PATTERN OF ANTIBIOTICS USE IN ADULT PATIENTS WITH URINARY TRACT INFECTION (UTI)

Introduction: Urinary tract infection (UTI) is an infectious disease caused by the growth and proliferation of bacteria in the urinary tract, including infections in the bladder to the renal parenchyma with a certain number of bacteria in the urine. The use of antibiotics is therapy that commonly used to treat infectious diseases caused by bacteria. Irrational use of antibiotics can lead to bacterial resistance and toxicity. Objective: To determine the rationality of using antibiotics in adult patients with a urinary tract infection (UTI) in the X Hospital Yogyakarta from January-December 2017.Methods: This study is a non-experimental study with a descriptive observational study design and retrospective data collection. The sample of this study was inpatients with a diagnosis of urinary tract infection (UTI) and was recorded in the Medical Record X Hospital Yogyakarta for the period January-December 2017 which was included in the inclusion criteria. Results: Medical records that were included in the inclusion criteria were 61. The single most widely used antibiotic was ceftriaxone in 25 cases (44.64%) and the most widely used combination antibiotic was ceftazidime + levofloxacin in 2 cases (40%). The use of antibiotics with the right indication was 61 patients (100%), the right type was 61 patients (100%), the correct duration was 54 patients (88.52%), the right dose was 61 patients (100%), the right interval was 60 patients (98.36%) and the right route of administration was 61 patients (100%).

Comparative Literature Study of Bligo Fruit Extract (Benincasa hispida (Thunb) Cogn) and Bitter Melon (Momordica charantia L.) Extract on the Minimum Inhibition of Salmonella typhi Bacteria

Salmonella typhi is a gram-negative bacteria species that causes typhoid fever. Salmonella typhi is sensitive to antibiotics such as amoxicillin, chloramphenicol, ciprofloxacin, and cotrimoxazole. However, there has been some increase in antibiotic resistance, so there is a need for new antibacterials that do not have a resistance effect to treat infection. Bligo fruit (Benincasa hispida (Thunb) Cogn) and bitter melon (Momordica charantia L.) contain saponins, tannins, flavonoids, alkaloids, and triterpenoids which have antibacterial power. The purpose of this study was to compare the effectiveness of the bligo fruit extract (Benincasa hispida (Thunb) Cogn) and bitter melon extract (Momordica charantia L.) on the minimum inhibition of Salmonella typhi bacteria. The method used is narrative literature review. The results of the journal study showed that the extract of bitter melon (Momordica charantia L.) was more effective in inhibiting Salmonella typhi bacteria than the extract of bligo (Benincasa hispida (Thunb) Cogn) with a minimum inhibitory power at a concentration of 20%, namely 8.5 mm. Keywords: Bligo Fruit (Benincasa hispida (Thunb) Cogn), Bitter Melon (Momordica charantia L.), Salmonella typhi.

Comparison of the Colonies Number of the Germs Formed Post Operation between the Utilization of Single, Double, and Orthopedic Gloves in Closed Fracture Operations More Than 2 Hours

Post-operative infection is still one of the most common nosocomial diseases that can cause great losses because it will increase the length of stay, use of drugs, and reduce the quality of life of the patients. The risk will increase if the number of colonies is> 105 bacteria per gram of tissue. Various ways have been done to reduce the number of bacteria in the operation area, including the use of surgical gloves. This study analyzed the comparison of the level of bacterial colonies that grew on the surface of single, double, and orthopedic surgical gloves in closed fracture management for more than 2 hours at Hasan Sadikin Hospital. The statistical analysis was done with p-value = 0.011 (<0.05), which means a significant difference in the number of germ colonies that grow between single, double, and orthopedic gloves. Double gloves and orthopedic gloves have a better ability to reduce bacterial colony growth. Meanwhile, there was no significant difference in the number of bacterial colonies formed between double gloves and orthopedics. Perforation is a factor affecting the number of germ colonies that formed. The use of double gloves and orthopedic gloves in closed fracture surgery for more than 2 hours shows the number of bacterial colonies formed is less than single gloves. There was a significant difference in the rate of perforation between standard surgical gloves and orthopedic gloves. Keywords: Bacteria colony, Single glove, Double glove, Orthopaedic glove, Perforation

Concomittan Hyperuricemia and Abcess Mid Thoracic Region: The Use of Dual Energy CT Scan

Dual energy scan was performed to differentiate any collection associated with calsium. Case report. This 23 year old man showed severe hyperuricemia and mid thoracic pain and MRI showed collection over posterior epidural thecal sac over T3 until T9. Dual energy CT scan was performed to assess uric acid crystal over thoracic region. The CT result was negative. He was treated over intravenous antibiotic and pain medication. His pain improved progressively and laboratory results showed towards normal value and he was discharged on day twelveth. Conclusion. This case report showed the comprehensive diagnostic tool to yield out the aetiology of thoracal epidural collection, despite negative result. Keywords: Hyperuricemia, abcess, mid thoracic, dual energy, CT scan

