20 research outputs found
Antibiotic Associated Diarrhea in Hospitalized Adult Patients
Background: Antibiotic associated diarrhea (AAD) occurs from the first initiation until 2 months of the end of antibiotic treatment. The aims of this study were to know the incidence of AAD, Clostridium difficile infection and other gastrointestinal symptoms in hospitalized adult patients.
Method: The study is a cross sectional study. We studied the antibiotic associated diarrhea (AAD), Clostridium difficile infection and other gastrointestinal symptoms in patients who were admited in Cipto Mangunkusumo Hospital. Inclusion were male or female, age 18-75 years old, Patients started receiving antibiotics maximal 2 x 24 hours prior to hospitalization, gave written informed consent.
Results: The incidence of AAD was 11.5%. The incidence of Clostridium difficile infection was 15.4%. The Upper gastrointestinal symptom was present on 20 (38.5%) patients. Lower abdominal symptom was present on 10 (19.2%) patients.
Conclusion: The Incidence of AAD and Clostridium difficile infection were 11.5% and 15.4% respectively. The clinical manifestations of AAD were diarrhea, other upper and lower abdominal symptoms
Total Lymphocyte Count as a Nutritional Parameter in Hospitalized Patients
Background: Nowadays, there are still many malnourished patients during hospitalization, which comprises around 45-50% patients. Malnutrition is related to increased mortality and morbidity rate; therefore, nutritional state should be assessed in hospitalized patients. Total lymphocyte count (TLC) is related to decreased body function in malnutrition and it is a means of nutritional assessment. Until now, there is no data showing association between malnutrition and TLC in hospitalized patients in Indonesia. The objective of this study was to identify the association between malnutrition and TLC < 1,200 cell/mm3 in hospitalized patients. Method: This study was a cross-sectional study. Subjects were new patients hospitalized at internal medicine ward of Cipto Mangunkusumo Hospital. Patients were collected by consecutive sampling. We conducted the study between April and May 2008. Fifty four patients were assessed for malnutrition by the subjective global assessment (SGA) and they also had undergone complete blood count. TLC was numbered with routine complete blood count test. Patients were classified into malnutrition according to SGA. TLC was classified with cut-off point of 1,200 cell/mm3. Statistical analysis included Chi-square test, which was used to compare proportion. Results: There were 52% malnourished patients, 33% patients with TLC < 1,200 cell/mm3, 57% patients with malnutrition and TLC < 1,200 cell/mm3. This study showed that there was an association between malnutrition and TLC < 1,200 cell/mm3 (p = 0.001). Moreover, there was also significant association between severe malnutrition (SGA C) with TLC < 900 cell/mm3 (p = 0.02). Conclusion: There is an association between malnutrition and TLC < 1,200 cell/mm3
Function and platelet count in thrombocyte concentrate (TC) during the storage
AbstrakLatar belakang: Evaluasi terhadap pemberian transfusi belum dilakukan secara optimal baik di hulumaupun di hilir. Tujuan penelitian ini untuk mengetahui pengaruh waktu penyimpanan terhadap perubahanpH, jumlah trombosit, dan fungsi agregasi yang terjadi pada trombosit pada beberapa hari penyimpanan.Metode: Disain penelitian potong lintang terhadap sample kantong konsentrat trombosit yang yang telahlolos skrining infeksi penyakit menular melalui transfusi darah. Pengujian yang dilakukan ialah terhadappH, jumlah trombosit dan fungsi agregasi terhadap sampel pada tiga waktu pengujian pada hari ke-0, ketiga, dan ke lima penyimpanan.Hasil: Pada 50 sampel kantong konsentrat trombosit didapatkan kenaikan pH pada hari ke tigapenyimpanan kantong trombosit yang disertai penurunan pada hari ke lima. Hal serupa ditemui pulapada jumlah trombosit. Sementara penurunan fungsi agregasi trombosit ditemukan lebih awal pada harike tiga penyimpanan dan didapatkan nilai rendah pada hampir semua sampel.Kesimpulan: Ketiga parameter yaitu pH, jumlah trombosit, dan fungsi agregasi mengalami penurunanpada hari kelima. (Health Science Journal of Indonesia;2015;6:48-51)Kata kunci: thrombocyte, concentrate, pH, agregasi, waktu penyimpanan. AbstractBackground: Evaluation for platelet transfusion is not optimal for this moment even in upstream at theblood center or in downstream at the hospital. The purpose of this