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Articles 6 Documents
Search results for , issue "Vol 49, No 1 (2017)" : 6 Documents clear
The effect of the implementation of evidence-based drug formulary on antibacterial use in a private hospital at Tanjung Enim, Sumatera Selatan, Indonesia Kristin, Erna; Anggraini, Dwi Indria; At Thobari, Jarir; Yasmina, Alfi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 1 (2017)
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (255.17 KB) | DOI: 10.19106/JMedSci004901201703

Abstract

The increase of drug expenditure in the hospital has facilitated the implementation of an evidence-based drug formulary. The aim of this study was to assess the change in antibacterial use after the implementation of an evidence-based drug formulary in a private hospital at Tanjung Enim, Sumatera Selatan, Indonesia. This study used a pre-posttest design. Drug use data in the period before (2010-2011) and after (2012-2013) the formulary implementation were extracted from the hospital medical records. The drug use in the hospital before and after the implementation was compared using t-test and chi-square test, with the significance level of 0.05. Average number of drugs prescribed per prescription after the implementation was similar with that before the implementation (4.4 vs 4.6; p > 0.05). However, the proportion of generic drugs prescribed increased significantly after the formulary implementation (17.0% vs 52.7%; p < 0.05). Moreover, it was still significantly increased when the analysis was conducted only for antibacterial drugs (25.9% vs 72.0%; p < 0.05). Average drug cost per prescription was 34% lower after the intervention (p < 0.05), and the average cost for antibacterial drug was also decreased (26%). The use of antibacterial drugs was significantly decreased after the intervention (12.5% vs 6.9%; p < 0.05). The most often antibacterial drugs prescribed before the interventions were beta-lactams and macrolides; while quinolones were more increasingly used after the intervention. In conclusion, the implementation of evidence-based hospital drug formulary in a private hospital at Tanjung Enim, Sumatera Selatan significantly increase generic drug use and decreased antibacterial use and average drug cost per prescription.    Key words : drug formulary – prescribing pattern – generic drug – antibacterial – private hospital
The effect of combination of hemofilter, pre- and intraoperative methylprednisolone administration on systemic inflammatory response syndrome (SIRS) post open heart surgery Supomo, .; Aryandono, Teguh; Soesatyo, Marsetyawan; Sudiharto, Paulus
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 1 (2017)
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (357.885 KB) | DOI: 10.19106/JMedSci004901201702

Abstract

Systemic inflammatory response syndrome (SIRS) occurs in almost all patients whom undergo open heart surgery causes the increase its morbidity and mortality. The effect of pre- and intraoperative methylprednisolone administration combined with hemofilter application in cardiopulmonary bypass machine in the reduction of SIRS incidence remains controversial. This study aimed to evaluate the effect pre- and intraoperative methylprednisolone administration combined with hemofilter on SIRS incidence after open heart surgery. This was an experimental study using prospective randomized open-blinded evaluation (PROBE) design. Ninety-five patients from Dr. Sardjito General Hospital, Yogyakarta, and Dr. Cipto Mangunkusumo General Hospital, Jakarta, who had open heart surgery within the period of December 2011 to May 2012 were enrolled in this study. The patients were randomly allocated into two groups i.e. Group A (48 patients) received pre-; intra-; and postoperative methylprednisolone (15; 5 and 5 mg/kg BW, respectively) and hemofilter and Group B (47 patients) just received intra- and postoperative methylprednisolone (15 and 5 mg/kg BW). The SIRS incidence was evaluated in 3; 24; 48 and 72 hours post surgery. This study showed that the SIRS incidence in Group B at 3 (OR= 0.12; 95%CI=0.03-0.39; p< 0.001) and 24 (OR= 0.38; 95%CI=0.14-0.996; p< 0.031) hours postoperative were significantly higher than that in Group A. In conclusion, pre- and intraoperative methylprednisolone administration combined hemofilter significantly decrease the SIRS incidence post open heart surgery.
Simple reaction time: how it relates to body mass index (BMI), gender and handedness in Ghanaian students. J Med Sci, Volume 49, No. 1, 2017 January: 1-7 Corresponding author: ampomahbrown@yahoo.com Simple reaction time: how it relates to body mass index (BMI), gender and handedness in Ghanaian students Brown, Ato Ampomah; Derkyi-Kwarteng, Leonard; K Ackom, Christian; Addae, Ernest; Newton, Francis; Amoah, Dennis; Blemano, Dennis Nartey
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 1 (2017)
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (260.873 KB) | DOI: 10.19106/JMedSci004901201701

Abstract

The purpose of this study was to examine the relationship between gender, handedness and body mass index (BMI) with simple reaction time. The study was conducted amongst 501 (232 females and 269 males) untrained University of Cape Coast students, Ghana whose ages ranged from 17-29 years. In this study it was found that males had faster reaction times than females, likewise the mean reaction time of the left hand was also faster than that of the right hand. There was however no significant difference in the mean reaction time across BMI classes In conclusion, simple reaction time is influenced by gender and handedness but appears not to be influence by BMI
Smoking cessation reduces ratio of total cholesterol/high density lipoprotein (HDL) cholesterol levels on adult people in Yogyakarta Special Region Farmawati, Arta; Marchelaona, Ratika; Anindyah, Dina Septari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 1 (2017)
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (256.651 KB) | DOI: 10.19106/JMedSci004901201705

