Bachti Alisjahbana
Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin, Bandung

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Implementation of 25-well culture plates for M. tuberculosis drug susceptibility testing in Indonesia Rosana, Yeva; Sudiro, Tjahjani M.; Alisjahbana, Bachti; Parwati, Ida; van Crevel, Reinout; van Soolingen, Dick
Medical Journal of Indonesia Vol 14, No 3 (2005): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (322.775 KB) | DOI: 10.13181/mji.v14i3.186

Abstract

At present, there is no standardized method for Mycobacterium tuberculosis drug susceptibility testing (DST) among laboratories in Indonesia. Since January 2001 to January 2004 we have tried to establish the method of 25-well culture plates with middlebrook’s media (Drug Susceptibility Culture Plate (DSCP) method) used by the Dutch Supranational Reference Laboratory at the Institute of Public Health and the Environment (RIVM), Bilthoven, Netherlands. Our experience showed that this method potentially gives better result as it can be very well standardized, faster and provides detailed MIC (Minimal Inhibitory Concentration) values. Data from 364 isolates that have been tested by DSCP method showed that resistance to INH, rifampicin, ethambutol, and streptomycin were 21.4%, 19.8%, 15.7%, and 16.5% respectively. Multidrug resistance were found in 13.2% isolates. (Med J Indones 2005; 14: 142-6)Keywords: M. tuberculosis, DST, DSCP method
EFEK PEMBERIAN SUPLEMEN SINBIOTIK DAN ZAT GIZI MIKRO (VITAMIN A DAN ZINC) TERHADAP STATUS GIZI PENDERITA TBC PARU ORANG DEWASA YANG MENGALAMI KEKURANGAN ENERGI KRONIK Hardinsyah, Suparman; Kusharto, Clara M; Sulaeman, Ahmad; Alisjahbana, Bachti
GIZI INDONESIA Vol 34, No 1 (2011): Maret 2011
Publisher : PERSATUAN AHLI GIZI INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (153.783 KB) | DOI: 10.36457/gizindo.v34i1.99