The Knowledge of Lombok Praya-Indonesia Regional Community on the Safety Use of Medicinal Plants

The use of medicinal plants to maintain or overcome health problems has long been carried out by worldwide community. Along with the development of knowledge, data about the existence of undesirable effects or side effects associated with the use of medicinal plants that are not appropriate are obtained. This research is conducted to determine public knowledge about the safety several medicinal plants use. The study was conducted with a questionnaire technique in Lombok Praya, Indonesia. The results show that knowledge about the safety of the use of medicinal plants in breastfeeding mothers obtains the correct answer by 48%, knowledge about the parts of medicinal plants that are dangerous for consumption by 39% and knowledge about medicinal plants that can increase health risks by 21%. Whereas, the knowledges for the use of medicinal plants in pregnant women and the use of medicinal plants that are not right obtains very good results with correct answers of 79% and 81%. Based on further interviews, these good results are obtained because they are supported more by traditional use of the plant that has already existed in the area. Public understanding of the safety of some medicinal plants in Lombok Praya is still lacking. It is necessary to add knowledge about the use of medicinal plants that requires special attention, especially on plants that are often used by people in the area. Local health agencies need to disseminate information on the safety of medicinal plants that is wider and more sustainable. Keywords: Community, medicinal plant, safety, public understanding.

Predictive Refractive Error Post Congenital and Developmental Cataract Surgery

Cataract is one of the leading treatable causes of visual impairment in children. Visual rehabilitation is crucial for the development of good visual function after cataract surgery in children. The research aimd to describe post-operative Predictive Refractive Error (PRE) in congenital and developmental cataracts in Cicendo National Eye Hospital from January 2017 to December 2018. This is a retrospective analytic observational study from medical records. We found 107 eyes of 62 children with congenital and developmental cataracts had had cataract surgery and primary implantation of Intraocular Lens (IOL) in Pediatric Ophthalmology and Strabismus Unit, Cicendo National Eye Hospital. The patients were divided into two groups, with axial length (AXL) of ≤ 24 mm and > 24 mm. The paired t-test was used to compare Predictive Error (PE) in SRK/T, SRK II, and Showa SRK formula. Mean age at surgery was 6.7 ± 4.0 years. Ninety-five eyes had AXL ≤ 24 mm, and 12 eyes had AXL > 24 mm. Prediction Error from patients with AXL ≤ 24 mm was 0.29 D, and from patients with AXL > 24 mm was 2.40 D in SRK/T formula (P < 0.05). There was no significant difference between PE and Absolute Predictive Error (APE) in SRK/T, SRK II, and Showa SRK in patients with AXL > 24 mm (P > 0.05). SRK/T is the most predictable formula in patients with AXL ≤ 24 mm. There is no significant difference in patients with AXL > 24 mm in all formulas. Keywords: congenital and developmental cataract, axial length, Prediction Error, intraocular lens

Correlation between Hemoglobin Reticulocytes and Ferritin in Chronic Kidney Disease Patients Undergoing Hemodialysis at PKU Bantul

As many as 7 – 12% of the world's population has chronic kidney disease (CKD). CKD patients can experience various complications, one of which is anemia. Anemia can cause a variety of cardiovascular complications in CKD patients. Enforcement of the diagnosis of anemia and its type is carried out by laboratory examination, among others by examination of reticulocytes-hemoglobin (ret-he) and iron status such as serum ferritin. Examination of these parameters can help in planning the right treatment for CKD patients who have anemia. The purpose of this study was to determine the relationship of Ret-he with ferritin levels in CKD patients undergoing hemodialysis at PKU Bantul Hospital. This study used cross-sectional method. The data source used was secondary data obtained from medical records and the Indonesian Renal Registry (IRR). Sampling research used consecutive sampling method. The analysis used univariate analysis which was frequency distribution table, and bivariate analysis. Univariate analysis obtained that average levels of ret-he from 50 subjects was 28.87 ± 3.75 pg and median serum ferritin levels were 118,1 (9,76 – 1615) mL. Bivariate analysis with pearson correlation test found a significant correlation between serum ret-he and ferritin levels (r = 0.498, p = 0.000).There was a significant correlation between he-ret levels and serum ferritin levels Keywords: chronic kidney disease, anemia, reticulocytes-hemoglobin, serum ferritin.

Ethanol Extract of Areca Nuts was Able to Improve the Histopathological Features of P. Berghei-Induced Liver Damage in Mice

