensi bakteri Salmonella thypii diinfeksikan ke mencit secara intraperitonium. Pada metode A, pengobatan diberikan 2 jam setelah mencit diinfeksi bakteri, sedangkan pada metode B, pengobatan diberikan 24 jam setelah mencit diinfeksi bakteri. Setelah tiga hari pengobatan, mencit dianestesi dan cairan intraperitonium mencit diambil untuk dilakukan uji kuantitatif dan uji kualitatif. Hasil uji kuantitatif metode A menunjukkan terjadi penurunan jumlah koloni bakteri dalam cairan intraperitonium mencit pada kelompok 4 (K4), 5 (K5) dan 6 (K6) terhadap kontrol negatif (K3) sebesar 16,54 %; 25,29 % dan 25,12 %; sedangkan pada metode B sebesar 3,37 %; 9,83 % dan 20,48 %. Hasil uji kualitatif pada metode A dan metode B menunjukkan bakteri yang terisolasi dari cairan intraperitonium mencit adalah Salmonella thypii. Hasil penelitian menunjukkan rebusan secang dapat menghambat pertumbuhan Salmonella thypii secara in vivo