Potential Drug-drug Interactions Analysis in Children Out-patients with Bronchopneumonia Medication Prescriptions

Drug-drug interactions (DDIs) is defined as the alteration of efficacy and toxicity of some drugs in the presence of other drugs. In the treatments of bronchopneumonia in outpatient settings, there is a lack of documentation of DDIs. This study was aimed to observe the potential DDIs on the prescriptions of children with bronchopneumonia. An observational and cross-sectional study was conducted on outpatient children with bronchopneumonia prescriptions during 2017. Potential for DDI was identified by online drug interaction checkers. The potential DDI then classified based on its severity (minor, moderate, and major) and mechanism (pharmacokinetic and pharmacodynamic). Among 86 prescriptions analyzed, potential DDIs observed at 48.84% of it. Of that, there were 67 potential DDIs where 72.34% of it were categorized as moderate. The majority of potential DDIs was pharmacodynamic interaction (76.12%) with the most frequently involved drug pair was Ephedrine-Salbutamol (29.85%). Children outpatients with bronchopneumonia are at risk of potential DDIs, especially to minor and moderate potential DDIs. Prescriptions screening for potential DDIs followed by monitoring of therapeutical effects and associated adverse drug events will optimize patient safety

Diagnosis dan Penatalaksanaan Nyeri Punggung Bawah dari Sudut Pandang Okupasi

AbstrakNyeri punggung bawah adalah suatu gejala berupa nyeri di bagian pinggang yang dapat menjalar ke tungkai kanan atau kiri. Nyeri ini umumnya pernah dirasakan oleh hampir setiap orang. Pada pekerja, keluhan ini umumnya dimulai pada usia dewasa muda dengan puncak prevalensi pada kelompok usia 45-60 tahun. Nyeri punggung bawah sering terjadi pada individu yang melakukan aktivitas berdiri atau duduk dalam jangka waktu yang lama, banyak mengangkat beban berat dengan posisi yang salah. Diagnosis dilakukan berdasarkan anamnesis, pemeriksaan neurologik, pemeriksaan X-Ray, computerized tomography scan (CT scan), magnetic resonance imaging (MRI), dual energy x-ray absorbtiometry (DEXA), atau myelography. Pengobatan akan dilakukan berdasarkan indikasi penyebabnya. Selain penggunaan obat-obatan pelemas otot, fisioterapi dengan berbagai modalitasnya sangat berperan untuk mengatasi nyeri pinggang bawah. Untuk mencegah timbulnya keluhan ini pada pekerja, perlu dilakukan pencegahan sedini mungkin, meliputi edukasi, manajemen terhadap faktor risiko, dan pemeriksaan prakerja.Kata kunci : Nyeri punggung bawah, diagnosis, terap

Monitoring, Pencegahan, dan Penanganan Keracunan pada Pekerja Terpapar Cadmium

Abstrak Cadmium merupakan logam berat yang berisiko besar bagi kesehatan manusia dan banyak ditemukan di daerah pertambangan, industri keramik, industri baterai, penyepuhan,  dan tempat peleburan logam. International Agency for Research on Cancer (IARC) mengklasifikasikan Cd dalam kelompok I, yaitu bersifat karsinogenik pada manusia. Waktu paruh Cd yang panjang menyebabkan logam ini sukar dieliminasi dari tubuh sehingga berpotensi menyebabkan kerusakan terutama pada ginjal. Keracunan yang disebabkan oleh cadmium dapat bersifat akut dan kronis. Toksisitas kronis menimbulkan gangguan paru, tulang, organ reproduksi, dan lain lain. Bila menyerang  sistem respirasi harus dirawat untuk diobservasi, monitoring fungsi ginjal. Therapi khelasi dilakukan pada intoksikasi akut. Nilai Biological Exposure Index (BEI) cadmium dalam urin adalah 5 μg/g kreatinin dan dalam darah adalah 5 μg/L. Untuk deteksi dini dilakukan pemeriksaan pada pekerja meliputi pemeriksaan prakerja dan berkala. Pengendalian dilakukan berupa pengukuran pajanan cadmium di tempat kerja, pengendalian teknis, administratif maupun penggunaan alat pelindung diri (APD).Kata kunci: cadmium, toksisitas akut, toksisitas kronik AbstractCadmium is one of the heavy metals which have impact in health. It is found in mining, porcelain process, metal platting, and steel process. International Agency for Research on Cancer (IARC) has classified Cd into Group I (carcinogen). Cadmium has a long period half time so it cause disorder especially in renal. Toxicity of cadmium can be acute and chronic. Chronic toxicity involve lung, bone, reproductive organ, and others. If it inhaled, the patient must be observe and monitore the renal function. Chealating therapy can be used for acute toxicity. Biological Exposure Index (BEI) of cadmium in urine 5 ug/g creatinine and in blood 5 ug/L. Early detection of workers should be done praemployment and regulary. Hygene industry of cadmium involve measuring cadmium at the workplace, technical engineering, administrative control, personal protection equipment (PPE). Keywords: cadmium, acut toxicity, chronic toxicit

