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Herry S. Sastramihardja
Universitas Padjadjaran, Bandung
Dentistry Health Professions Immunology & microbiology Nursing Public Health

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Askariasis di Daerah Endemis Rendah Askariasis Tidak Meningkatkan Kejadian Tuberkulosis Aktif Ratna Dewi Indi Astuti; Herry S. Sastramihardja; Sadeli Masria
Global Medical & Health Communication (GMHC) Vol 4, No 1 (2016)
Publisher : Universitas Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (161.568 KB) | DOI: 10.29313/gmhc.v4i1.1601

Abstract

Askariasis di daerah endemis seperti Indonesia menyebabkan polarisasi respons Th2 yang dapat menekan respons Th1 yang penting dalam perlawanan terhadap tuberkulosis melalui penekanan ekspresi IL-12Rẞ2 oleh IL-4. Tujuan penelitian ini adalah mencari hubungan antara kejadian askariasis dan tuberkulosis aktif di daerah endemis rendah askariasis. Penelitian observasional analitik dilakukan pada 30 penderita dewasa tuberkulosis paru aktif baru dan 29 penderita tuberkulosis laten. Penelitian dilaksanakan di Kota Bandung selama periode April–Juni 2014. Pemeriksaan telur Ascaris lumbricoides dilakukan dengan teknik Kato-Katz smear dan pengukuran kadar reseptor terlarut IL-12Rẞ2 dalam plasma mengunakan metode enzyme linked immunosorbent assay (ELISA). Hasil penelitian menunjukkan proporsi askariasis pada penderita tuberkulosis aktif secara signifikan lebih rendah (5 dari 30 subjek) dari proporsi askariasis pada penderita tuberkulosis laten (13 dari 29 subjek) dengan p=0,019. Penghitungan jumlah telur menunjukkan semua subjek askariasis menderita askariasis intensitas ringan. Kadar reseptor terlarut IL-12Rẞ2 pada penderita tuberkulosis aktif dan laten dengan askariasis maupun tanpa askariasis tidak berbeda signifikan. Simpulan penelitian ini adalah askariasis intensitas ringan tidak menekan respons Th1 dan tidak meningkatkan kejadian tuberkulosis aktif di daerah endemis rendah askariasis. ASCARIASIS IN LOW ENDEMIC AREA DOES NOT ASSOCIATE WITH THE INCREASE INCIDENCE OF ACTIVE TUBERCULOSISPolarization toward Th2 response in ascaris investation suppresses Th1 responses which is important in defence against tuberculosis. Such suppression is hipothesized to supress the expression of IL-12Rẞ2 by IL-4. The purpose of this study was to find out the relationship between ascaris investation and TB in low endemic area of ascariasis that is endemic for TB. We gathered samples from 30 adult active pulmonary TB patients and 29 adult latent TB patients as control. The study was performed in Bandung during April to June 2014. Ascaris investation was established with Kato-Katz smear technique and the detection of plasma level of the soluble receptor of IL-12Rẞ2 was conducted with enzyme linked immunosorbent assay (ELISA). We showed that the proportion of ascaris investation significantly higher in latent TB patients (13 from 29 subjects) compared to in active Tb patients (5 from 30 subjects) with p value 0.019. All subjects positive for ascaris investation had low intensity of investation in accordance with low endemicity. Also, the median level of IL-12Rẞ2 did not differ between active and latent TB patients with ascaris or without ascaris investation. We concluded that low intensity of ascaris investation does not associate with suppression of Th1 response, as assessed by IL-12Rẞ2 receptor level, hence does not associate with the increase incidence of active tuberculosis.
Determinan Peresepan Polifarmasi pada Resep Rawat Jalan di Rumah Sakit Rujukan Yuke Andriane; Herry S. Sastramihardja; R. Ruslami
Global Medical & Health Communication (GMHC) Vol 4, No 1 (2016)
Publisher : Universitas Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (240.096 KB) | DOI: 10.29313/gmhc.v4i1.2000