Abstract

Pasien  TB  paru  pada  akhirnya  akan  mengalami  keadaan gizi  buruk  dan  menurunnya  respon  imun. Kemoterapi  dengan  menggunakan  obat-obatan  TB  merupakan  langkah  yang  efektif  untuk  mengobati penyakit ini, tetapi mempunyai pengaruh negatif terhadap keseimbangan mikropola usus inflamasi karena infeksi TB paru, menurunkan pengaturan sintesa zat  gizi dan menurunkan nafsu makan, sehingga terjadi kekurangan  gizi.  Penelitian  bertujuan  untuk  menganalisa  efikasi  symbiotik  dan  suplemen zat  gizi  mikro terhadap status gizi pada pasien dewasa TB paru yang sedang diobati yang menderita kekurangan energi kronik  setelah  2  bulan  menjalani  intervensi.  Desain penelitian  ?a  double-blind  randomized  treatment control trial? dilakukan pada 2 pusat penyembuhan TB paru di Bandung dan Garut. Sejumlah 43 orang yang  menderita  kekurangan  energi  kronik  (KEK)  dipilih  dari  76  pasien  TB  paru  yang  terekrut  dengan variasi umur antara 20?45 tahun. Kelompok ini dibagi 2 kelompok, kelompok pertama diberikan susu yang berisi  protein,  symbiotik  dan  suplemen  micronutrien (MSM)  dan  kelompok  kedua  diberi  susu  yang berbasis protein saja (MO) sebagai kelompok kontrol. Seluruh pasien menerima terapi standar untuk TB paru, parameter status gizi (BB, IMT, masa Lemak, hemoglobin, serum vitamin A dan seng) dikumpulkan pada saat awal setelah 1 bulan, 2 bulan dari pemberian intervensi data di awalnya. Perbedaan antara dan dalam kelompok menggunakan statistik parametrik dannon parametric. Hasil menunjukan bahwa setiap kelompok  pada  akhir  intervensi  parameter  status  gizi  secara  signifikan  mengalami  perbaikan dibandingkan  pada  awal  penelitian  (P<0,05)  tetapi  tidak  ada  perbedaan  signifikan  antara  dua  kelompok (p>0,05). Ada pengaruh potensial dari setiap suplemen dalam meningkatkan status gizi, penelitian yang lebih lama dengan tidak memberikan susu berbasis protein pada kelompok kontrol dibutuhkan. Kata kunci: imunitas, zat gizi mikro, symbiotik, TBparu
EFEK PEMBERIAN SUPLEMEN SINBIOTIK DAN ZAT GIZI MIKRO (VITAMIN A DAN ZINC) TERHADAP STATUS GIZI PENDERITA TBC PARU ORANG DEWASA YANG MENGALAMI KEKURANGAN ENERGI KRONIK Hardinsyah, Suparman; Kusharto, Clara M; Sulaeman, Ahmad; Alisjahbana, Bachti
GIZI INDONESIA Vol 34, No 1 (2011): Maret 2011
Publisher : PERSATUAN AHLI GIZI INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Pasien  TB  paru  pada  akhirnya  akan  mengalami  keadaan gizi  buruk  dan  menurunnya  respon  imun. Kemoterapi  dengan  menggunakan  obat-obatan  TB  merupakan  langkah  yang  efektif  untuk  mengobati penyakit ini, tetapi mempunyai pengaruh negatif terhadap keseimbangan mikropola usus inflamasi karena infeksi TB paru, menurunkan pengaturan sintesa zat  gizi dan menurunkan nafsu makan, sehingga terjadi kekurangan  gizi.  Penelitian  bertujuan  untuk  menganalisa  efikasi  symbiotik  dan  suplemen zat  gizi  mikro terhadap status gizi pada pasien dewasa TB paru yang sedang diobati yang menderita kekurangan energi kronik  setelah  2  bulan  menjalani  intervensi.  Desain penelitian  “a  double-blind  randomized  treatment control trial“ dilakukan pada 2 pusat penyembuhan TB paru di Bandung dan Garut. Sejumlah 43 orang yang  menderita  kekurangan  energi  kronik  (KEK)  dipilih  dari  76  pasien  TB  paru  yang  terekrut  dengan variasi umur antara 20–45 tahun. Kelompok ini dibagi 2 kelompok, kelompok pertama diberikan susu yang berisi  protein,  symbiotik  dan  suplemen  micronutrien (MSM)  dan  kelompok  kedua  diberi  susu  yang berbasis protein saja (MO) sebagai kelompok kontrol. Seluruh pasien menerima terapi standar untuk TB paru, parameter status gizi (BB, IMT, masa Lemak, hemoglobin, serum vitamin A dan seng) dikumpulkan pada saat awal setelah 1 bulan, 2 bulan dari pemberian intervensi data di awalnya. Perbedaan antara dan dalam kelompok menggunakan statistik parametrik dannon parametric. Hasil menunjukan bahwa setiap kelompok  pada  akhir  intervensi  parameter  status  gizi  secara  signifikan  mengalami  perbaikan dibandingkan  pada  awal  penelitian  (P<0,05)  tetapi  tidak  ada  perbedaan  signifikan  antara  dua  kelompok (p>0,05). Ada pengaruh potensial dari setiap suplemen dalam meningkatkan status gizi, penelitian yang lebih lama dengan tidak memberikan susu berbasis protein pada kelompok kontrol dibutuhkan. Kata kunci: imunitas, zat gizi mikro, symbiotik, TBparu
Treatment Seeking Patterns among Dengue Fever Patients: A Qualitative Study Krisnian, Tharani; Alisjahbana, Bachti; Afriandi, Irvan
Althea Medical Journal Vol 4, No 3 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (269.718 KB)

