Rational prescribing is an important element in achieving the quality of health services which is one indicator in patient safety in hospital. The purpose of this study was to find out how the collaboration of the role of doctors and pharmacists in rational prescribing at Rantauprapat District Hospital. The research methodology uses a qualitative method with a phenomenological approach. Data was collected through in-depth interviews with doctors and pharmacists on duty at Rantauprapat District Hospital. The results showed that the form of collaboration between doctors and pharmacists in rational prescribing conducted at Rantauprapat District Hospital included: reviewing prescription contents, solving problems related to drug use and providing drug information. The results also showed that the obstacles in implementing collaborative roles of doctors and pharmacists included: the problem of the quantity of pharmacists that did not meet the standards and the limited pharmacist's knowledge of clinical pharmacy and the limited communication between doctors and pharmacists. Mitigation efforts include: recruiting pharmacists with clinical pharmacy qualifications, providing continuing education and training in clinical pharmacy to pharmacists, evaluating the implementation of pharmacy service policies in hospitals especially visits with doctors and pharmacists and building communication links between doctors and pharmacists through empowering the role of the pharmaceutical and therapeutic committee.
Abstract. Obesity can cause a state of chronic low-grade inflammation due to hypertrophy and hyperplasia of adipose tissue which is not followed by the formation of balanced vascularization. Interleukin-6 is one of the mediators of inflammation that results from obesity. Changes in lifestyle during fasting for the entire month of Ramadan are thought to have an effect on the lipid profile and inflammatory mediators. Method. This research is a prospective cohort observational study conducted in March 2019-May 2019 endocrine polyclinic outpatient clinic Haji Adam Malik Hospital Medan in 30 subjects. Anthropometric measurements and examination of lipid profiles and IL-6 levels, one week before Ramadan fasting and the fourth week of Ramadan. Results. This study showed that there were significant differences in total cholesterol and HDL levels in the study subjects before and after Ramadan fasting (p <0.001; p = 0.049). Also found significant differences in median IL-6 study subjects before and after Ramadan fasting (p <0.001). Conclusion. There was a decrease in levels of IL-6, a decrease in total cholesterol and a statistically significant increase in HDL in obese patients undergoing Ramadan fasting.
The catchment area of Lake Toba continues to experience a decline in quality due to frequent fires in this area. Various recovery measures in the form of reforestation are continuously being carried out but often fail due to the difficult terrain due to the steep slope and the rapid loss of water due to gravity. The water immediately dissipates to a lower elevation leading to the lake. As a result, this condition leaves an expanse of barren area that is only overgrown with weeds. This study aimed to see whether lowland and highland peat soil can be used as a water retaining material that has the same quality as manure and to obtain the right dose of this water retaining material to support the growth of Macadamia integrifolia plants. The study was designed using 3 types of water retaining material briquettes, namely: chicken manure, lowland peat and highland peat, each of which was divided into several treatments, namely: 0, 0.5, 0.75, 1.0, 1.25 and 1.5 kg/plant. The difficulty of the steep terrain makes it difficult for planting actions. Therefore, the technology of making briquettes is considered to be a solution. In addition, the conversion into briquettes gives a positive value to peat where acidic peat water can be removed so that the toxic effects of peat can be reduced. The results showed that the three types of briquettes significantly increased plant growth in terms of plant height, leaf area and crown area of M. integrifolia. Although the best plant growth performance was shown by the briquette dose of 1.5 kg/plant, the dose of 0.75 kg/plant seemed to have given no significant growth when compared to a dose of 1.0-1.5 kg/plant.
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