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All Journal Paediatrica Indonesiana Majalah Kesehatan Pharmamedika Health Information : Jurnal Penelitian Jurnal Penyakit Dalam Indonesia
Sarwono Waspadji
Department of Internal Medicine, Universitas Indonesia Faculty of Medicine, Jakarta.
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

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Clinical Picture and Microbiological Pattern in 3rd and 4th Degrees of the Pedis Classification of Diabetic Foot Infection Sumarjo, Kusmardi; Waspadji, Sarwono; Sosrosumihardjo, Rustadi; Suhendro, Suhendro
Majalah Kesehatan Pharmamedika Vol 10, No 1 (2018): JUNI 2018
Publisher : Lembaga Penelitian Universitas YARSI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33476/mkp.v10i1.683

Abstract

Diabetic foot infection (DFI) is one complication of diabetes mellitus that has high morbidityand mortality. The success of management of DFI is influenced by many factor. This study aimed to recognize clinical picture and microbiological pattern in 3rd and 4th degrees of the PEDIS classification. The design was a prospective cross-sectional study conducted in RSCM at March until May 2005. The clinical pictures in 52 DFI’pateints were included to the PEDIS classification with the wound’s odour and crepitation. Microbiological examination was done culture for microorganisms and the antibiotiks sensitivity test. The female were greate (55,8%) than male the greatest age group were at 51-60 years old (44,2%). Poorly controlled blood glucose was found in 88%, duration of wound 2 weeks in 56%, wound without critical-limb ischaemia in 81% with wound size 25 cm2 in 58%, with bottom of wound had reached tendons in 75%. Most of the patiens undergroune sepsis (65%), diabetic neouropathy (77%), with odour distance of ≥1 m (65%), and crepitation/gas (63%). We found 96 types of microorganism, of which the greatest number was: E.coli 17,7% with highest sensitivity towards cefepime; S.aureus 15,6% towards co-amoxyclav; Bacteroides spp 4,2% towards co-amoxyclav, sultamicillin and metronidazole.
The Changes of Amino Terminal Pro B-type Natriuretic Peptide(NT-proBNP) Concentration and Left Ventricular EjectionFraction on Doxorubicin Chemotherapy Patients Kamelia, Telly; Waspadji, Sarwono; Makmun, Lukman Hakim; Effendi, Shufrie; Ramli, Muchlis; Timan, Ina Susanti
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 2
Publisher : UI Scholars Hub

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Abstract

Introduction. Cancer patients who received chemotherapy regimen containing doxorubicin has been known to have serious side effect in heart, called as cardiotoxicity. The measurement of NT-proBNP proposed to be used as a new parameter to identify and evaluate cardiotoxicity in cancer patients earlier before it has been manifested, superior than measurement of left ventricle ejection fraction (LVEF). The aims of this study to examine the changes of NT-proBNP concentration and LVEF on patients with cancer who receive chemotherapy regimen containing doxorubicin. Methods. The study used pre and post test design to observe the changes of NT-proBNP concentration and LVEF on the patients who receive naïve doxorubicin chemotherapy and after chemotherapy-cycle I to cyce IV at the Ciptomangunkusumo hospital, Jakarta. Echocardiography and NT-proBNP were examined on naïve chemotherapy and after chemotherapy each cycle. Statistical analysis was performed by using two way Anova and Friedman nonparametric test. Results. During the period of October 2007 to June 2008, a total of 29 consecutive patiets receiving doxorubicin chemotherapy regimen CHOP (Cyclophosphamide, doxorubicin, Vincristine, Prednisone and FAC-5 Fluorouracil, doxorubicin, Cyclophosphamide) were collected. The increase of median NT-proBNP concentration between naïve chemotherapy and: post chemotherapy cycle I was 32 pg/mL (12,5-124,6 pg/mL), post chemotherapy cycle II was 135 pg/mL (44-275,2 pg/mL), post chemotherapy cycle III was 275,1 pg/mL (97,8-907,2 pg/mL), post chemotherapy cycle IV was 514,6 pg/mL (80,6-6458,2 pg/mL). With Friedman test, p< 0,000. With Anova two way test, it was found the difference between naïve LVEF and LVEF: post chemotherapy cycle I was 5,1% (p 0,000), post chemotherapy cycle II 8,9% (p 0,000), post chemotherapy cycle III 11,2% (p 0,000), post chemotherapy cycle IV 12,5% (p 0,000). Conclusions. Elevated NT-proBNP concentration and LVEF reduction had been observed in doxorubicin chemotherapy patients.
Perubahan Kendali Glikemik dan Plasminogen Activator Inhibitor-1 (PAI-1) pada Penyandang Diabetes Melitus Tipe-2 yang Berpuasa Ramadhan di RSUPN Cipto Mangunkusumo Khomimah, Khomimah; Waspadji, Sarwono; Yunir, Em; Abdullah, Murdani
Jurnal Penyakit Dalam Indonesia Vol. 1, No. 1
Publisher : UI Scholars Hub

