Irrational utilization of antibiotic led to several burdens for healthcare providers, one of them is antibiotic resistance. Community acquired pneumonia (CAP) has increased mortality rate due to irrational antibiotic utilization. This study was aimed to obtain a general depiction and antibiotic rational utilization quantitatively assessed of CAP in adult patients at Prof. Dr. R. D. Kandou Hospital Manado from June 2017 to May 2018. This was a retrospective descriptive study with a cross sectional design. Samples were 42 patients with CAP obtained by using simple random sampling. The results showed that values of DDD/100 inpatient days were, as follows: beta-lactam (33), macrolides (13.758), and fluoroquinolone (20.072). According to the ratio between estimated DDD value of Prof. Dr. R. D. Kandou and DDD WHO, all prescribed antibiotics had DDD values below or close to the value of DDD WHO. Albeit, there were discrepancies between antibiotic utilization in the field and reccomendation of Clinical Practice Guideline of Internal Medicine Department. Conclusion: Within the period of June 2017 - May 2018 the most prescribed antibiotic classes for CAP in adult patients at Prof. Dr. R. D. Kandou Hospital were beta-lactam, macrolides, and fluoroquinolone meanwhile the most prescribed antibiotics were ceftriaxone and azithromycin. In general, drug utilization was rational assessed quantitatively by using DDD WHO criteria.Keywords: antibiotic rationality, CAP, DDD WHO, Prof. Dr. R. D. Kandou Abstrak: Penggunaan antibiotik yang tidak rasional dapat membebani tenaga kesehatan, salah satunya ialah resistensi antibiotik. Community acquired pneumonia (CAP) mengalami peningkatan mortalitas tinggi akibat penggunaan antibiotik yang tidak tepat. Penelitian ini bertujuan untuk mendapatkan gambaran umum dan penilaian rasionalitas secara kuantitatif dari penggunaan antibiotik pada pasien dewasa dengan CAP di RSUP Prof. Dr. R. D. Kandou Manado periode Juni 2017-Mei 2018. Jenis penelitian ialah deskriptif retrospektif dengan desain potong lintang. Sampel sebanyak 41 pasien dewasa dengan CAP diambil dengan simple random sampling. Hasil penelitian mendapatkan DDD/100 hari rawat inap penggunaan antibiotik dari tiga golongan antibiotik yaitu beta-lactam (33), makrolida (13,758), dan florokuinolon (20,072). Berdasarkan rasio estimasi DDD di RSUP Prof. Dr. R. D. Kandou Manado dan DDD WHO seluruh obat yang digunakan masih berada di bawah DDD WHO atau mendekati nilai tersebut. Terdapat perbedaan antara penggunaan antibiotik di lapangan dan rekomendasi dari Panduan Praktek Klinis dari Bagian Ilmu Penyakit Dalam. Simpulan: Pada periode Juni 2017 - Mei 2018 golongan antibiotik yang paling banyak diberikan untuk pasien dewasa dengan CAP di RSUP Prof. Dr. R. D. Kandou Manado ialah beta-lactam, diikuti makrolida dan florokuinolon sedangkan antibiotik yang paling banyak diberikan ialah ceftriaxone dan azithromisin. Secara keseluruhan penggunaan obat sudah rasional secara kuantitatif diukur dengan kriteria DDD WHO.Kata kunci: rasionalitas antibiotik, CAP, DDD WHO, RSUP Prof. Dr. R. D. Kandou Manado
Malaria is an infectious disease with a high morbidity and mortality rate caused by Plasmodium and is transmitted through the Anopheles mosquito. Garlic (Allium sativum) has active substances that can be used as medicinal ingredients. Several active substances, namely allicin, ajoene, and quercetin contained in garlic have the potential to act as an effective and safe anti plasmodium for the host. This writing is a literature review using relevant literature. The results of the study concluded that the active ingredients in garlic have potential to be a new antimalarial agent, and it is hoped that it can be a cheaper and more effective malaria treatment so that drug resistance and morbidity and mortality from malaria can be reduced.
Background : MRI brain is a routine examination, after finished examination will felt warm and sweaty on the back. The heat produced by the SAR effect affected by the body weight examined. This research to determine increasing body temperature and SAR value after MRI brain examination based on different body weight. Methods :The kind of this research is experiment. Research has been done at thirteen (13) samples with characteristic as follows : consisted of 3 men and 10 women with variation of body weight 45 kg until 75 kg. Samples had normal body temperature, no abnormalities in the head, and no claustrophobia. Each samples measure body weight and body temperature before MRI examination, then performed examination of MRI brain used brain routine protocol during 19 minutes 49 seconds. After that, measure body temperature again to find the increasing body temperature and saw the SAR value on SAR information. Then analyzed the affection of the variation of body weight and increasing body temperature, and variation of body weight and SAR value. Data were analysed statistically by using Linear Regression test. Results : The results showed that there were significant affection between variation of body weight and increasing body temperature (p value<0,05) significant with very strong influence (R Square=0,889) and negative correlation with equation y=2,098–0,024x.On variation of body weight and SAR value showed that there were significant affection (p value<0,05) with medium influence (R Square=0,596) and positive correlation with equation y=0,214+0,004x. Conclusion : Based on these results indicate thatmore body weight, increase body temperature will decrease due to the fat in people overweight and more body weight, SAR value will increase according the amount of RF exposure required
Background : PET/CT examination is an examination performed by injection of a radiopharmaceutical that consist of 18 F-FDG which given intravenously to evaluate lesions in whole body. However, some PET/CT examination using delay phase for certain pathologies and if the doctor unsure about the resultiong image. This study peform the difference image in quantitative of PET/CT examination between non-delay phase and delay phase in area bladder and surrounding. Methods : The type of research conducted is quantitatif research with a case study approach, the research that provides a detail description of the actual situation in the hospital. Subjects consist of radiographers, nuclear medicine specialist, and scientific literature and objects are the images of non delay and delay phase PET/CT in the bladder area. Data is taken by observation, interview, and documentation. Results : Assessment image of PET/CT using the value of SUV by ROI on several organ such us the baldder, rectum, ileum, and sacrum. In the non delay and delay phase, the value of the SUV was compared and the result on rectum area was increased, in other organ such as the bladder, ileum, and sacrum the value of SUV was decreased. Conclutions : The difference of image between non delay and delay phase can be seen from the value of SUV organ. SUV value can high in the bladder area because of the accumulation of FDG and scanning from the head so when scanning the pelvis value of SUV is high and can infuluence the image of surrounding organs.
Background : Liver nodules are tumors that are less than 2 cm in size and are single or multiple. In making a diagnosis of liver nodules can be done by examination of abdominal MSCT. According to Seeram (2009), using 50% overlapping there was an increase in nodule detection by 10% compared to incremental increments. The purpose of the study was to determine differences in information on anatomical images on the use of increment variations in abdominal MSCT examination and to find the appropriate increment values to produce optimal anatomical image information.Methods : This type of research is quantitative with an experimental approach. The study was conducted at the RSUD. Tugurejo Semarang, the image was taken from abdominal MSCT examination in 5 patients with a variation of increments of 100% (8 mm), 50% (4 mm), 30% (2, 4 mm). The results of the study were assessed by 3 respondents. Data analysis used the kappa statistical test, crosstabulation, and friedman.Results : From the statistical test, the results of the 2.4 mm increment value show clear anatomical criteria and can detect small nodules. Supported by using friedman statistical test p-value = 0.000 which means that p-value 0.05 thus Ha is accepted so that there are differences in anatomical image information.Conclusion : The most optimal increment value is 30% (2.4 mm) because it has the highest mean rank value of 2.37.
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