Perbandingan Efikasi Beberapa Kombinasi Antiretroviral Pada Pasien Hiv/aids Ditinjau Dari Kenaikan Jumlah Cd4 Rata-rata (Analisis Data Rekam Medis Di Rsk Dharmais Jakarta Tahun 2005 – 2006)

Dharmais Cancer Hospital is one of 237 hospital appointed by the government of Indonesia to give treatment, support and ARV therapy for HIV/AIDS patients. Ev-ery year, there is a significant increasing number of HIV/AIDS patients in DharmaisCancer Hospital, therefore successfully of therapy is needed to be carried out regularly for the optimum result to the patients. One of methods to evaluating therapy is by reviewing efficacy of ARV combinations toward escalation of immunity respond (es-calation of CD4). The ARV combinations give a good efficacy if increasing CD4 > 50 cell/mm3. The objective of this study was to know the efficacy of four ARV combina-tion (each type consists of two Nucleosides Reverse Transcriptase Inhibitor and one Non-Nucleosides Reverse Transcriptase Inhibitor) base on increasing CD4 mean HIV/AIDS patients after 6 – 12 months treatment in Dharmais Cancer Hospital from 2005 – 2006, and to compare the efficacy of four ARV combinations. The four ARVcombinations are combination I (Lamivudin + Zidovudin + Efavirenz), combina-tions II (Lamivudin + Zidovudin + Nevirapin), combination III (Lamivudin + Stavudin + Efavirenz), and combination IV (Lamivudin + Stavudin + Nevirapin).This study was analytical, cross-sectional design. Samples for this study were taken by total sampling using all data of HIV/AIDS patients in Dharmais Cancer Hospital from the year 2005 – 2006. The inclusion criteria were patients of fifteen years of age or more, baseline count CD4  < 200 cell/mm3, received ARV treatment for 6 – 12 months, received treatment of either one of the four ARV combination, and had dataof CD4 from laboratory result before and after the treatment. Data were taken from patients’ medical record and analyzed with ANOVA-test. The result of this study from 151 patients showed that all the four combinations gave good efficacy based on the increasing CD4 mean. There was a significant difference increasing CD4 mean to HIV/AIDS patients between those received ARV combination II and those received ARV combination III (p value = 0,032). And there was not a significant difference for the other combinations. This study was from the four ARV combinations gave two the best efficacy are combination II and combination III

Efektivitas Leaflet dan Konseling terhadap Kepatuhan Minum Tablet Besi dan Kadar Hemoglobin Ibu Hamil dengan Anemia di Puskesmas di Kabupaten Bogor

According to National Basic Health Research (Riskesdas) 2013, the prevalence of anemia in pregnant women in urban area is 36.4%. The treatment of anemia in pregnant women is conducted by administering 90 iron tablets during pregnancy. The majority of anemia in pregnant women is mostly caused by lacking of iron (Fe) due to lack of adherence in taking iron tablets. The objective of this research was to assess the effectiveness of leaflet compared to counseling to improve adherence and increasing hemoglobin status of pregnant women with anemia in primary health care in Bogor District. The research design was quasi-experimental by giving counseling as an intervention conducted by pharmacists to 79 pregnant women with anemia in Cibungbulan primary health care and delivering leaflet to 79 pregnant women with anemia in Ciluengsi primary health care Bogor District in 2013. The evaluation was conducted by using MMAS-8 (Morisky Medication Adherence Scale) questionnaires and Hb rate with STAT-Site MHgb equipment a month after the intervention. Data analysis was carried out with Chi-Square test, Wilcoxon test, Mann-Whitney test and multivariate logistic regression analysis. This research suggests that either counseling by pharmacist or leaflet increases adherence to take iron tablets (P < 0.05). The effectiveness of leaflets and counseling to increase adherence to pregnant women with anemia were not statistically different. Pregnant women with anemia who adhere to take iron tablet have their Hb rate improved 3.24 times compared to those who do not adhere to take iron tablet. Pregnant women with anemia who eat food source of heme every day have their Hb rate improved 2.31 times compared to those who do not eat food source of heme every day

Risiko Penggunaan ACEi Terhadap Kejadian Batuk Kering Pada Pasien Hipertensi Di RSUD Cengkareng Dan RSUD Tarakan DKI Jakarta

The use of angiotensin converting enzyme inhibitors (ACEi) as an antihypertensive agent can cause side effects such as dry cough. The aim of this study is to evaluate risk of ACEi administration on dry cough incidence with captopril as the standard against lisinopril and ramipril in hypertensive patients at RSUD Cengkareng and RSUD Tarakan Jakarta. The design of this study is prospective cohort. The inclusion criteria were patients who received ACEi as hypertension therapy for ≤ 3 months gathered from outpatient and willing to participate as sample in this study at RSUD Cengkareng and RSUD Tarakan. Subject of this study consist of 54 patients who received captopril and 54 patients received non captopril ACEi, taken by consecutive sampling from January-July 2014. Data was collected using structured interviews and medical record. Dry cough incidence due to ACEi was evaluated using Naranjo Algorithm and analyzed using Chi Square test. Dry cough incidence was found in 19,44% of sample. No significant relationship of age, gender, ethnic, comorbidity, body mass index (BMI), dosage, and duration of use with the dry cough incidence due to the use of ACEi. There is no difference on dry cough incidence between the use of captopril, lisinopril and ramipril

