Typhoid is a global health problem especially in developing countries, one of which is in Indonesia. The incidence of antibiotic resistance in typhoid therapy can occur due to inappropriate use of antibiotics. This study aims to determine patterns of antibiotic use as well as the quality and quantity of antibiotic use in typhoid therapy in one of the provincial government hospitals in Bali. This study was an observational study conducted retrospectively which was analyzed using the Gyssens and ATC/DDD methods. The research data were taken from the medical records of patients in the January-December 2019 period that met the inclusion criteria. The results showed that of the 40 total antibiotics prescribing, ceftriaxone was the most widely used antibiotic for typhoid therapy. The quality of antibiotic use as much as 40% is stated rational (category 0), while the other 60% is irrational (categories I-VI) which includes the use of antibiotics with incorrect interval of administration (IIB; 5%), the use of antibiotics that is too long (IIIA; 40%), the use of antibiotics that are too short (IIIB; 5%), there are other antibiotics that are more effective (IVA; 5%), and there are other antibiotics that are less toxic/safer (IVB; 5%). The quantity of antibiotic use was stated more than WHO standards which includes the use of ceftriaxone at 83.80 DDD/100 patient days; levofloxacin at 27.47 DDD/100 patient days; and azithromycin at 3.52 DDD/100 patient days. The results of this study are expected to be a consideration for the hospital as a material for evaluation and improvement in order to improve the rationality of antibiotic use.
Swamedikasi bila dilakukan secara irasional dapat menimbulkan masalah seperti efek samping obat. Hal tersebut dapat diturunkan dengan meningkatkan pengetahuan masyarakat, dimana hal tersebut terwakilkan dari pengetahuan mahasiswa. Oleh karena itu penelitian ini bertujuan untuk mengevaluasi pengetahuan, sikap dan praktik swamedikasi mahasiswa Farmasi dan Non-Farmasi di Universitas Bali Internasional. Penelitian ini menggunakan desain cross-sectional. Instrumen kuisioner yang mengandung 20 pertanyaan digunakan pada penelitian. Data dianalisis menggunakan SPSS (21.0). Chi-square test digunakan untuk membandingkan distribusi proporsi tiap kelompok sampel. Prevalensi swamedikasi antara mahasiswa Farmasi (77,4%) dan Non-Farmasi (40,4%) berbeda signifikan (p=0,000). Pengetahuan dan Praktik swamedikasi mahasiswa Farmasi signifikan lebih tinggi dibandingkan mahasiswa Non-Farmasi. Gejala flu merupakan indikasi obat yang paling banyak digunakan oleh mahasiswa Farmasi dan Non-Farmasi (43,1%). Mahasiswa Non-Farmasi (24,8%) signifikan (p=0,001) lebih tinggi menganggap penggunaan antibiotika aman untuk swamedikasi dibandingkan mahasiswa Farmasi (5,1%). Terdapat perbedaan signifikan lebih tinggi pengetahuan dan praktik swamedikasi pada mahasiswa Farmasi dan Non-Farmasi.
Menunggu merupakan suatu aktivitas yang seringkali menimbulkan perasaan yang tidak nyaman dan stress, khususnya dalam pelayanan kesehatan. Pasien yang datang ke sarana pelayanan kesehatan seperti puskesmas, menginginkan suatu sistem pelayanan kesehatan yang baik dan berkualitas tanpa harus menunggu dalam waktu yang lama. Perlu dilakukan observasi lama waktu tunggu pelayanan obat atas resep dokter serta identifikasi faktor-faktor penyebab lama waktu tunggu di Puskesmas, karena puskesmas merupakan sarana kesehatan tingkat pertama di era JKN. Pendekatan studi kualitatif observasional dilakukan untuk mendapatkan gambaran waktu tunggu pelayanan obat atas resep dokter di puskesmas-puskesmas Kota Denpasar serta identifikasi faktor penyebab lama waktu tunggu pelayanan tersebut. Rata-rata waktu tunggu pelayanan obat atas resep dokter adalah 7 menit untuk resep racikan dan 4 menit untuk resep non-racikan. Sejumlah 424 resep racikan dan non-racikan telah observasi, hanya 32,74% resep non racikan dan 7,96% resep racikan yang memenuhi standar. Faktor-faktor yang mempengaruhi lama waktu tunggu pelayanan resep di Puskesmas Kota Denpasar diantaranya faktor kurangnya asisten apoteker, tidak adanya apoteker yang bertugas, faktor dokter interhensip, faktor manajemen persediaan farmasi, dan faktor instrumen yang digunakan dalam melakukan pelayanan kefarmasian. Waktu tunggu pelayanan resep di puskesmas belum sesuai dengan SOP yang ditetapkan oleh puskesmas tersebut. Permasalahan lama waktu tunggu tersebut disebabkan oleh 3 faktor utama yaitu faktor SDM, metode, dan manajemen.
