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All Journal International Journal of Integrated Health Sciences
Evan Susandi
Department Of Internal Medicine, Faculty Of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung
Health Professions

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Defined Daily Dose and Cost of Therapy of Empirical Ceftriaxone Pre- and Post-Antimicrobial Stewardship Program Model Implementation in Sepsis Patients in A Tertiary Hospital in Indonesia Uun Sumardi; Anggra Filani; Evan Susandi; Ida Parwati
International Journal of Integrated Health Sciences Vol 7, No 2 (2019)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v7n2.1693

Abstract

Objective: Antibiotic resistance requires substantial responses through two mechanisms: new antibiotic development and smart antibiotic use. Antibiotic Stewardship Program (ASP) is one of the responses that reduce the overall antibiotics use and prevent the overuse of antibiotics to avoid antibiotic resistance. The purpose of this study was to assess the difference in defined daily dose (DDD) and the cost of therapy (COT) for empirical ceftriaxone therapy in sepsis patients pre- and post-ASP model implementation in Dr. Hasan Sadikin General Hospital, Bandung.Methods: A pre- and post-intervention quasi-experimental study on ASP model implementation in empirical ceftriaxone therapy provided to sepsis patients treated in the intensive or semi-intensive care units was performed from December 2015 to July 2016 using the Mann Whitney test and t-test. The DDD was calculated as DDD/100 patient-days, while the COT was calculated as the COT/patient-day. The ASP model intervention implemented in these units applied 2 main strategies: ceftriaxone use restriction and ceftriaxone therapy duration audit.Results: Participants of this study consisted of 112 sepsis subjects (n=112) with 55 subjects in the pre-ASP group and 57 subjects in the post-ASP group. The mean DDD/100 patient-days in the post-ASP subject was lower than that of the pre-ASP (16.3±4.3 and 45.8±16.8; p=0.018). The median COT/patient-days in post-ASP subject was IDR 42,000 (IDR 14.000–42.000), which was lower than that of the pre-ASP group of IDR 84.000 (IDR 28.000–420.000, p=0.001).Conclusion: The differences in the DDD/100 patient-day and COT/patient-day values between the pre-ASP and post-ASP are significant. The ASP model applied in Dr. Hasan Sadikin General Hospital, Bandung leads to a smart use of ceftriaxone and reduces costs for the empiric ceftriaxone therapy in sepsis patients.
Erythropoiesis Differences in Various Clinical Phases of Dengue Fever using Immature Reticulocyte Fraction Parameter Amaylia Oehadian; Putri Vidyaniati; Jeffery Malachi Candra; Uun Sumardi; Evan Susandi; Bachti Alisjahbana
International Journal of Integrated Health Sciences Vol 9, No 1 (2021)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v9n1.1805

Abstract

Objective: To determine the mechanism of erythropoiesis that led to anemia using the Immature Reticulocyte Fraction (IRF) parameter in various clinical phases of dengue fever.Methods: This study was a comparative analytical research using secondary data derived from the Dengue-associated Endothelial Cell Dysfunction and Thrombocyte Activation (DECENT) research. The study was performed at Dr. Hasan Sadikin Hospital Bandung, Indonesia from March 2011 to March 2012. Patients were grouped into fever, critical, recovery, and convalescent phases and a healthy control was established. Data collected were analyzed using the Kolmogorov-Smirnov normality test, followed by Friedman test and Mann-Whitney post hoc test.Results: There were 244 subjects participating in this study. The median IRF for all subjects was 4.8% with an IQR of 2.4-8.1%. The values of Immature Reticulocyte Fraction in fever-phase, critical-phase, recovery-phase, convalescent-phase and healthy-control were 1.8% (IQR of 0.5-2.85%), 3.6% (IQR of 1.8-5.0%), 7.05% (IQR of 4.08-11.85%, 7.3 % (IQR of 3.95-9.3%) and 4.1% (IQR of 2.2-6.6%), respectively. There was a significant difference in IRF between groups (p<0.05).  The immature Reticulocyte Fraction in fever phase was significantly different from the IRF in other phases and healthy controls (p<0.05).Conclusions:There are changes in erythropoiesis activities detected through the IRF in various clinical phases of dengue infection. Erythropoiesis suppression occurs mainly during the fever phase and starts to be restored in the critical phase. In the recovery and convalescent phases, the erythropoiesis activities increase.  This is the first study describing IRF in multiple phases of dengue disease. 
Elevated Endothelin-1 in Intradialytic Hypertension Rubin Surachno Gondodiputro; Andika Wiratama; Stefanie Yuliana Usman; Erma Arnika Dewi; Evan Susandi; Afiatin Afiatin; Ria Bandiara
International Journal of Integrated Health Sciences Vol 7, No 2 (2019)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v7n2.1737

