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Analisa Klaim JKN Rawat Inap di RS Universitas Indonesia Tahun 2023 Hardiyanti, Widya; Bachtiar, Adang
Jurnal Ilmiah Kesehatan Vol 16 No 1 (2024): Jurnal Ilmiah Kesehatan
Publisher : Universitas Mohammad Husni Thamrin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37012/jik.v16i1.2181

Abstract

Rumah Sakit Universitas Indonesia sudah bekerja sama dengan BPJS Kesehatan cabang Depok sejak akhir tahun 2020. Selama bekerja sama dengan BPJS Kesehatan jumlah pasien yang dirawat semakin meningkat, terutama di tahun 2023 jumlah pasien rawat inap di akhir tahun meningkat 71% dibandingkan dengan di awal tahun 2023, dan nilai BOR (Bed Occupancy Ratio) mencapai 76,2%. Dengan meningkatnya jumlah pasien rawat inap JKN ini memerlukan adanya strategi untuk melakukan kendali mutu kendali biaya agar pelayanan yang diberikan bisa efektif dan efisien. Metode penelitian ini menggunakan metode kualitatif studi kasus dengan analisa data primer dari data klaim JKN tahun 2023. Berdasarkan data klaim tahun 2023, total pasien rawat inap JKN di RS Universitas Indonesia mencapai 9.819 pasien dengan selisih antara tarif INA CBGs dengan tarif RS sebesar 23%. Kasus rawat inap terbanyak yaitu Penyakit Dalam, Anak, Bedah Mulut, Syaraf, dan Jantung. Dari kelima kasus terbanyak tersebut dianalisa berdasarkan komponen tarifnya, dan yang menduduki komposisi tarif terbanyak dari kelima kasus tersebut adalah kamar akomodasi disusul kemudian obat dan bmhp. Dengan tingginya tarif kamar dan penggunaan obat serta BMHP, maka strategi untuk mengefisienkan biaya adalah dengan memperpendek lama rawat (LOS) dan efisiensi penggunaan obat serta BMHP.
A fruit fly-based approach to unraveling enteropathy-causing pharmaceuticals Pratama, Muhammad R.; Wahyudin, Elly; Putri, Tenri ZAD.; Hardiyanti, Widya; Fatiah, Dewita; Chaeratunnisa, Rizkya; Bapulo, Nurdewi N.; Latada, Nadila P.; Mudjahid, Mukarram; Nainu, Firzan
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.898

Abstract

Enteropathy is a gastrointestinal disorder characterized by inflammation in the small intestine and one of the causes of enteropathy is the side effects of certain drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs). The mechanism of NSAIDs, such as indomethacin, could inhibit prostaglandin synthesis, leading to a decrease in mucus production and small intestine integrity. To test the effects of a drug, it is necessary to undergo preclinical testing using animal models. Commonly used animal models such as mice and rats have several drawbacks including high cost, ethical issues, and long lifespan. Therefore, alternatives such as using invertebrate animals like Drosophila melanogaster as a more economical in vivo platform with genetic similarity to mammals and devoid of ethical concerns are needed. The aim of this study was to evaluate Drosophila melanogaster as an in vivo model organism in testing the side effects of pharmaceuticals that cause enteropathy. In this study, flies aged 3–5 days were starved and then placed into treatment vials comprising untreated control and indomethacin-treated (3.75 mM, 7.5 mM, and 15 mM). Survival analysis was conducted during the treatment period, followed by a Smurf assay test after seven days of treatment. Subsequently, the expression of pro-inflammatory cytokine-related genes (drs and totA), mitochondria stability-related genes (tom40), and endogenous antioxidant-related genes (sod1, sod2, and cat) was performed using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Our data indicated that indomethacin did not impact lifespan or cause intestinal damage. However, we observed increased expression of pro-inflammatory cytokine-related genes, including drs, and a twofold increase in totA gene expression. Furthermore, there was a significant upregulation of mitochondrial stability gene tom40, endogenous antioxidant genes sod1 and cat, and a threefold increase in sod2 at 15 mM indomethacin. Although no phenotypical changes in gut integrity were detected, the increased expression of pro-inflammatory cytokine genes suggests the occurrence of inflammation in the indomethacin-treated flies.
Undernutrition-induced stunting-like phenotype in Drosophila melanogaster Putri, Tenri ZAD.; Wahyudin, Elly; Pratama, Muhammad R.; Fatiah, Dewita; Hardiyanti, Widya; Chaeratunnisa, Rizkya; Latada, Nadila P.; Fatmawati, Fatmawati; Mudjahid, Mukarram; Nainu, Firzan
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.999