Abstract

Background: Incidence of dengue fever is increasing drastically and has become a major public health problem globally. The reason patients are late in seeking medical treatment should be identified in order to prevent complications which can be avoided to produce a good prognosis. This study was conducted to find the pattern of treatment seeking behaviour among dengue fever patients and their influencing factors using a health utilisation model. Methods: Data on health seeking behaviour were collected among the dengue fever patients who were admitted to Dr. Hasan Sadikin General Hospital Bandung from September–October 2014. The data were collected through in-depth interview with patients who were diagnosed with dengue fever and dengue haemorrhagic fever. All the interviews were recorded using an audio recorder. The recordings were transcribed and then translated into English and analyzed using thematic analysis.Results: Nine patients were interviewed. The age of the patients ranged between 17 to 46 years.  Altogether 7 patterns were identified with patients treatment seeking behavior. Most of them took longer steps to reach adequate care with blood examination. These longer steps, caused by lack of facilities to perform blood test in primary health care facilities, no bed for admission and also low skills of health care providers in diagnosing patients. The primary health care facility played an important role in the delay of patients acquiring definite care for their dengue fever.Conclusions: Health care seeking behavior is hampered by the inadequacy of primary health care facilities to provide adequate services to dengue patients. 
Knowledge, Attitude and Behavior Related to Antibiotic Use in Community Dwellings Parse, Rocci Jack; Hidayat, Eva Mardiana; Alisjahbana, Bachti
Althea Medical Journal Vol 4, No 2 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (169.303 KB) | DOI: 10.15850/amj.v4n2.1082

Abstract

Background: Irrational antibiotic use is the major reason for insidence of antibiotic resistance. Antibiotic misuse in community is influenced by environmental and behavioral factors. Environment included community preference for purchasing antibiotics, lack of health care infrastructure, lack of general practitioner and policy in regulating  antibiotic use. Behavior is influenced by lack of information in antibiotic use and unawareness of antibiotic resistancy. The aim of the study was to assess the level of knowledge, attitude and behavior regarding antibiotic use in community dwellings.Methods: A cross sectional descriptive study was carried out to 96 respondents who were selected by a rapid survey sampling method in Cileles village Jatinangor, Sumedang, West Java, Indonesia in August 2013. Data were collected using questionnaires. The data was analyzed in the form of frequency and percentage.Results: Out of 96 respondents, only 40.6% had good knowledge regarding antibiotic use, 12.5% of respondents were prescribed antibiotics, but in the last course did not purchased all the antibiotics prescribed by the clinician and 55.2% of respondents did not complete their treatment course.Conclusions: Most of the community still have poor knowledge regarding antibiotic use and its consequences such as allergy, and resistancy based on the knowledge questions has a total score ≤6. Their attitude and behavior regarding antibiotic use are still poor which is also based on  incompletion of the antibiotic treatment and irregular use.DOI: 10.15850/amj.v4n2.1082
Health-Seeking Behavior of Dengue Hemorrhagic Fever Patients in Several Hospitals in Bandung West Java Indonesia Afandi, Ressa Novita; Alisjahbana, Bachti; Raksanagara, Ardini S.
Althea Medical Journal Vol 5, No 3 (2018)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (615.378 KB) | DOI: 10.15850/amj.v5n3.1609

Abstract

Background: Dengue hemorrhagic fever is one of  the major global public health problems. Secondary prevention of dengue fever must be conducted to prevent high mortality rate by giving appropriate diagnosis and early management. This study was conducted to identify health-seeking behavior in dengue hemorrhagic patients and its related factors.Methods: This study involved 98 dengue hemorrhagic patients from four hospitals in Bandung region during July until November 2014. The hospitals were 2 public hospitals and 2 private hospitals. A questionnaire and in depth interview were used to collect the data.Results: Among 98 patients, 54 patients (55%) sought a right medical treatment timely, whereas 44 patients (45%) delayed. The first seeking behaviour to treat the disease was using over-the-counter drugs, followed by visiting a private clinic doctor. The second choice to seek health care was going to a private clinic doctor and hospital.Conclusions: Health-seeking behavior in dengue hemorrhagic patients in Bandung is inappropriate which can cause delay in treatment. 
Growth diagrams of Indonesian children The nationwide survey of 2005 Batubara, Jose; Alisjahbana, Anna; Alisjahbana, Bachti; Sadjimin, Tony; Tasli, Yulniar; Juhariah, Juhariah; Tririni, Angky; Padmosiwi, Woro Indri; Listiaty, Tya; Gerver, Willem J; JGMGerver-Jansen, Angèle; Delemarre–van de Waal, Henriette A
Paediatrica Indonesiana Vol 46 No 3 (2006): May 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.3.2006.118-26

