Tingkat kematian akibat resistensi terhitung cukup tinggi dan hal ini disebabkan tingginya angka ketidaktepatan dalam terapi antibiotik. Penelitian Antimicrobial Resistance in Indonesia (AMRIN) menunjukkan 42% penggunaan antibiotik terindikasi tidak tepat pada pasien bedah. Penggunaan antibiotik secara bijak merupakan solusi atas masalah resistensi antibiotik. World Health Organization (WHO) dan Kementerian Kesehatan Republik Indonesia merekomendasikan penggunaan metode Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) untuk menilai kuantitas penggunaan antibiotik. Penelitian ini bertujuan untuk mengetahui nilai DDD dan Drug Utilization (DU) 90% dari antibiotik. Penelitian ini merupakan penelitian cross-sectional dengan pengambilan data secara retrospektif yang dilakukan pada November 2016-April 2017 di Rumah Sakit Universitas Airlangga dan data dianalisis menggunakan metode DDD dan DU 90%. Sampel diambil dengan cara total sampling. Sebanyak 463 pasien menjadi sampel pada penelitian ini, dengan 381 pasien mendapatkan antibiotik profilaksis dan 82 pasien mendapatkan antibiotik terapi. Sefazolin merupakan antibiotik profilaksis yang memiliki DDD tertinggi yaitu 69,08/100 operasi dengan lama pemberian sebagian besar dihentikan dalam waktu kurang dari 24 jam post-operasi (82,41%). Antibiotik profilaksis yang masuk segmen DU 90% adalah sefazolin dan seftriakson. Antibiotik terapi yang memiliki DDD tertinggi adalah seftriakson dengan 52,62/100 patient-days dan antibiotik yang masuk segmen DU 90% adalah seftriakson, metronidazol, sefazolin dan meropenem.

Objectives The study aimed to determine the effect of quercetin on the expression of primary regulator gene involved in lipogenesis and triglycerides synthesis in the liver, and the sterol regulatory binding protein-1c (SREBP-1c) mRNA in non-alcoholic fatty liver disease (NAFLD) with a high-fat diet (HFD) model. Methods Fifty-six Balb/c mice were divided into seven groups: standard feed; HFD; HFD and quercetin 50 mg/kg for 28 days; HFD and quercetin 100 mg/kg BW for 28 days; HFD and quercetin 50 mg/kg for 14 days; HFD and quercetin 100 mg/kg for 14 days; HFD and repaired fed for 14 days. Quercetin was administered intraperitoneally. The animals were sacrificed 24 h after the last treatment; the liver was taken for macroscopic, histopathological staining using hematoxylin–eosin and reverse transcription-PCR analysis sample. Results HFD significantly increased the expression of SREBP-1c mRNA; meanwhile, quercetin and repaired feed significantly reduced the expression of SREBP-1c mRNA in the liver. Quercetin at a dose of 50 mg/kg and 100 mg/kg also improved liver cells’ pathological profile in high-fat diet NAFLD. Conclusions The present study suggests that quercetin has an inhibitory effect on SREBP-1c expression and improved liver pathology in NAFLD mice.

Background It was reported that hemodialysis (HD) with either a new or reused dialyzer raises medical problems that require therapeutic regimens. This study aimed to investigate the medical problems and their management in patients undergoing HD. Methods This study was conducted by prospectively observing patients with chronic kidney disease undergoing HD. The incidence of medical problems and the treatment given were recorded. Results Among 351 cases of HD, medical problems occurred in 15.7% of cases, including hypotension as the most dominant, followed by muscle cramps, shivering, headache, asphyxia, fever, chest pain, and pruritus. Hypotension was ameliorated with intravenous 40% dextrose and normal saline. Muscle cramps were overcome with 40% dextrose, normal saline, methampyrone, and calcium gluconate. Shivering was managed by warming the patients followed by intravenous methampyrone, 40% dextrose, and normal saline. Meanwhile, headache was reduced by paracetamol or intravenous methampyrone and 40% dextrose. Fever was treated by intravenous methampyrone or oral paracetamol. Pruritus was managed by intravenous dexamethasone and diphenhydramine. Conclusions Medical problems occurring during HD are prevalent and need immediate therapy. Pharmacists and clinicians should work in collaboration to improve the patients’ quality of life.

Reuse of dialyzers for hemodialysis can help in bringing down the cost of hemodialysis. On the other hand reuse of dialyzer may change dialyzer integrity. This study was underta ken to determine dialyzer reuse effect on Urea Reduction Ratio (URR), Kt/V urea and serum albumin. This was prospective study in Sanglah Public General Hospital Denpasar. Inclusion criteria for this study were patients who receive hemodialysis more than 3 months on twice weekly hemodialysis. In the study we used hollow fiber or dialyzer Elisio type H-130H reprocessed with Renaline automatically by machine renatron. After each session blood urea, post dialysis weight and serum albumin were measured. Measurements was performed on the use new dialyzer, 1 st reuse, 4 th reuse and 7 th reuse. The dialyzer was discarded, if TCV fell below 80% of baseline value. Kt/V and urea reduction ratio (URR) were calculated as measure of dialysis adequacy. A total of 23 people completed the study. There was a lack of uniformity duration of hemodialysis, so that we also performed an analysis using a uniform length hemodialysis duration (4.5 hours) with 15 samples. There were no significant difference between URR and Kt/V urea of new dialyzer and dialyzer reprocessed by renaline respectfully with p=0.131 and p=0.373. If we analyzed only using uniform time of dialysis (4.5 h) the value of URR and Kt/V urea between new and reused dialyzer not significantly different with p=0.520 and p=0.784. There was also not found significant differences between serum albumin of the use new dialyzer and reused dialyzer by the time of uniform or nonuniform, respectfully with p=0.271 and 0.073. Reuse dialyzer does not alter efficacy of hemodialysis.

Background The cases of Rifampicin-Resistant Tuberculosis (RR-TB) in our country have increased every year and RR-TB deaths are thought to be caused by prolongation of the QTc interval due to side effects of anti-tuberculosis drugs. Thus, cytokines are needed to be used as early markers of prolongation of the QTc interval in RR-TB patients. Objective This study aims to analyze the correlation of inflammatory cytokines on QTc interval in RR-TB patients who received shorter regimens. Methods This study uses a case-control study with a time series conducted in the period September 2019 to February 2020 in one of the referral hospitals for Tuberculosis in Indonesia. Cytokines levels from blood samples were measured using the ELISA method, while QTc intervals were automatically recorded using an electrocardiography machine. The statistical analysis used was the Chi-square test, Man Whitney test, Independence t -test, and Spearman-rank test with p < 0.05. Results There was no significant correlation between inflammatory cytokines and QTc prolongation in intensive phase which TNF-α value (6.8 pg/ml; r = 0.207; p = 0.281), IL-1β (20.13 pg/ml; r = 0.128; p = 0.509), and IL-6 (43.17 pg/ml; r = −0.028; p = 0.886). Meanwhile, in the continuation phase, the values for TNF-α (4.79 pg/ml; r = 0.046; p = 0.865), IL-1β (7.42 pg/ml; r = −0.223; p = 0.406), and IL- 6 (40.61 pg/ml; r = −0.147; p = 0.586). Conclusion inflammatory cytokines (TNF-α, IL-1β, and IL-6) cannot be used to identify QTc interval prolongation in RR-TB patients who received shorter regimens.