Hubungan Kerja Gilir dan Faktor-Faktor Lain dengan Insomnia pada Pekerja Laki-Laki di Pabrik Sepatu PT X, Tangerang

Kerja gilir telah lama diterapkan pada beberapa sektor pekerjaan yang mengharuskan beroperasi selama 24 jam. Berbagai masalah kesehatan  telah diketahui sebagai akibat dari kerja gilir dan salah satunya adalah gangguan tidur atau insomnia. Insomnia pada pekerja pabrik yang menjalani kerja gilir dapat mengganggu kerja dan dapat menurunkan produktivitas. Sebanyak 202 pekerja laki-laki pabrik sepatu di Tangerang menjadi responden penelitian yang menggunakan metode comparative cross sectional. Informasi diperoleh dengan mewawancarai semua responden. Diagnosis insomnia didapatkan melalui pengisian kuesioner Insomnia Rating Scale.  Dari 202 responden yang terdiri atas 101 orang kerja gilir dan 101 orang yang tidak kerja gilir didapatkan perbandingan  prevalensi insomnia pada kerja gilir sebesar 63,4% dan pada tidak kerja gilir 23,8%. Kerja gilir mempunyai risiko 6,65 kali lebih besar untuk terjadinya insomnia dibandingkan dengan yang tidak kerja gilir. Faktor risiko insomnia lainnya adalah umur 40 tahun atau lebih (OR=3,38), waktu merokok tiga jam atau kurang sebelum tidur (OR = 9,33), dan lingkungan tidur yang tidak nyaman. (OR = 4,00). Terdapat hubungan antara kerja gilir, umur, merokok, dan lingkungan tidur dengan terjadinya insomnia.Kata kunci: kerja gilir, insomnia,umur, merokok, lingkungan tidu

Gejala, Diagnosis, dan Tata Laksana pada Pasien Peminum Kafein yang Mengalami Adiksi

 AbstrakKafein merupakan zat psikoaktif yang paling sering dikonsumsi oleh masyarakat. Kafein digunakan sebagai stimulan sistem saraf pusat dan mempercepat metabolisme.  Konsumsi kafein berguna untuk meningkatkan kewaspadaan, menghilangkan kantuk, dan menaikkan mood. Penggunaan kafein juga dapat menyebabkan gangguan ansietas dan gangguan tidur yang terinduksi kafein Kondisi intoksikasi kafein dapat memberikan gejala antara lain gelisah, gugup, insomnia, emosional, urinasi berlebihan, gangguan pencernaan, otot berkedut, denyut jantung yang cepat dan tidak teratur. Adiksi kafein dapat menyebabkan intoksikasi, keadaan putus kafein, dan kafein dependen. Konsumsi kafein yang bekelanjutan dapat mempengaruhi beberapa faktor seperti efek farmakologi kafein, predisposisi genetik, gejala putus kafein, usia, dan norma sosial. Semakin bertambahnya coffee shop di Indonesia, menyebabkan semakin banyaknya masyarakat yang berpeluang menjadi adiksi kafein, sebaiknya diberikan sosialisasi mengenai pencegahan ketergantungan kafein, tatalaksana sesuai gejala simptomatik dan dapat diberikan psikoterapi. Kata kunci: kafein, adiksi kafein, intoksikasi kafein AbstractCaffeine is a psychoactive agent and the most consumed substance in the society. Caffeine is commonly used to stimulate central nervous system and accelerate metabolism. Consuming caffeine can increase alertness, mood, and get rid of drowsiness. Excess in caffeine can cause both sleep and anxiety disorders. Caffeine intoxication can cause symptoms such as anxiety, nervous disorder, insomnia, excessive emotion, excessive diuresis, gastrointestinal disorders, wrinkled muscle, tachycardia and arrhythmia. Caffeine addiction can cause caffeine intoxication. Continuous consumption of caffeine affects many factors such as caffeine pharmacology effects, genetic predisposition, caffeine-withdrawal symptoms, age, and social norms. The increasing the number of coffee shops in Indonesia increase the chance of people to be caffeine addict. Hence,  socialization on preventing caffeine addiction, management of caffeine addiction, and psychotherapy should be given. Key words: caffeine, caffeine addiction, caffeine intoxicationÂ

