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Survei Pengetahuan Dokter Spesialis terhadap Penggunaan Opiat pada Tatalaksana Nyeri Kanker di Rumah Sakit Pemerintah, Jakarta, 2017 INDRAYANI, LENNY; SETIABUDY, RIANTO; SOETIKNO, VIVIAN; IRAWAN, COSPHIADY
Indonesian Journal of Cancer Vol 11, No 4 (2017): October- December 2017
Publisher : Indonesian Journal of Cancer

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1097.236 KB)

Abstract

Treatment of cancer pain often requires opioids, and morphine is a gold standard in the management of severe cancer pain. Inadequate knowledge of cancer pain management causes opioid usage is not optimal. Indonesia is one of the countries with very low opioid consumption. The purpose of this study was to find out the physician’s knowledge about the management of cancer pain in choosing opioid, administration, doses, side effects, addiction and factors of opioid that barrier in pain management. This cross-sectional study was conducted in General Hospital Jakarta and a Private Hospital in Tangerang. Inclusion criteria were medical specialist who treating cancer pain. This study used questionnaires that filled out by respondents and confidential. Score of adequate knowledge was ≥ 70, and to assess the relationship between knowledge of opioid use with specialization analyzed by Chi-square test and Fisher’s exact if Chi-square requirement is not fulfilled. Statistical analysis was performed by SPSS version 20. From a total of 146 distributed questionnaires, we received 103 questionnaires (70,5%). In this study, the majority of respondents (69,9%) had inadequate knowledge. The highest rate (70,55) was found in the choosing opioid section, while the lowest rate (49,5) was found in the opioid side effects section. There is no significant relationship between physician knowledge on opioid usage and specialization (P= 0,355). Government regulation is major obstacle to opioid use, followed by lack of training, drug availability and knowledge of side effects ABSTRAK Penatalaksanaan nyeri kanker sering kali membutuhkan opiat dengan morfin sebagai gold standard menurut panduan WHO analgesic step ladder . Pengetahuan penalaksanaan nyeri kanker yang kurang menyebabkan penggunaan opiat yang tidak optimal. Indonesia merupakan salah satu negara dengan konsumsi opiat yang sangat rendah. Tujuan studi ini adalah untuk mengetahui pengetahuan dokter mengenai penanganan nyeri kanker dalam pemilihan opiat, cara pemberian, dosis, efek samping, dan adanya adiksi, serta faktor-faktor yang menjadi penghambat pada penanganan nyeri kanker. Desain penelitian ini merupakan survei potong lintang ( cross sectional ) yang dilakukan terhadap dokter spesialis yang menangani nyeri kanker di Rumah Sakit Umum Pemerintah Jakarta dan salah satu rumah sakit swasta di Tangerang. Penelitian ini menggunakan kuesioner yang diisi responden dan bersifat rahasia. Pengetahuan dianggap baik bila nilai ≥ 70. Sedangkan untuk menilai hubungan antara pengetahuan tentang penggunaan opiat dengan bidang spesialisasi dokter dianalisis dengan uji Chi-square . Hasil statistik dianalisis dengan menggunakan SPSS versi 20. Dari total 146 kuesioner yang didistribusikan, didapatkan 103 kuesioner (70,5%) yang direspons. Pada penelitian ini, mayoritas responden (69,9%) mempunyai pengetahuan yang tidak adekuat. Rerata tertinggi didapatkan pada bagian pemilihan opiat 70,55; sedangkan rerata terendah didapatkan pada bagian efek samping opiat, yaitu 47,56. Tidak terdapat hubungan bermakna antara pengetahuan dokter tentang penggunaan opiat dengan bidang spesialisasi (P= KORESPONDENSI: Lenny Indrayani Departemen Farmakologi dan Terapeutik, Universitas Indonesia. Email: lenny3ma@gmail.com Indonesian Journal of Cancer Vol. 11, No. 4 October - December 2017160 0,355). Regulasi pemerintah merupakan penghambat utama pada penggunaan opiat, disusul dengan kurangnya pelatihan, ketersediaan obat dan pengetahuan tentang efek samping.
Molecular Adaptation of Cardiac Remodeling in Metabolic Syndrome: Focus on AMPK, SIRT1 and PGC-1a Ramadhan, Andika Yusuf; Soetikno, Vivian
Molecular and Cellular Biomedical Sciences Vol 8, No 1 (2024)
Publisher : Cell and BioPharmaceutical Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21705/mcbs.v8i1.367