Abstract

Background Reference curves of growth have been developedin many countries based on cross-sectional data. The World HealthOrganization (WHO) has recommended an international referencewhich is based on the growth standards developed within the UnitedStates during the 1970s. In general these growth references areused in Indonesian pediatric clinics although it is known that thesereferences are not appropriate for this population with a differentethnic background. In order to evaluate reliably Indonesian chil-dren with growth disorders reference standards based on mea-surements in Indonesian children are necessary.Objective To make a standard growth chart for Indonesian chil-dren especially with regards to height, weight, and head circum-ference from a healthy Indonesian infants and children, age 0-18years. This standard charts were compared to CDC growth charts.Methods Weight and height and head circumference were takenfrom children with age ranging from birth up to 18 years. All sub-jects were recruited from 7 different parts of Indonesia. The agegrouping for children from 0-1 years old was based on 3-monthinterval, while for children older than 12 months was based on a 6-month interval. The study was cross sectional.Results There were 34 800 children (17 229 boys and 17 571girls) included in this study with age ranging from 0 up to 18 years.Graphs were presented for weight for age, supine length for age,head circumference for age in male and female infants, and weightfor height and height for age in boys and girls 1-18 years.Comparson of the results of this study with the CDC data werepresented as a graph.Conclusion The standard charts for Indonesian children basedon weight for height, supine length for height and head circumfer-ence for age were presented in graphs for children 0-1 year, weightfor height and height for age for boys and girls 1-18 years old. Allchildren were compared to CDC growth charts and there exists amean difference of -1.47 SDS for boys and -1.43 SDS forgirls.
Health-Seeking Behavior of Dengue Hemorrhagic Fever Patients in Several Hospitals in Bandung West Java Indonesia Afandi, Ressa Novita; Alisjahbana, Bachti; Raksanagara, Ardini S.
Althea Medical Journal Vol 5, No 3 (2018)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (615.378 KB) | DOI: 10.15850/amj.v5n3.1609

Abstract

Background: Dengue hemorrhagic fever is one of  the major global public health problems. Secondary prevention of dengue fever must be conducted to prevent high mortality rate by giving appropriate diagnosis and early management. This study was conducted to identify health-seeking behavior in dengue hemorrhagic patients and its related factors.Methods: This study involved 98 dengue hemorrhagic patients from four hospitals in Bandung region during July until November 2014. The hospitals were 2 public hospitals and 2 private hospitals. A questionnaire and in depth interview were used to collect the data.Results: Among 98 patients, 54 patients (55%) sought a right medical treatment timely, whereas 44 patients (45%) delayed. The first seeking behaviour to treat the disease was using over-the-counter drugs, followed by visiting a private clinic doctor. The second choice to seek health care was going to a private clinic doctor and hospital.Conclusions: Health-seeking behavior in dengue hemorrhagic patients in Bandung is inappropriate which can cause delay in treatment. 
Gambaran Validitas Pemeriksaan Complex Specific Cocktail Antigen Mycobacterium tuberculosis (ESAT-6, CFP-10, MPT-64) Metode Rapid Immunochromatography pada Bahan Pemeriksaan Sputum dan Serum Penderita Tuberkulosis Paru Subroto, Hendra; Parwati, Ida; Turbawaty, Dewi Kartika; Alisjahbana, Bachti
Majalah Kedokteran Bandung Vol 49, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.856 KB) | DOI: 10.15395/mkb.v49n3.1120