Dampak dan Monitoring pada Pekerja Terpapar Benzena

AbstrakBenzena merupakan salah satu senyawa hidrokarbon aromatik yang banyak digunakan di sektor industri karet, penyulingan minyak, pabrik kimia, pabrik sepatu, dan industri yang terkait dengan minyak. Benzena juga ditemukan pada fasilitas publik seperti asap rokok, pompabensin, pembakaran bahan bakar mobil, dan sebagainya. American Conference of Government Industrial Hygienists (ACGIH) menggolongkan benzena kedalam bahan karsinogen group-1A. Pengukuran benzena dapat dilakukan dalam udara ekspirasi, urin dan darah.Pajanan benzena dalam kadar yang rendah di tempat kerja dapat dinilai dengan baik oleh t,t-asam mukonat dan S-asam fenil merkapturat dalam urin. Dengan nilai ambang batas (NAB) benzena 0,5 ppm, ACGIH merekomendasikan pengukuran t,t-asam mukonat dan asam fenilmerkapturat dalam urin dengan indeks monitoring biologis 0,5 mg/g kreatinin sedangkan untuk asam mukonat yaitu 25µg/g kreatinin. Diperlukan berbagai pengendalian pajanan agar para pekerja terlindung dari dampak buruk benzena terhadap kesehatan pekerja.  AbstractBenzena is a aromatic hydrocarbon prevalently used in the rubber industry, oil refinery, chemical industry, shoe factories and other industries correlated with oil. Benzena can also be found in public facilities as it is contained in smoke of the cigarette, petrol station and the result of fuel burning. ACGIH (American Conference of Government Industrial Hygienists) classifies Benzena in Carcinogen group 1A. Benzena measurement can be conducted in the expiration air, urine and blood. The exposure of benzena at working place can be measured precisely by t-Mukonat Acid and S-Phenylmercapturat acid content in the urine with biological monitoring index of 0,5 mg/g Creatinin for Mukonat Acid and 25µg/g Creatinin for Phenylmercapturat acid. There should be control in the level of the chemicals to protect the workers from the harmful effects of benzena to their health

ANALISIS LINGKUNGAN ORGANISASI DALAM MENUNJANG KINERJA ORGANISASI PADA DINAS PERPUSTAKAAN DAN KEARSIPAN KABUPATEN LAMPUNG BARAT

The research method used in this research is descriptive qualitative method. The use of this method is to describe the Organizational Environment in Support of Organizational Performance at the Library and Education Service of West Lampung Regency, qualitatively examining how all data is obtained directly from informants in the field using interviews and document studies. The results showed that the organizational environment at the Department of Library and Education of West Lampung Regency is one of the causes of success in carrying out a job, because the organizational environment can affect workers, especially the organizational environment that is psychological in nature. The organizational environment at the West Lampung Regency Library and Readiness Service aims to provide maximum work comfort, so that employees in providing quality services, in the sense that if employees work and the results of the work get appreciation and recognition, then the work must be of quality. Supporting and inhibiting aspects in an effort to improve the organizational environment at the Library and Readiness Office of West Lampung Regency. These aspects can occur both internally and externally to the organization. Internal factors include elements contained in the body of the organization, namely the Library and Readiness Service of West Lampung Regency. Then the external factors of aspects that come from outside the West Lampung Regency Library and Readiness Service, such as local government, relevant agencies and the community. This occurs because a good organizational environment has been strived for, but it has not materialized as expected because there are still employees who are not fully comfortable with the existing organizational environment, such as air circulation, noise in the workplace

Analisis Gaya Kepemimpinan dalam Meningkatkan Kinerja Karyawan Kantor Pusat PT. Bank Lampung

The aims of this study was to determine what kind of leadership style is applied by management in improving employee performance at the Head Office of PT. Bank Lampung and whether it has a good impact in improving employee performance, because still many employees at the Head Office of PT. Bank Lampung have not applied discipline to the rules, both written and unwritten rules. The research method used by the researcher is a descriptive method with a qualitative approach. The research was conducted at the Head Office of PT. Bank Lampung with data collection techniques in the form of interviews, observations and documentation. The results of the research showed that the leadership style used by the leaders or managers at the Head Office of PT. Bank Lampung in improving employee discipline is an autocratic leadership style, because the model of this autocratic leadership style further enhances supervision to monitor what activities are carried out by employees. This autocratic leadership style is very effective in increasing the level of employee discipline because the leader can further improve supervision and monitor the activities of subordinates or employees. Employee indiscipline is caused by an incompetent leader so that many employees ignore the rules, both written and unwritten, therefore the leaders or managers at the Head Office of PT. Bank Lampung applies an autocratic leadership style in improving employee discipline, because one of the factors that affect performance is the level of employee discipline. Keywords: leadership style, employee performanc

Optimization of Tween 80 and Span 60 on Cream Ethanol Extract the Leaves Matoa (Pometia Pinnata) as an Antioxidant

Matoa is one of Papua’s endemic plants that have enormous potential for it is used in health as a nutrient, inhibits early aging process, and lowers the risk of some diseases. Matoa leaves extract (Pometia pinnata) contained compound class of flavonoids, alkaloids, tannins, saponins, terpenoids, and coumarins, so it can be utilized as one source of natural antioxidants that are good for the body. This study aims to determine the effect of Tween 80 and Span 60 on the physical quality of the optimum formula and test the antioxidant activity of ethanol leaves extract of matoa leaves. Determination of optimum formula using Simple Lattice Design (SLD) method. The results showed that the optimum composition was obtained on Tween 80: Span 60 of 50:50%. The cream with this optimum composition had a power of 3.35 cm; pH test 5.9; sticking power 58.60 sec. The optimum formula of ethanol extract of matoa leaves had a potent antioxidant activity potency with IC50 value of 40.6 ppm