Abstract

Obesity, lack of physical activity, and genetic predisposition might play a pivotal role in pathogenesis of metabolic syndrome. Cardiac function alteration including hemodynamic changes, contractility function, arrhythmia, and cellular respiratory function, might happen due to chronic condition in metabolic syndrome. Insulin resistance, neurohormonal activation and chronic inflammation might contribute to these changes. Cardiomyocyte had capabilities to adapt from these abnormalities, one of them is the activation of cellular pathway to resist cardiac injury from metabolic syndrome. This molecular pathway involves three proteins, including AMP-activated protein kinase (AMPK), sirtuin-1 (SIRT1) and peroxisome proliferator-activated receptor γ coactivator-α (PGC-1α). The aim of this narrative review is to elucidate role of AMPK, SIRT1, and PGC-1α in cardiac adaptation against cardiac dysfunction in metabolic syndrome. AMPK, SIRT-1, and PGC-1α contribute to adapt and to repair the cardiac injury resulting from celullar and mechanical stress from metabolic syndrome and prevent cardiac remodeling event. Several pathological events, such as insulin resistance, induce alteration of switching energy fuel to the heart, causing cardiomyocte to rely on glucose metabolism and lipotoxicity, leading to damages of cardiomyocyte through reactive oxygen species (ROS) generation and lipid peroxidation. Increase of ROS promotes cardiac injury followed by necrotic and apoptotic events. AMPK, SIRT1, and PGC-1α act as cardioprotector molecule against metabolic syndrome insults to several mechanism such as: AMPK play role as counter act of lipotoxicity and insulin resistance through increasing insulin sensitivity and regulate redox reaction. SIRT1 plays role in regulating apoptotic genes and PGC-1α repairs cardiac fuel sources. Activation of AMPK/SIRT1/PGC-1α prevent cardiac remodeling due to metabolic syndrome by increasing insulin sensitivity, increases mitochondrial biogenesis and reduce pro-apoptotic signals in cardiomyocte.Keywords: AMPK/SIRT1/PGC-α, cardiac remodeling, metabolic syndrome
6-Gingerol Slightly Reduces Hepatic Endoplasmic Reticulum Stress Markers in Rats with High-Fat, High-Fructose Diet-Induced Metabolic Syndrome Ahmad, Nouman; Syarifah Dewi; Soetikno, Vivian
EKSAKTA: Berkala Ilmiah Bidang MIPA Vol. 26 No. 01 (2025): Eksakta : Berkala Ilmiah Bidang MIPA (E-ISSN : 2549-7464)
Publisher : Faculty of Mathematics and Natural Sciences (FMIPA), Universitas Negeri Padang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24036/eksakta/vol26-iss01/581

Abstract

Metabolic syndrome (MetS) is linked to hepatic endoplasmic reticulum (ER) stress. This study evaluated 6-gingerol’s potential to alleviate ER stress in a high-fat high-fructose (HFHF)-induced MetS rat model. Male Sprague-Dawley rats (8 weeks, 180–220 g) were assigned to five groups: Normal, HFHF, and HFHF with 6-gingerol (50, 100, or 200 mg/kg). The Normal group received a standard diet, while others had HFHF for 16 weeks. From Week 8, intervention groups received 6-gingerol daily. Except for Normal, other groups also received Streptozotocin (22mg/kg, i.p.) at Week 8. At Week 16, rats were euthanized, and liver tissues collected to assess ER stress markers (GRP78, IRE1, TRAF2, PERK, CHOP) via qPCR and apoptotic markers (Bax, Bcl-2) via ELISA. 6-Gingerol slightly reduced liver ER stress markers, including GRP78 (P=0.392), CHOP (P=0.798), IRE1 (P=0.419), TRAF2 (P=0.470), and PERK (P=0.357), but these changes were not significant. Similarly, apoptotic markers Bax and Bcl-2 showed no significant differences, though the Bax/Bcl-2 ratio decreased (P=0.186). These results indicate that 6-gingerol had only a slight effect on ER stress and apoptosis within the parameters of this experiment.
Evaluation of potential drug-drug interactions in stage 5 chronic kidney disease patients on routine hemodialysis at Dr. Cipto Mangunkusumo General Hospital, Jakarta Ulfa, Nusmirna; Soetikno, Vivian; Hustrini, Ni Made
Indonesian Journal of Pharmacology and Therapy Vol 6 No 2 (2025)
Publisher : Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada and Indonesian Pharmacologist Association or Ikatan Farmakologi Indonesia (IKAFARI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijpther.19437