Abstract

Objective: To determine the relative change in endothelin-1 (ET-1) during hemodialysis procedure in Stage Five Dialysis-Dependent Chronic Kidney Disease (CKD-5D)patients with and without intradialytic hypertension (IDH).Methods: This was a cross-sectional, observational study involving 40 CKD-5D patients who received two hemodialysis per week for at least three months at the dialysis unit of Dr. Hasan Sadikin Hospital General Bandung, Indonesia during September 2016. Subjects were divided two groups: with IDH (n=20) and without IDH (n=20). Plasma ET-1 level was examined before and after hemodialysis.Results: There was a significant elevation of ET-1 level (mean±SD pg/mL) between pre- and post-dialysis state in patients with IDH (3.33±1.28 vs. 3.84±1.75; relative changes: 15.32%, p=0.013). No change was observed in patients without IDH (3.99±2.30 vs. 4.38±1.81; relative changes: 9.77% p=0.083). The post-dialysis absolute ET-1 level was significantly lower in CKD-5D patients with IDH (3.84±1.75 vs. 4.38±1.81; p=0.024).Conclusion: There was a significant elevation of ET-1 level in CKD-5D patients with IDH during hemodialysis procedure at the dialysis unit of Dr. Hasan Sadikin General Hospital Bandung.
Global Longitudinal Strain of Chronic Granulocytic Leukemia Patients treated with Imatinib and Nilotinib Indra Wijaya; Arief Sumarna; Eliza Nurazizah; Evan Susandi; Erwan Martanto
International Journal of Integrated Health Sciences Vol 9, No 2 (2021)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v9n2.2217

Abstract

Objective: To determine left ventricular function of patients with Chronic Granulocytic Leukemia in Chronic Phase (CGL-CP) who received imatinib and nilotinib by using Global Longitudinal Strain (GLS) examination.Methods: This was a descriptive study involving 46 CGL-CP patients who received imatinib and nilotinib therapy at the Hemato-Oncology Clinic of the Internal Medicine Departement of Dr. Hasan Sadikin General Hospital,, Bandung, Indonesia. Sampling was performed consecutively during the period of October to December 2019. Variables assessed in this study were age, gender, BMI, length of treatment, hemoglobin level, Left Ventricular Ejection Fraction (LVEF) value, and Global Longitudinal Strain (GLS). Primary data were tested for normality  using the Saphiro-Wilk test. Statistical analysis was performed using SPSS software version 25.0.Results: Thirty-nine patients (seventeen males and twenty-two females with a mean age of 42±11) who had been in therapy for about 8 to 179 months at the time of the study were included as subjects. On average, the GLS results for both treatment groups indicated a normal value based on the classification of the American Society of Echocardiography. The imatinib group gained a score of -22.4% (average range = -16.4% to (-28.1%)), while the nilotinib group gained a score of -21.6% (average range = -18.0% to (-25.9%)). Conclusion: This study described the left ventricular function based on results of GLS in CGL-CP patients receiving imatinib and nilotinib.
Co-Authors Afiatin Afiatin Amaylia Oehadian Andika Wiratama Anggra Filani Arief Sumarna Bachti Alisjahbana Eliza Nurazizah Erma Arnika Dewi Erwan Martanto Ida Parwati Indra Wijaya Jeffery Malachi Candra Putri Vidyaniati Ria Bandiara Rubin Surachno Gondodiputro Stefanie Yuliana Usman Uun Sumardi, Uun