Abstract

Resep polifarmasi (≥5 jenis obat/resep) berpotensi meningkatkan interaksi obat, efek samping obat, dan masalah lain. Pasien yang berobat ke rumah sakit (RS) rujukan umumnya berpenyakit kronik, dengan komorbiditas dan komedikasi. Dilakukan penelitian potong silang untuk menganalisis determinan peresepan polifarmasi dari berbagai klinik rawat jalan di RS rujukan di Bandung. Analisis statistik menggunakan uji chi square dan dihitung rasio prevalensi (RP). Selama bulan Oktober 2012 terdapat 2.548 resep dari lima klinik rawat jalan dengan jumlah resep polifarmasi terbanyak. Prevalensi polifarmasi adalah 32% dan median jumlah jenis obat adalah 5 (rentang: 5–11). Terdapat perbedaan karakteristik pasien dalam hal usia ≥60 tahun (59,8% vs 44,8%; p<0,001), jenis kelamin laki-laki (57,1% vs 44,6%; p<0,001), peserta Askes (73,6% vs 56,1%; p<0,001), dan asal poliklinik: kardiovaskular (72,1% vs 33,1%; p<0,001) antara yang menerima resep polifarmasi dan tidak polifarmasi. Faktor dominan terhadap peresepan polifarmasi adalah dari klinik kardiovaskular (RP:8,80; IK95%: 6,35–12,19). Faktor lain dengan risiko polifarmasi >3 kali adalah dari klinik geriatri (RP:6,68; IK95%: 4,43–10,08) dan peserta Askes (RP:6,23; IK95%: 3,49–11,12). Prevalensi polifarmasi resep gabungan beberapa klinik (574 pasien) lebih besar, yaitu 59,8%. Simpulan, prevalensi peresepan polifarmasi di RS rujukan cukup tinggi, terlebih jika pasien menerima resep dari berbagai klinik. Determinan utama peresepan polifarmasi di RS rujukan adalah dari poli kardiovaskular, poli geriatri, dan peserta Askes.DETERMINANTS FOR POLYPHARMACY PRESCRIBING OF THE PRESCRIPTION IN THE OUTPATIENT CLINICS OF REFERRAL HOSPITALPolypharmacy prescription (≥5 drugs in one prescription) potentially increased drug-drug interaction, side effects, and other problems. Patients who come to referral hospital usually were with chronic diseases, comorbidities and comedications. A cross sectional study was performed to analyze the determinants for polypharmacy prescription from clinics in referral hospital in Bandung. Data were analyzed using chi-square test and prevalence ratio (PR) were calculated. During October 2012, there were 2,548 prescriptions from five clinics with highest number of prescription. Prevalence of polypharmacy prescription was 32%, the median number of drugs written were 5 (ranged: 5–11). The characteristics of the patients showed a difference in aged ≥60 years (59.8% vs 44.8%, p<0.001), gender: males (57.1% vs 44.6%, p<0.001), had health insurrance (73.6% vs 56.1%, p<0.001), and origin cardiovascular clinic (72.1% vs 33.1%, p<0.001) between those receiving polypharmacy prescriptions and those receiving non polypharmacy prescription. The dominant factor for polypharmacy prescription was treated at cardiovascular clinic (PR:8.80, 95%CI: 6.35–12.19), followed by treated at geriatry clinic (RP:6.68, 95%CI: 4.43–10.08) and had health insurrance (RP:6.23, 95%CI: 3.49–11.12). Polypharmacy of combined prescriptions (574 patients) was 59.8%. In conclusions, prevalence of polypharmacy prescription in referral hospital in Bandung is high, even higher in patients received combined prescriptions. Main determinants for polypharmacy prescription in referral hospitals are being treated at cardiovascular clinic, geriatry clinic, and having health insurance.
Co-Authors Astuti, Ratna Dewi Indi R. Ruslami Sadeli Masria Yuke Andriane