ABSTRAK

Caesarean section is the delivery through a surgical incision in the abdomen and uterus with various risks, such as Surgical Site Infection (SSI) which either occurs rapidly (24-48 hours postoperatively) or delayed. To reduce the risk of various post-cesarean section infections, prophylactic antibiotics are given. The administration of prophylactic antibiotics with recommended regimens, such as in developed countries as in the United States and Europe, with first generation of cephalosporins has not been applied in Dr. Iskak Hospital, Tulungagung. This hospital still used other types of antibiotics, such as cefotaxime or ceftriaxone. In addition, for several reasons, prophylactic antibiotics were continued with other antibiotics to reduce the risk of delayed infection. This study was designed to analyze the effectiveness of prophylactic antibiotics as recommended in cesarean section. This was a prospective observational study with consecutive sampling type, examined 41 mothers with cesarean section at the Department of Obstretics and Gynecology, Dr. Iskak Hospital, Tulungagung, Indonesia. This study was conducted from May to July, 2017. The results of the study showed that the effectiveness of prophylactic antibiotic use was 98% based on the clinical parameters and maternal laboratory outcome, which showed that SIRS was in normal category. Whereas, there was one mother (2%) who had SSI on day 10 postoperatively.

Cytotoxic chemotherapy suppresses the hematopoietic system, and the most serious hematologic toxicity is neutropenia. This can decrease a risk of infection that causes delays in treatment and reduction of dose intensity, which reduces therapeutic outcome. Filgrastim is used to increase neutrophils level whose therapeutic effect is unknown. The effectiveness of filgrastim is based on the ANC level pre- and post-therapy. This study aimed to analyze the use of filgrastim on ANC level changes in acute leukemia children with neutropenia, and to analyze the patient that achieve ANC level’s targeted therapy = 1000 cell/mm3. A prospective observational study with a longitudinal design was conducted from June to October 2016. The inclusion criteria of the study were patients who diagnosed acute leukemia with neutropenia and received filgrastim 10 µg/kgBW for 3, 4, 5 days. Patients’ ANC levels were measured before and after filgrastim therapy. This study has been approved its ethical clearance by Dr. Saiful Anwar Hospital, Malang. Data were obtained on the basis of neutropenic episodes, followed by 7 episodes of obtaining filgrastim for 3 days, 1 episode of obtaining filgrastim for 4 days, and 7 episodes of obtaining filgrastim for 5 days. Thus, it consists of 15 episodes. In 3 days, ANC levels increased by 9.5 fold from 381.3 ± 91.8 cell/mm3 to 3984.9 ± 426.8 cell/mm3, but in 5 days, ANC levels decreased by 0.9 fold from 200.9 cell/mm3 ± 98.2 to 189.7 ± 14.2 cell/mm3. Filgrastim was able to increased the ANC levels around nine fold for 3 days of theraphy. There were 53% neutropenia patients who achieved the goal of therapy. Filgrastim therapy with dose 10 µg/kgBW for 3 to 5 days has been able to reach the therapeutic target of 53% in acute leukemia children with neutropenia. The increased levels of ANC maximum was reached on the third day with increased levels of 9.5 fold.

Tuberculosis (TB) is an acute infectious disease that primarily affects the lungs. Probiotics supplementation can increase the number and activity of NK cell in peripheral blood by modulation of interleukin-12 (IL-12), thus increasing interfenon-γ (IFN-γ) production by T-helper cells type 1 (Th1) response. Vitamin B 1 acts on macrophages and affects neutrophil motility. Vitamin B 6 is associated with the release of cytokines and the responsiveness of NK cells, while vitamin B 12 affects to lymphocytes, Tcell proliferation, CD4 + ratios, and NK cell activity. This study aim to analyze the effects of probiotics and vitamin B 1 , B 6 , B 12 supplementation on IFN-γ and IL-12 levels during intensive phase of antituberculosis treatment. The study was pre-post test randomised control by time series. The control group was TB patients with standard therapy of antituberculosis and vitamin B6, while the intervention group was TB patients receiving therapy plus once daily probiotics and vitamin B 1 , B 6 , B 12 supplementation during the intensive phase. Blood samples were withdrawn at baseline, one month, and two months after therapy to measure plasma IFN-γ and IL-12 levels using the ELISA method. Twenty two patients were divided equally into two groups. There was a tendency to greater increase of IFN-γ in the first month of the intervention group, followed by a significant decline after two-month therapy (p <0.05). In both groups there was a rise in IL-12 levels after one month followed by a decrease in the second month (p>0.05). However, the percentage was higher in the supplementation group. Addition of probiotics and vitamins B 1 , B 6 , B 12 could improve immune response through IL-12 and IFN-γ modulation during intensive phase therapy.

Premature labor is a cause of high rates of perinatal morbidity and mortality. The use of tocolytics is one of the efforts to handle the risk of preterm labor. Tocolytics which are widely used in Indonesia is isoxsuprine and nifedipine. The purpose of this study was to identify the difference of effectiveness and safety of isoxsuprine as tocolytics in the risk of preterm labor. This was an observational study in the form of a case study that was done in detail and depth to the patients who were diagnosed as imminent preterm labor. In conclusion, there were differences in the effectiveness and safety of isoxsuprine and nifedipine as tocolytics in the risk of preterm labor. (FMI 2017;53:242-246)