Abstract

Penegakan diagnosis tuberkulosis (TB) paru penting dalam mengurangi morbiditas dan mortalitas. Diagnosis laboratorium TB paru berdasar atas pemeriksaan BTA dan kultur M. tuberculosis memiliki sensitivitas rendah. Terdapat pemeriksaan cocktail antigen TB rapid immunochromatography (ICT) yang mendeteksi antigen ESAT-6, CFP-10, MPT-64 yang disekresikan oleh M. tuberculosis. Tujuan penelitian menganalisis validitas pemeriksaan cocktail antigen TB metode rapid ICT sputum dan serum penderita TB paru terhadap kultur Ogawa. Penelitian dilaksanakan Juli–Oktober 2014 di RSUP Dr. Hasan Sadikin Bandung. Bentuk penelitian adalah observasional deskriptif khusus dengan rancangan penelitian potong lintang. Subjek penelitian penderita yang datang ke Poliklinik Pulmonologi atau Poliklinik DOTS, didiagnosis TB paru. Sebanyak 68 sputum dan serum dari 33 kultur sputum M. tuberculosis positif dan 35 kultur negatif dilakukan pemeriksaan cocktail antigen TB rapid ICT. Angka positivitas cocktail antigen TB rapid ICT sputum 54,4%; serum tanpa pemanasan 0%. Pada serum dilakukan pemanasan pada suhu 56oC selama 30 menit untuk menghilangkan aktivitas antibodi dan didapatkan angka positivitas sebesar 19,1%. Nilai sensitivitas dan spesifisitas pemeriksaan untuk sputum 93,9% dan 82,8%, untuk serum tanpa pemanasan 0% dan 100%, serta serum dengan pemanasan 24,2% dan 85,7%.  Validitas pemeriksaan sputum memiliki sensitivitas tinggi dan spesifisitas sedang, untuk serum memiliki sensitivitas rendah dan spesifisitas tinggi. [MKB. 2017;49(3):178–85]Kata kunci: Cocktail antigen TB rapid ICT, kultur Ogawa, mikroskopik BTA, tuberkulosis paru, serum, sputum Validity of Complex Specific Cocktail Antigen Mycobacterium tuberculosis (ESAT-6, CFP-10, MPT-64) Rapid Immunochromatography Method on Sputum and Serum Samples from Patient with Pulmonary TuberculosisEarly diagnosis of pulmonary tuberculosis (TB) is very important in reducing morbidity and mortality. The current diagnosis of TB includes direct staining (acid fast bacilli) or M. tuberculosis culture, but these examinations have a low sensitivity. An assay using rapid ICT cocktail antigen TB is currently available for diagnosing TB. This method can detect ESAT-6, CFP-10, and MPT-64 antigen which is secreted by M. tuberculosis. The aim of this study was to analyze the validity of cocktail antigen TB rapid ICT using sputum and serum with Ogawa culture. This was a cross-sectional descriptive observational study. Sputum and serum were collected from patients who were diagnosed as lung TB suspects in the lung and DOTS Clinic of Dr. Hasan Sadikin General Hospital Bandung during the period of July–December 2014 in . Cocktail antigen TB detection assay using two kind of samples (sputum and serum) were evaluated. A total of 68 subjects of33 subjects presented positive culture and 35 presented negative cultures. Positivity rates for sputum and serum were 54.4% and 0%, respectively. Heated sputum assay had a sensitivity of 93.9% and specificity of 82.8%, Serum assay presented a sensitivity of 0% and specificity  of100%.  Serum were modified by heating at 56oC for 30 minutes. The positivity rate of heated serum was 19.1%. The result of modified serum assay showed a sensitivity  of 24.2% and specificity of 85.7%. Conclusion: the sensitivity of the sputum assay is high and the specificity is medium. The sensitivity of this serum assay is low and the specificity is high. [MKB. 2017;49(3):178–85]Key words: Acid fast bacilli, cocktail antigen TB rapid ICT, pulmonary tuberculosis, Ogawa culture, sputum, serum
KESESUAIAN TERHADAP PROSEDUR STANDAR RESUSCITATION BUNDLE 6 JAM PADA PELAKSANAAN PENDERITA SEPSIS BERAT DAN SYOK SEPSIS Wirawan, Chevie; Alisjahbana, Bachti; Sumardi, Uun
Majalah Kedokteran Bandung Vol 50, No 1 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (15.169 KB) | DOI: 10.15395/mkb.v50n1.1157