study was to determine the effect ofstorage time to changes in pH, platelet count and function that occurs on platelet aggregation duringdifferent time storage.Methods: The study design was cross-sectional on selected bags of platelet concentrates that have passedthe screening for infection transmitted through blood transfusions. The regular assessment in UTDD forPC has been done every month by random sampling with three parameters pH, platelets count and volumein the bag of blood. The testing for pH, platelet count, and aggregation functions for 50 samples with threedifferent test time were conducted on day 0, third day, and fifth day storage.Results: On 50 bags samples, pH, and number of platelets increased, but the platelet aggregation functiondecreased on the third day of storage. On the fifth day of storage the pH, number of platelets and theplatelets aggregation function decreased and found the lowest number almost in all samples.Conclusion: The three parameters: pH, platelet counts, and aggregation functions decreased on the fifthday of storage. (Health Science Journal of Indonesia;2015;6:48-51)Keywords: platelets, pH, aggregation, platelet storage</p
Function and platelet count in thrombocyte concentrate (TC) during the storage
AbstrakLatar belakang: Evaluasi terhadap pemberian transfusi belum dilakukan secara optimal baik di hulumaupun di hilir. Tujuan penelitian ini untuk mengetahui pengaruh waktu penyimpanan terhadap perubahanpH, jumlah trombosit, dan fungsi agregasi yang terjadi pada trombosit pada beberapa hari penyimpanan.Metode: Disain penelitian potong lintang terhadap sample kantong konsentrat trombosit yang yang telahlolos skrining infeksi penyakit menular melalui transfusi darah. Pengujian yang dilakukan ialah terhadappH, jumlah trombosit dan fungsi agregasi terhadap sampel pada tiga waktu pengujian pada hari ke-0, ketiga, dan ke lima penyimpanan.Hasil: Pada 50 sampel kantong konsentrat trombosit didapatkan kenaikan pH pada hari ke tigapenyimpanan kantong trombosit yang disertai penurunan pada hari ke lima. Hal serupa ditemui pulapada jumlah trombosit. Sementara penurunan fungsi agregasi trombosit ditemukan lebih awal pada harike tiga penyimpanan dan didapatkan nilai rendah pada hampir semua sampel.Kesimpulan: Ketiga parameter yaitu pH, jumlah trombosit, dan fungsi agregasi mengalami penurunanpada hari kelima. (Health Science Journal of Indonesia;2015;6:48-51)Kata kunci: thrombocyte, concentrate, pH, agregasi, waktu penyimpanan. AbstractBackground: Evaluation for platelet transfusion is not optimal for this moment even in upstream at theblood center or in downstream at the hospital. The purpose of this study was to determine the effect ofstorage time to changes in pH, platelet count and function that occurs on platelet aggregation duringdifferent time storage.Methods: The study design was cross-sectional on selected bags of platelet concentrates that have passedthe screening for infection transmitted through blood transfusions. The regular assessment in UTDD forPC has been done every month by random sampling with three parameters pH, platelets count and volumein the bag of blood. The testing for pH, platelet count, and aggregation functions for 50 samples with threedifferent test time were conducted on day 0, third day, and fifth day storage.Results: On 50 bags samples, pH, and number of platelets increased, but the platelet aggregation functiondecreased on the third day of storage. On the fifth day of storage the pH, number of platelets and theplatelets aggregation function decreased and found the lowest number almost in all samples.Conclusion: The three parameters: pH, platelet counts, and aggregation functions decreased on the fifthday of storage. (Health Science Journal of Indonesia;2015;6:48-51)Keywords: platelets, pH, aggregation, platelet storage</p
Pelaksanaan Dana Pensiun Untuk Pegawai Negeri Sipil (PNS) Berdasarkan PP Nomor 20 Tahun 2013 Tentang Perubahan PP Nomor 25 Tahun 1981 Tentang Asuransi Sosial PNS
All countries definitely want to realize the welfare for all its citizen. One form
of government efforts to realize it is made policy regarding social insurance. There
are social insurance that imposed to the public and there is also applies only for a
certain group. One form of social insurance that aimed at a certain group is the
pension funds. Pension funds initially intende only for retired civil servants.over time,
a lot of legislation regarding civil servants�s social insurance changed and replaced.