Abstract

Patients with chronic kidney disease (CKD) face heightened susceptibility to adverse drug reactions (ADRs) owing to alterations in the pharmacokinetics and pharmacodynamics of medications. Patients with Stage 5 CKD receiving hemodialysis (HD) have numerous medications that are eliminated during the HD process. This study aims to assess the prescribing patterns in stage 5 CKD patients undergoing routine HD and their association with drug-drug interactions (DDIs) and the potential for adverse drug reactions (ADRs) resulting from DDIs. This cross-sectional study encompassed stage 5 CKD patients undergoing routine HD at Dr. Cipto Mangunkusumo General Hospital from 2020 to 2021. Data were obtained from the medical records of the HD Unit. An evaluation was performed utilizing the Lexicomp software to discover DDIs. The study had 147 individuals, with 101 different medications taken, the most prevalent being epoetin alfa (70.4%). Eighty nine percent of patients who underwent treatment associated with a potential DDIs, with the bulk of these interactions classified as moderate (88%). Fifty percent of patients were suspected of experiencing ADRs due to DDIs. Diabetes mellitus exhibited a statistically significant association with suspected ADRs attributable to DDIs (p = 0.04). Hypertension was the most predicted ADR resulting from DDIs, and diabetes mellitus significantly contributed to the incidence of ADRs owing to DDIs in patients with stage 5 CKD on routine HD. In conclusion, DDI in patients undergoing routine HD is sometimes unavoidable considering the many comorbidities. The DDI that occurred was moderate in severity and could be managed well at the Dr. Cipto Mangukusumo General Hospital.
Antiviral Properties and Potential of Ginger (Zingiber Officinale) and Its Derivatives: A Systematic Review Ahmad, Nouman; Ahmad, Hamdan; Dewi Syarifah; Vivian Soetikno
Science Education and Application Journal Vol 7 No 2 (2025): Science Education and Application Journal
Publisher : Program Studi Pendidikan IPA, Universitas Islam Lamongan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30736/seaj.v7i2.1205

Abstract

Antiviral Properties and Potential of Ginger (Zingiber Officinale) and Its Derivatives: A Systematic Review. Ginger has long been valued in traditional medicine for its therapeutic benefits. Recently, its antiviral capabilities have attracted significant interest, highlighting its potential as a natural antiviral agent. This systematic review seeks to thoroughly evaluate the antiviral effects of ginger and its active compounds, providing valuable insights to support future research and clinical applications in natural antiviral therapies. A comprehensive electronic search was undertaken across PubMed, Embase, and Scopus databases, employing MeSH terms, Emtree, and relevant synonyms to capture studies on ginger and its antiviral effects. The initial search yielded 531 records, which were de-duplicated and subsequently screened by title and abstract using Rayyan software. Fourteen studies specifically addressing antiviral effects against human pathogens met the inclusion criteria. This systematic review was conducted in strict accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure rigorous reporting of findings. The majority of included studies were in vitro, revealing anti-viral effects of ginger against various viruses, including Influenza A, Chikungunya, Dengue, hRSV, HSV-2, and SARS-CoV-2 in different cell lines across various concentrations. In addition, Ginger extracts also demonstrated efficacy against Influenza A in both in vivo and in ovo studies, and a randomized controlled trial showcased encouraging antiviral effects targeting SARS-CoV-2. Ginger shows promising antiviral effects in most of the in vitro studies. Translating these findings to in vivo models is imperative for clinical relevance. Further in vivo research is essential before progressing to human studies to ascertain ginger's potential as an effective antiviral agent
Iron-Overload Conditions: Manifestations to the Kidney Organs – A Review Heriatmo, Nadia Larasinta; Estuningtyas, Ari; Soetikno, Vivian
Borneo Journal of Pharmacy Vol. 6 No. 4 (2023): Borneo Journal of Pharmacy
Publisher : Institute for Research and Community Services Universitas Muhammadiyah Palangkaraya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33084/bjop.v6i4.4411