Abstract

Stunting resulting from undernutrition is a significant global health challenge, particularly in developing countries, yet its underlying mechanisms and consequences remain inadequately understood. This study utilizes Drosophila melanogaster as an in vivo model to investigate the molecular basis of stunting. Due to the conserved nature of signaling pathways between Drosophila and vertebrates, this organism serves as an effective model for studying growth disorders. The aim of this study was to establish a Drosophila model exhibiting a stunting-like phenotype and to elucidate the molecular mechanisms underlying this condition. The stunting phenotype was induced through dietary manipulation, involving a standard nutrient-rich diet (100%) and treatment diets with reduced concentrations of sucrose, glucose, yeast, and cornmeal at 50%, 25%, and 12.5%. Phenotypic assessments included measurements of larval body size, fecundity, survival rates, and locomotor activity, alongside molecular analyses of gene expression related to metabolism, cell proliferation, and survival, using RT-qPCR. Results demonstrated that undernutrition profoundly affected D. melanogaster, causing growth retardation, reduced larval body size, diminished fecundity, and lower survival rates, though locomotor function remained unaffected. Molecular analysis revealed a significant decrease in the expression of the totA gene and notable increases in the expression of dilp5, srl, and indy genes, with no significant changes observed in the expression of the pepck gene. These findings indicate that undernutrition induces a stunting-like phenotype, likely driven by alterations in the expression of genes associated with metabolism, cell proliferation, and survival. Overall, this study establishes D. melanogaster as a valuable in vivo model for studying stunting-like phenotypes resulting from nutritional deficiencies and provides insights into the molecular pathways involved in growth impairment.
Chemical fingerprinting and antioxidant properties of Glochidion philippicum Khairuddin, Khairuddin; Manggau, Marianti A.; Rante, Herlina; Hardiyanti, Widya; Latada, Nadila P.; Umar, Abdul H.; Nur, Syamsu; Wahyudin, Elly; Rahman, Latifah; Yulianty, Risfah; Nainu, Firzan
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1886

Abstract

Glochidion philippicum has been suggested to exhibit considerable pharmacological potential, yet its chemical composition and bioactivity remain inadequately explored. The aim of this study was to investigate the chemical fingerprint and antioxidant properties of G. philippicum leaf extracts using Fourier-transform infrared spectroscopy (FTIR) with chemometric analyses, and in vitro and in vivo evaluations. Four extraction methods (maceration, reflux, ultrasound-assisted extraction (UAE), and microwave-assisted extraction (MAE)) were optimized with water, 70% ethanol, ethyl acetate, and n-hexane as solvents. FTIR profiles were analyzed with principal component analysis (PCA), hierarchical cluster analysis, and orthogonal partial least squares discriminant analysis. An in vitro study assessing the free radical scavenging capacity was conducted using the 2,2'-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), 2,2-diphenyl-1-picrylhydrazyl (DPPH), and ferric-reducing antioxidant power (FRAP) methods, while in vivo evaluations were conducted using Drosophila melanogaster to measure antioxidant enzyme activity and expression of endogenous antioxidant-related genes. FTIR profiles identified functional groups contributing to antioxidant activity. In vitro assays using ABTS and FRAP methods revealed that extracts obtained with 70% ethanol and water exhibited the highest antioxidant activity, attributed to key functional groups such as C=C (aromatic), O−H (acidic), N=O (nitro), and C−O (ester). In vivo studies showed that ethanol-based MAE extracts (MAEEO) significantly improved the survival of autoinflammatory PGRP-LBΔ mutant larvae exposed to heat-killed Escherichia coli. Real-time quantitative PCR analysis indicated this effect was dependent on endogenous antioxidant gene activation. The study highlights that G. philippicum leaf extracts as a natural source of bioactive compounds with exogenous antioxidant properties, offering potential for therapeutic applications.
Dual effects of Camellia sinensis and Andrographis paniculata on hyperglycemia and infection in Drosophila Nainu, Firzan; Sartini, Sartini; Subehan, Subehan; Sari, Dwi K.; Bahar, Muhammad A.; Mudjahid, Mukarram; Latada, Nadila P.; Asbah, Asbah; Hardiyanti, Widya; Pratama, Muhammad R.; Suhenro, Suhenro
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1972

Abstract

The coexistence of hyperglycemia and infectious diseases represents a critical global health challenge, particularly in resource-limited settings where it amplifies disease severity and complicates treatment approaches. Medicinal plants such as Camellia sinensis and Andrographis paniculata have gained recognition for their antioxidant, anti-inflammatory, and antimicrobial properties, making them promising candidates for addressing this double health burden. The aim of this study was to establish a preclinical model of hyperglycemia and infection (HI model) using Drosophila melanogaster and to investigate the therapeutic potential of C. sinensis and A. paniculata extracts in alleviating the burden associated with the HI condition. In this study, the HI model was established by simultaneously exposing D. melanogaster larvae to a high-concentration sucrose solution and Staphylococcus aureus for 24 hours. The larvae were then transferred to a high-sucrose diet supplemented with C. sinensis or A. paniculata extracts. Survival assays and molecular analyses were subsequently performed to evaluate the outcomes. Our findings revealed that the combination of hyperglycemia and infection significantly reduced survival rates in the Drosophila model. However, treatment with 1.25% C. sinensis and A. paniculata extracts notably improved survival, attributed to their antibacterial activity and regulation of key molecular pathways involved in immune responses, metabolic balance, and endogenous antioxidant defenses. These findings validate the utility of D. melanogaster as a model organism for investigating the double burden of HI. Furthermore, the study offers compelling evidence of the dual therapeutic potential of C. sinensis and A. paniculata in mitigating the detrimental effects of this condition. Overall, this research underscores the significant promise of plant-derived compounds in managing HI and paves the way for future studies to explore their underlying mechanisms and potential clinical applications.