Authors take the title of legal writing �The Implementation Of Pension Funds For
Civil Servants Based On Government Regulations Number 20 In 2013 About
Changes In The Government Regulations Number 25 In 1981 About Social Insurance
Civil Servants�. In this legal writing, the authors discuss the implementation of
pension funds for civil servants in Yogyakarta and constraints experienced in the
implementation.
Research methods used in this legal writing is the literature research and
sphere research. After doing literature research and sphere research, then the author
get the research result that can provide answers to the problems which is discussed in
this legal writing. As for the answer the problems can be concluded into two main
point. The first pointm that the implementation of civil servants�s pension funds in
Yogyakarta has been running in accordance with the legislation applicable. The
second point that the contraints experienced in the implementation of civil servants�s
pension funds in Yogyakarta is the lack of the number of labor that provide services
to the participants civil servants�s pension funds that is in Yogyakarta
Iron Absorption in Iron-Deficient Women, Who Received 65 mg Fe with an Indonesian Breakfast, Is Much Better from NaFe(III)EDTA than from Fe(II)SO4, with an Acceptable Increase of Plasma NTBI. A Randomized Clinical Trial
Plasma non-transferrin-bound iron (NTBI) is potentially harmful due to the generation of free radicals that cause tissue damage in vascular and other diseases. Studies in iron-replete and iron-deficient subjects, receiving a single oral test dose of Fe(II)SO4 or NaFe(III)EDTA with water, revealed that FeSO4 was well absorbed when compared with NaFeEDTA, while only the Fe(II) compound showed a remarkable increase of NTBI. As NaFeEDTA is successfully used for food fortification, a double-blind randomized cross-over trial was conducted in 11 healthy women with uncomplicated iron deficiency. All subjects received a placebo, 6.5 mg FeSO4, 65 mg FeSO4, 6.5 mg NaFeEDTA, and 65 mg NaFeEDTA with a traditional Indonesian breakfast in one-week intervals. Blood tests were carried out every 60 min for five hours. NTBI detection was performed using the fluorescein-labeled apotransferrin method. Plasma iron values were highly increased after 65 mg NaFeEDTA, twice as high as after FeSO4. A similar pattern was seen for NTBI. After 6.5 mg of NaFeEDTA and FeSO4, NTBI was hardly detectable. NaFeEDTA was highly effective for the treatment of iron deficiency if given with a meal, inhibiting the formation of nonabsorbable Fe-complexes, while NTBI did not exceed the range of normal values for iron-replete subjects
SMASH standardised perioperative management of patients operated with acute abdominal surgery in a high-risk setting
Objective of the study: Emergency laparotomy and other high-risk acute abdominal surgery procedures have a high mortality rate. The perioperative management of these patients is complex and poses several challenges. The objective of the study is to implement and evaluate the outcome of protocol-based standardised care for patients in need of acute abdominal surgery in a Swedish setting. NÄL is a large county hospital in Sweden serving a population of approximately 270,000 inhabitants. The study seeks to determine whether standardised protocol-based perioperative management in emergency abdominal surgical procedures leads to a better outcome measured as short- and long-term mortality and postoperative complications compared with the present standard in Swedish routine care. The study is ongoing, and this article describes the methodology used in the study and discusses the benefits and limitations the study design. Results: There are no results so far. The inclusion rate for the first 22 months is as expected; 404 patients have been included and protocols have been followed and reviewed according to the study plan. 25 patients have been missed and demographic data and outcome data for these patients will be collected and analysed. © 2020 The Author(s)
Development of Food Multi-Mix Using a Linear Programming Approach to Fill the Nutrient Gap of Amino Acids and Micronutrients for Stunted Non-Wasted Children