Abstract

Excess iron is a risk factor for organ dysfunction and damage resulting in various organ diseases such as liver, heart, and kidney, diabetes mellitus, and neurodegenerative diseases. Iron overload in some individuals is caused by various factors, including genetic predisposition such as genetic hemochromatosis, repeated transfusion of red blood cells, and parenteral iron administration in conditions of transfusion-dependent anemia. A disturbance in the globin gene in diseases such as β-thalassemia major causes an imbalance of the globin chain, resulting in chronic anemia in the sufferer. It has been reported that the human body does not have a mechanism for eliminating excess iron levels. Routine transfusion has become a solution to overcome chronic anemia so that patients can maintain hemoglobin levels, and the result of this transfusion repetition is the accumulation of iron in various organs, such as the heart, liver, endocrine glands, pancreas, lungs, and kidneys. Excess iron can be toxic to the body due to the formation of harmful free radicals that can damage cells and tissues. An increase in excessive ROS can result in the saturation of the antioxidant system. The presence of free radicals can lead to damage and the occurrence of filtration dysfunction in the glomerulus.
Cardioprotective Effect of Quercetin in 5/6-Nephrectomized Rats: Focus on Myocardial fibrosis and Oxidative Stress Yuliani, Tri; Louisa, Melva; Arozal, Wawaimuli; Soetikno, Vivian; Nafrialdi, Nafrialdi; Dewijanti, Indah D
Jurnal Jamu Indonesia Vol. 2 No. 3 (2017): Jurnal Jamu Indonesia
Publisher : Tropical Biopharmaca Research Center, IPB University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29244/jji.v2i3.37

Abstract

Uremic cardiomyopathy is the leading cause of death in patients with chronic kidney disease. Fluid overload and oxidative stress play important roles in its pathogenesis. This study aims to determine the effect of quercetin on uremic cardiomyopathy in 5/6-nephrectomized rats. To our knowledge, its cardioprotective effect on uremic cardiomyopathy induced in rats by 5/6 nephrectomy has not been investigated yet. Uremia was induced surgically in male Sprague-Dawley rats via 5/6 nephrectomy. Quercetin was administered per orally at a dose of 100 mg/kg/day for 8 weeks prior to sacrifice. Meanwhile, captopril was administered at a dose of 10 mg/kg/day. Lipid peroxidation was assessed using TBARS reaction, while GPX activity was determined to explore the endogen antioxidant mechanism. Myocardial fibrosis was analyzed using Massons’ Trichrome staining and the level of NT-proBNP in plasma was measured as a marker of cardiac dysfunction. Nephrectomy 5/6 had no effects on plasma NT– proBNP levels, cardiac and plasma MDA levels, but induced mild myocardial fibrosis and significant increase in cardiac GPX activity in comparison with normal rat (p<0.05). However, administration of quercetin or captopril did not ameleriote those mild myocardial fibrosis and increased GPX activity. Uremic cardiomyopathy induced by 5/6 nephrectomy demonstrated mild myocardial fibrosis but preservation of cardiac function demonstrated by NT-proBNP levels. Increased of GPX activity in the nephrectomized-rats compared to the control rats (p<0.05) suggests induction of antioxidant defense mechanisms that might not be exhausted yet. This condition highlighted a compensatory phase which was unchanged following chronic administration of either quercetin or captopril.