Pengaruh Informasi Obat Kepada Dokter terhadap Penurunan Kejadian Permasalahan yang Terkait Obat (Pto) pada Resep Pasien Penyakit Jantung dan Pembuluh Darah di Apotek X Jakarta

. Drug Related Problems (DRPs) are of major concern because of physical, psychological and economical implications for the patients and for society. The potential risk factor for DRPs is polypharmacy. The aim of this study was to evaluate the influence of drug information to the doctors for decreasing drug related problems on cardiovascular patient prescriptions at X pharmacy Jakarta.The method of this study was experimental with two groups pretest and posttest designs. Samples were Health Insurance (Askes) patient prescriptions that diagnose cardiovascular desease, above 40 years old age with two hundreds prescriptions each groups. The intervention to the doctor was a letter about analysis of drug related problems (DRPs) which found at prescriptions. The DRPs's studies were drug interactions, subtherapy doses, supratherapy doses, non Plafon and Price List of PT.Askes's Standard Drugs (DPHO) giving and polypharmacy.The results showed that the amount of drugs in a control group was 6.45 items, mode 7 items, non DPHO drugs 0.92 items, the price of one prescription was Rp. 229.471 andthe cost by the patient was 13.42 %. The amount of drugs in an intervention group was 6.06 items, mode 6 items, non DPHO drugs 0.67 items, the price of one prescription was Rp. 206.298 and the cost by the patient was 12.72%. DRPs found were drug interactions, non DPHO drugs giving and polypharmacy. There were no sub therapy doses and supra therapy doses at prescriptions. The influence of interventions to the doctor for decreasing drug related problems in a drug interactions and polypharmacy were significant, butdecreasing of non DP HO drugs giving was not significant. The number of drugs in oneprescription decreasing lowered price of total drugs

Faktor Risiko Umur Lansia Terhadap Kejadian Reaksi Obat Yang Tidak Dikehendaki Pada Pasien Hipertensi, Diabetes, Dislipidemia Di Tiga Puskesmas Di Kota Depok

Treatments in elderly patients are very complex and usually multiphatology thus causing an increase in number of polypharmacy for every clinical condition. The presence of hypertension, diabetes, and/or dyslipidemic will increase the risk of Adverse Drug Reaction (ADR) because of polypharmacy and long term of treatments. This study aimed to assess the effect of elderly age on the incidence of ADR in patients with hypertension, diabetes, and/or dyslipidemia at Puskesmas Pancoran Mas, Beji, and Tanah Baru in Depok. The design of the study is cohort study. The study was conducted at January-June 2014. Sixty two elderly patients were collected as cohort group and 62 non-elderly patients as control group. Subjects were monitored every week for a month. Clinical Manifestation of ADR event was an evaluation result of the recording complaints experienced by the subject using Naranjo scale. Clinical manifestation of ADR events obtained from both group were analyzed using Chi-square and Logistic Regression Test. This study found that 30,6% patients experienced ADR events with 39 times of accurrences. The most common clinical manifestation was dry cough related to the use of captopril (56,3%). The risk factor of ADR event in elderly age is 3,577 times greater than non-elderly age

Perbandingan Kualitas Pelayanan Puskesmas Kecamatan Koja dan Tarumajaya terhadap Kepatuhan Minum Obat Pasien Tuberkulosis

WHO global data indicated that Indonesia is in the second rank of a country with largest prevalance of pulmonary tuberculosis after India. The main cause of healing failure in health centers is patients' compliance in taking medication. The purpose of this study is to analyze the influence of health services to medication adherence among pulmonary TB patients in health centers. The study design was crosssectional comparative study using data from questionnaires and medical status records. The populationwas all pulmonary TB patients aged 15 years and above and being a category one in the Koja and Tarumajaya health centers from January until May 2016. Data analysis was a chi square test and multiple logistic regression method. The result showed that service quality provided for the TB patients between the two health centers were the service including accessible location, incomplete indoor facilities and active caregivers. There is a significant relationship between adequacy of seating facilities (p-value 0.038) and accessible location (p-value 0.038) in both health centers on the level of medication compliance. Medication service quality (p-value 0.042; OR 1.66) active caregivers (p-value 0.000; OR 2.4) and otheradditional medication (p-value 0.01; OR 0.5) are the determinants of TB patients' medication compliance