Food-based approaches using locally available food escalates the feasibility and the sustainability of nutrition intervention. A complementary feeding recommendation (CFR) integrated with the food multi-mix (FMM) formulation was targeted to fulfill micronutrient and amino acid requirements for stunted non-wasted (SNW) children aged 12–23 months living in agricultural areas. A seven-day estimated food record (EFR) of 87 children was used to design the CFR and 4 identified underutilized foods were integrated as the FMM. A linear programming approach using Optifood was applied to optimize the CFR and FMM. CFR alone successfully fulfills the vitamin C, riboflavin, iron, and zinc, but it cannot fulfill calcium, thiamin, niacin, vitamin B6, folate, vitamin B12, and histidine. With the incorporation of the selected underutilized cowpea, buncis batik, wader fish, and cows’ milk in the FMM development, the nutrients that are challenging in CFR development, can be fulfilled. Therefore, these findings present evidence that food multi-mix developed based on locally available nutrient-dense food sources can help to meet the nutrient gaps, which often remained even after a complementary feeding diet is optimized. Efficacy study using the developed CFR and FMM is recommended to assess effect in improving intake of micronutrients and amino acids and improving the linear growth of stunted, non-wasted children
Greenhouse gas observation network design for Africa
An optimal network design was carried out to prioritise the installation or refurbishment of greenhouse gas (GHG) monitoring stations around Africa. The network was optimised to reduce the uncertainty in emissions across three of the most important GHGs: CO2, CH4, and N2O. Optimal networks were derived using incremental optimisation of the percentage uncertainty reduction achieved by a Gaussian Bayesian atmospheric inversion. The solution for CO2 was driven by seasonality in net primary productivity. The solution for N2O was driven by activity in a small number of soil flux hotspots. The optimal solution for CH4 was consistent over different seasons. All solutions for CO2 and N2O placed sites in central Africa at places such as Kisangani, Kinshasa and Bunia (Democratic Republic of Congo), Dundo and Lubango (Angola), Zoétélé (Cameroon), Am Timan (Chad), and En Nahud (Sudan). Many of these sites appeared in the CH4 solutions, but with a few sites in southern Africa as well, such as Amersfoort (South Africa). The multi-species optimal network design solutions tended to have sites more evenly spread-out, but concentrated the placement of new tall-tower stations in Africa between 10ºN and 25ºS. The uncertainty reduction achieved by the multi-species network of twelve stations reached 47.8% for CO2, 34.3% for CH4, and 32.5% for N2O. The gains in uncertainty reduction diminished as stations were added to the solution, with an expected maximum of less than 60%. A reduction in the absolute uncertainty in African GHG emissions requires these additional measurement stations, as well as additional constraint from an integrated GHG observatory and a reduction in uncertainty in the prior biogenic fluxes in tropical Africa
MMP-9, brain edema, and length of hospital stay of patients with spontaneous supratentorial intracerebral hemorrhage after hematoma evacuation along with the administration of tigecycline
Background: The high plasma level of matrix metalloproteinses-9 (MMP-9) is believed to disrupt the blood-brain barrier (BBB) and cause brain edema, as well as increase patient's length of hospital stay (LOS). Tigecycline showed ability to reduce the MMP-9 level on study in animals. This study aimed to evaluate whether tigecycline can reduce the plasma levels of MMP-9; brain edema; and LOS of patients with supratentorial spontaneous intracerebral hemorrhage (SSICH).
Methods: A randomized clinical trial (RCT) was conducted on 72 SSICH patients who underwent hematoma evacuation in eleven hospitals in Jakarta; 100 mg tigecycline (n=35) or 2 g fosfomycine (n=37) administered intravenously before skin incision as an prophylactic antibiotics to avoid post-operative infections. Plasma levels of MMP-9 were measured in all subjects before and on the first and seventh day after the surgery. Reduction of brain edema was assessed by comparing the extent of brain edema on computed tomography scan (CT scan) before and CT scan after surgery. The length of stay (LOS) was recorded at the time of hospital discharge either survive or death. Data were analyzed using Mann-Whitney and Chi-Square test.
Results: There were non-significant statistical differences between two groups in the proportion of subjects with reduced MMP-9 levels on the first day (48% vs 50%; p=0.902; OR=1.1) and seventh day after the surgery (33% vs 48%; p=0.296; OR=1.9); proportion of the subjects with brain edema reduction (86% vs 80%, p=0.58); LOS (median 12 days vs 13 days, p=0.256; LOS ≥15 days 40% vs 27%; p=0.243; OR=1.81; NNT=8).
Conclusion: On SSICH patients who underwent hematoma evacuation, tigecycline did not either reduce MMP-9 levels and brain edema or shorthen LOS