Abstract

Cigarette smoking is a major cause of cardiovascular disease due to elevation of free radical substances as well impairment in lipid metabolism. Smoking cesation has been linked with reduced risk of mortality. However, data regarding cardiovascular disease (CVD) risk factor in former smoker is limited. The aim of the study was to evaluate the CVD risk factor among smoker, non-smoker and former smoker in Yogyakarta Special Region, Indonesia. A cross-sectional design from 86 apparently healthy male, aged between 25-50 years old was performed for this study. From total subjects, 45 subjectsare smokers, 26 are non-smokers and 15 are former smokers. Body weight, height, and blood pressure were also measured from the subjects. Blood was drawn for assessment of total cholesterol (TC), triglyceride, low density lipoprotein (LDL), high density lipoprotein(HDL) and C-reactive protein (CRP) concentrations. We found significant difference in the level of HDL, cardiovascular risk index (LDL/HDL ratio), atherogenic index (TC/HDL ratio) and also in systolic blood pressure among groups (p<0.05). Smoking person hadsignificantly low HDL level with high CVD risk index and atherogenic index (p<0.05). The CVD risk index was not different between former smoker and smoker groups. Serum CRP level was not different among the groups. In conclusion, smoking is associated with increased risk of CVD. Smoking cessation slightly decrease the CVD risk.
Assessing downgrading of esophageal adenocarcinoma after neoadjuvant chemotherapy: a case report Indrasto Histopaedianto1, Adeodatus Yuda Handaya2*, Hendro Wartatmo2 Handaya, Adeodatus Yuda; Histopaedianto, Indrasto; Wartatmo, Hendro
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 1 (2017)
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1828.741 KB) | DOI: 10.19106/JMedSci004901201706

Abstract

Esophageal carcinoma, squamous cell carcinoma, and adenocarcinoma, are a deadly serious malignancy. The delay in diagnosis due to the lack of specific symptoms in the early stages of the disease and the nature of esophageal cancer is very aggressive lead to a poor prognosis with a survival rate of small. Current management of esophageal cancer is recommended multimodal approach in the form of neoadjuvant chemotherapy or combined radiochemotherapy (CRT) and with surgery. In this article, multimodality treatment using chemotherapy and surgery on esophageal adenocarcinoma was reported. A 52-year-old male presented with a total obstruction of the esophagus and was planned to perform temporary gastrostomy for chemotherapy preparation. Gastrostomy found a solid and fixed tumor located in the gastroesophageal junction, with the size of 7 x 6 x 5 cm3. He underwent a chemotherapy using the regimen of 8 cycles paclitaxel without radiotherapy due to the long queue of radiotherapy schedule. After chemotherapy, we re-evaluated and planned to perform surgical removal of the tumor. During surgery, we found a total obstruction along with fibrosis of the esophagus but found no tumor/mass. We performed partial esophagectomy and end to side anastomosis using anastomosis end to side using the CDH25 circular stapler. Surgery was carried out by the thoracoabdominal approach. The patient was discharged on day 12 in a stable condition and was undergoing soft diet. We planned to evaluate the patient using Carcinoembryonic Antigen (CEA) test and Positron Emission Tomography (PET) scan. In conclusion, multimodality treatment using chemotherapy and surgery on a case of one-third distal esophageal adenocarcinoma provides good results.
Risk of zidovudine-induced anemia on human immunodeficiency virus (HIV) infection patients with different CD4 cell counts Wedayani, Anak Agung Ayu Niti; Sholikhah, Eti Nurwening; Kristin, Erna; Triyono, Erwin Astha
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 1 (2017)
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci004901201704

Abstract

Anemia is the most common hematologic abnormality in patients with human immunodeficiency virus (HIV) infection. This abnormality is associated with HIV infection itself, HIV-related opportunities infections or drug use. Zidovudine (AZT) is the most common cause of anemia in HIV patients. Recent study showed anemia in HIV patients is also associated with CD4 cell counts. Aim of this study was to evaluate the risk of anemia on HIV patients with different CD4 cell counts after AZT-based antiretroviral therapy (ART).This retrospective cohort study was conducted using medical record of HIV patients in Dr. Soetomo General Hospital, Surabaya. Subjects who fulfilled the inclusion and exclusion criteria were divided into two group i.e. HIV patients with CD4 cell counts 200-350 cell/mm3 and those with CD4cell counts ≥350 cell/mm3. All available demographics, clinical and laboratory data of subjects before and after AZT-based ART were then recorded and evaluated. Ninety-seven HIV patients (50 male and 47 female) were involved in this study. The result showed that the anemia incidence significantly increased after AZT-based ART (p<0.05), however no significantly different in anemia incidence, mean Hb level reduction and Hb level time reduction were observed between HIV patients with CD4 cell counts 200-350 cell/mm3 and those with CD4cell counts ≥350 cell/mm3(p>0.05). Gender, age, weight and clinical stage were not associated with anemia incidence (p>0.05). In contrast, anemia incidence is associated with Hb level before AZT therapy (p<0.05). In conclusion, the anemia incidence in HIV patients after AZT based ART is not associated with the level of CD4 cell counts, however it is associated with Hb levels before AZT therapy.

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