Adequate therapy is necessary to prevent further damage to the liver infected with Plasmodium sp. Areca catechu and curcumin have the potential for malaria therapy, and scientific evidence is required to examine such potential either alone or in combination. This experimental study used a posttest-only group design involving 24 male Swiss mice (Mus musculus) as the subjects divided into 6 groups (@4 mice). P. berghei was injected intraperitoneally in 5 groups, and different types of treatment (4 days, feeding tube) were administered to 4 groups (K1 = chloroquine, K3 = ethanol extract of Areca nuts + curcumin, K4 = ethanol extract of Areca nuts, K5 = curcumin). The doses were 0.012mg/kgBW of chloroquine, 150mg/kgBW of Areca nut ethanol extract, and 30mg/kgBW of curcumin. K2 was the unhealthy group (infected with P. berghei without therapy), while K6 was the normal/healthy group. Parasitemia was examined in 3 days after induction by P. berghei (inclusion criterion: parasitemia >5%, exclusion criterion: parasitemia >15%). The liver was embedded in paraffin blocks and stained with HE. Observations were made to identify the presence of necrosis, portal inflammation, and hemosiderin. The data of histopathological changes in the liver was expressed in percentages. The administration of Areca nut ethanol extract was able to provide better histopathological features than curcumin therapy alone, in combination, or chloroquine therapy (K4, no necrosis; mild portal inflammation = 50%, moderate = 25%; hemosiderin = 25%). Areca nut ethanol extract had yet to show histopathological features that resembled a healthy condition (K6 = normal inflammation, mild, moderate = 50%, 50%, 0%, respectively; hemosiderin = 0%). The ethanol extract of Areca nuts alone was shortly able to improve the histopathological features of P. berghei-induced liver damage in mice. Keywords: Areca nuts, Plasmodium berghei, histopathology of liver

Stabilization of the Interaction of the Compunds of Mallotus paniculatus Müll.Arg. on Gluthations S-Transferase (GSTs)

Gluthathione s-transferases (GSTs) play an important role against carcinogens, therapeutic drugs, and various types of cellular oxidative damage. Judging from its role in overcoming cellular oxidative damage, the activity of GSTs is one of the antioxidant enzymes. One of the plants that has been tested for its antioxidant ability is M. paniculatus. The content of M. paniculatus has been found so that it can be used to test the stability of the interaction between ligands and receptors. The aim of this research is to find compounds from M. paniculatus that have the potential to stabilize the interaction with the receptors. This docking method begins with ligand preparation and protein preparation followed by docking, visualization of interactions and analysis of the results. The research resulted in various docking scores with the various proteins involved. The stability of the interaction is obtained when the ligand binds to Glutathione S-transferase type A3 is hesperetin, sitosterol and sitosterol, to Glutathione S-transferase type theta-2 is β-daucostero, to Glutathione S-transferase type P is quercetin. Keywords: GSTs, M. paniculatus, docking

Correlation of Vitamin D with Ferritin in Pregnant Mothers Chronic Energy Deficiency of the Second Trimester

Based on the prevalence of the Kediri Health Office in 2013 and 2014, pregnancy in CED in Kediri was 6.6% and 6.7%, which was an increase of 0.1% from the previous year. According to the prevalence of CED pregnancy in Badas Puskesmas in 2013 and 2014, it was 7.8% and 6.1%. Aimed at knowing the differences in vitamin D levels in normal pregnancy with second trimester CED pregnancy; know the difference between ferritin in normal pregnancy and second trimester CED pregnancy; know the correlation between vitamin D and ferritin in normal pregnancy and second trimester CED pregnancy; know the correlation between vitamin D and UAC in normal pregnancy and second trimester CED pregnancy. This study used an analytical test (case-control) with randomization of pregnant and pregnant CED patients in the Sukomanunggal district. The results showed that the difference in Vitamin D (33.5380 ± 5.60498 vs 32.4300 ± 4.40708) p = 0.166, the comparison was not significant. The difference in ferritin (17.4080 ± 10.90625 vs 24.7420 ± 21.79586) p = 0.388 comparison was not significant. The correlation between vitamin D and ferritin (p = 0.030) had a significant relationship. There was no significant correlation between Vitamin D and UAC (p = 0.730). The correlation between ferritin and UAC (p = 0.304) was not significant. Keywords: Vitamin D, Iron, Ferritin, UAC, CEDAbstract: Based on the prevalence of the Kediri Health Office in 2013 and 2014, pregnancy in CED in Kediri was 6.6% and 6.7%, which was an increase of 0.1% from the previous year. According to the prevalence of CED pregnancy in Badas Puskesmas in 2013 and 2014, it was 7.8% and 6.1%. Aimed at knowing the differences in vitamin D levels in normal pregnancy with second trimester CED pregnancy; know the difference between ferritin in normal pregnancy and second trimester CED pregnancy; know the correlation between vitamin D and ferritin in normal pregnancy and second trimester CED pregnancy; know the correlation between vitamin D and UAC in normal pregnancy and second trimester CED pregnancy. This study used an analytical test (case-control) with randomization of pregnant and pregnant CED patients in the Sukomanunggal district. The results showed that the difference in Vitamin D (33.5380 ± 5.60498 vs 32.4300 ± 4.40708) p = 0.166, the comparison was not significant. The difference in ferritin (17.4080 ± 10.90625 vs 24.7420 ± 21.79586) p = 0.388 comparison was not significant. The correlation between vitamin D and ferritin (p = 0.030) had a significant relationship. There was no significant correlation between Vitamin D and UAC (p = 0.730). The correlation between ferritin and UAC (p = 0.304) was not significant. Keywords: Vitamin D, Iron, Ferritin, UAC, CED