Abstract

Sepsis berat dan syok sepsis memiliki angka kematian tinggi. Resuscitation bundle 6 jam adalah panduan tata laksana sepsis berat dan syok sepsis yang terbukti menurunkan mortalitas. Kesesuaian penatalaksanaan sepsis berat dan syok sepsis dalam 6 jam pertama dengan prosedur standar resuscitation bundle diteliti. Penelitian observasional deskriptif ini dilaksanakan selama September?Desember 2015 terhadap penderita sepsis berat dan syok sepsis di SMF Ilmu Penyakit Dalam RSUP Dr. Hasan Sadikin Bandung. Data dikumpulkan adalah data umum penderita dan pelaksanaan prosedur 6 jam pertama sesuai standar: pemeriksaan laktat, kultur darah, pemberian antibiotik, resusitasi cairan, pemberian vasopresor, pengukuran CVP, dan pemeriksaan Scvo2/Svo2. Dari 80 subjek penelitian, 59 (74%) sepsis berat dan 21 (26%) syok sepsis. Pada sepsis berat dan syok sepsis, dalam 3 jam pertama pemeriksaan laktat dilakukan pada 2%  dan 14%, kultur darah sebelum antibiotik 17% dan 10%, pemberian antibiotik spektrum luas 32% dan 43%, serta  resusitasi cairan 30 mL/kgBB 2% dan 14%. Pada syok sepsis dalam 6 jam pertama pemberian vasopresor 62% dan pengukuran CVP 5%. Pemeriksaan Scvo2/Svo2 tidak dilakukan pada syok sepsis. Angka kematian sepsis berat 7% dan syok sepsis 19,1% dalam 6 jam pertama. Simpulan, kesesuaian penatalaksanaan 6 jam pertama penderita sepsis berat dan syok sepsis dengan prosedur standar masih kurang.Kata kunci: Resuscitation bundle 6 jam, sepsis berat, syok sepsis  Compliance to 6-Hour Resuscitation Bundle Standard in Severe Sepsis and Septic Shock ManagementSevere sepsis and septic shock have a high mortality rate. Six-hour resuscitation bundle is a management standard for severe sepsis and septic shock that has been proven to reduce mortality rate. Compliance to the 6-hour resuscitation bundle standard was studied. This was a descriptive observational study on severe sepsis and septic shock patients in the Internal Medicine Department of Hasan Sadikin General Hospital Bandung in the period of September?December 2015. Data collected were patient?s general data and the implementation of the 6-hour management standard procedures that include lactate measurement, blood culture, broad spectrum antibiotics, fluid resuscitation, vasopressor use, CVP measurement, and Scvo2/Svo2 measurement. Of 80 subjects, 59 (74%) had severe sepsis and 21 (26%) had septic shock. In the first 3 hours, for severe sepsis and septic shock patients, lactate was examined in 2% and 14% respectively. For blood culture before antibiotics, broad spectrum antibiotic provision, and 30 mL/kgWt fluid resuscitation, the values were 17% and 10%, 32% and 43%; and 2% and 14%, respectively. In septic shock, in the 6 hours, vasopressor was given to 62% and CVP was measured in CVP 5%. Scvo2/Svo2 was not measured. The mortality rates in the first 6 hours for severe sepsis and septic shock were 7% and 19%. Compliance to first 6-hour standard procedure for severe sepsis and septic shock is still inadequate. Key words: Septic shock, severe sepsis, six hours resuscitation bundle