Background: Neuropathy in diabetes mellitus is a disorder that occurs in the peripheral nervous system. Diabetic neuropathy is more prevalent in elderly (44%) compared to adult (24%). The most commonly used agent in diabetic neuropathy are Amitriptyline and Gabapentin, mostly to treat the neuropathic pain. However, there were variations in the results of the studies that have been done related to safety between both drugs. Thus, further research is needed to confirm the safety of both drugs in diabetic neuropathy treatment especially in geriatrics patients. Objective: The aim of this study was to compare the safety of Amitriptyline versus Gabapentin administration for diabetic neuropathic pain in geriatric. Methods: A prospective cohort study involving 70 elderlies were observed during 4 weeks. The outcome targets were incidence of side effect and comparison incidence of side effect between both drugs. Non-parametric Mann Whitney U, Chi-Square, and Fisher's Exact test were used to analyze the outcome. Result: Most side effects have appeared in the group Amitriptyline is a dry mouth followed by sedation / drowsiness, fatigue, dizziness, and constipation. In the group of Gabapentin, the incidence of adverse events that most often arises is sedation (sleepiness) followed by dizziness, dry mouth, and fatigue. Low doses administration showed that Amitriptyline has significantly greater adverse effects (p < 0.05) compared with Gabapentin. However, no significant differences were found in therapeutic dose (p > 0.05). Conclusion:The incidence of adverse events was more common in geriatric patients receiving Amitriptyline compared to Gabapentin.
Background: Bacteria develop naturally in the human body to aid in protecting the individual. Antibiotic resistance is quickly increasing and is becoming a global health concern. In this situation, the risk of synthetic antibiotic resistance against bacterial infections makes it critical to find alternative medications that are safe, easy to obtain, and better than synthetic antibiotic alternatives. The frangipani plant is one of the medicinal plants used in traditional medicine as an antibacterial. The frangipani plant possesses antibacterial properties comparable to broad-spectrum medicines against uro-gastro pathogens. Objective: The purpose of this study was to determine the activity of the frangipani flower as an antibacterial. Methods: studying literature from various databases, websites, national journals, and relevant international journals to identify frangipani flowers with antibacterial activity. Results: Results showed that frangipani flowers have antibacterial activity against gram-positive and gram-negative bacteria because frangipani flowers contain various antibacterial chemical components, such as terpenoids, saponins, phenols, flavonoids, tannins, and essential oils. Conclusion: Frangipani flowers have the potential to an antibacterial against gram-positive and gram-negative bacteria. Keywords: Frangipani flower, Antibacterial, Bacteria
Oral antibiotics are one of the drugs that must be used wisely. Irrational use can cause fatal problems, including resistance and increased mortality due to infection. Many people try to get oral antibiotics without a doctor's prescription. This behaviour is worrying because it can lead to irrational use of antibiotics. This study aimed to identify the factors that encourage people to get oral antibiotics without a doctor's prescription, especially in Bali-Indonesia. A cross-sectional study design was conducted to identify factors that encourage patients to take oral antibiotics without a doctor's prescription. The identified factors were then analyzed in relation to the demographic characteristics of the patient. A total of 400 respondents were successfully observed. 59% of respondents came to the community pharmacy to try to get Amoxicillin, 75% of them stated that they had health problems such as cough, cold, painful swallowing. As many as 52% of respondents indicated that they knew about this antibiotic from their previous healing experience with the same symptoms, and 95% of them tried to buy oral antibiotics because it was more efficient and saved money. Factor analysis found three characteristics influencing this behaviour: age, distance from residence to the pharmacy, and insurance ownership. Most of the people in Bali tried self-medication with oral antibiotics. This condition is at risk of causing antibiotic resistance will be broader in the future. The founding of this. Keywords: Oral Antibiotics, Self Medication, Community Pharmacy, Bali.
Introduction: Coronary heart disease (CHD) is a disorder of heart function due to a lack of blood in the heart muscle due to narrowing of the coronary arteries. Antiplatelet in patients with CHD is a therapy that must be obtained by patients throughout their lives to prevent recurrent attacks and deaths from CHD. In the Province of Bali, especially in Denpasar, there is a lack of information about the type of side effects that occur on antiplatelet medication, so it is necessary to do a related study. Objective: The aim of this study is to identify the type of side effects that occur on antiplatelet medication in patients with CHD. Methods: A cross-sectional study involving 97 patients was done by observed the CHD patients treated with antiplatelet medication. Side effects were evaluate using Naranjo Algorithm. Patients were divided into three groups, including a low dose aspirin user group, clopidogrel user group, and aspirin-clopidogrel combination user group. Results: Antiplatelet side effects that occur in patients include headache (2.06%), diarrhea (1.03%), cyanosis (1.03%), gastrointestinal bleeding (8.25%), heartburn (11.34%), and nausea (6.19%). These side effects only occurred in 31.96% of the total subjects. The incidence of aspirin side effects was significantly greater than clopidogrel as well as aspirin-clopidogrel in combination (p <0.05). Conclusion: Patients with CHD who use antiplatelet agents in the long term to be more aware of the potential side effects that will occur, especially heartburn in chronic low-dose aspirin users. Keywords: Coronary Heart Disease, Side Effects, Antiplatelet, Aspirin, Clopidogrel
Introduction: Diabetes Mellitus (DM) is a complex chronic disease that requires ongoing medical care with a multifactorial risk reduction strategy beyond glycemic control. Self-management, education, and support are essential to prevent acute complications and reduce the risk of long-term complications. Stress levels may affect fasting blood glucose (FBG) and 2-hours postprandial blood glucose (2HPPBG). Objectives: This study aims to determine the effect of stress levels on the therapeutic outcomes of type 2 DM patients at the regional public hospital of West Nusa Tenggara province. Methods: This observational, cross-sectinal research was carried out on a sample of 37 patients using the Perceived Stress Scale (PSS). Data analysis used a linear regression test. Results: The results showed that stress had a significant effect on FBG (p=0.038) and 2HPPBG (p=0.001) levels.
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