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Abstract

Pendahuluan: Penyandang diabetes melitus (DM) mempunyai risiko tinggi mengalami penyakit kardiovaskular (PKV), yang progresivitasnya dipercepat oleh penurunan kapasitas fibrinolisis. Penyandang DM yang berpuasa Ramadhan mengalami berbagai perubahan yang dapat memengaruhi kendali glikemik dan status fibrinolisisnya. Penelitian ini bertujuan mengetahui penurunan fruktosamin dan plasminogen activator inhibitor-1 (PAI-1). Metode: Penelitian dikerjakan dengan metode kuasi eksperimental one group design self control study pada penyandang DM tipe-2 yang berpuasa Ramadhan dan berusia 40-60 tahun. Hasil: Penelitian ini menunjukkan sebagian besar subjek memiliki 3 faktor risiko PKV dan dengan kendali glikemik yang jelek sebelum puasa Ramadhan. Terdapat penurunan yang bermakna pada glukosa puasa plasma, tetapi tidak bermakna pada glukosa darah 2 jam setelah makan. Tidak terdapat perbedaan asupan kalori pada 18 subjek yang dianalisis. Tidak didapatkan penurunan yang bermakna pada fruktosamin serum maupun PAI-1 plasma. Kendali glikemik yang dicapai sebelum dan asupan kalori selama berpuasa Ramadhan kemungkinan merupakan faktor yang memengaruhi penurunan fruktosamin. Selain glukosa darah, faktor yang memengaruhi kadar PAI-1 plasma di antaranya adalah insulin plasma, angiotensin II, faktor pertumbuhan dan inflamasi, yang tidak diukur dalam penelitian ini. Simpulan: Tidak terdapat penurunan kadar fruktosamin serum sesudah berpuasa Ramadhan lebih dari sama dengan 21 hari pada penyandang DM tipe-2. Tidak terdapat penurunan kadar plasminogen activator inhibitor-1 (PAI-1) plasma sesudah berpuasa Ramadhan lebih dari sama dengan 21 hari pada penyandang DM tipe-2.
Zinc supplementation on cellular immune response in splenectomized thalassemia major Sari, Teny Tjitra; Gatot, Djajadiman; Akib, Arwin AP; Waspadji, Sarwono; Hadinegoro, Sri Rezeki S; Harahap, Alida Roswita; Idjradinata, Ponpon S
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.145-51

Abstract

Background: The immune response of thalassemia patients is different from usual; therefore, thalassemia patients are susceptible to infection. A study at Thalassemia Center in Cipto Mangunkusumo Hospital showed that all thalassemia patients experience zinc deficiency. The decreased cellular immune response is associated with zinc deficiency, whereas splenectomy exacerbates the condition. This study aims to evaluate the improvement of cellular immune response in splenectomized thalassemia major patients after zinc supplementation. Method: Randomized double-blinded controlled trial was conducted on splenectomized thalassemia major patients in 12 weeks period. The inclusion criteria were aged > 12 years and had negative HIV test results. The subject receiving corticosteroids were excluded. Fifty-six subjects were randomly divided into two groups, the zinc group and the placebo group. Between 2 groups, data on zinc serum, T lymphocyte count, CD4+ T lymphocyte count, CD8+ T lymphocyte count, and CD4+/CD8+ ratio were evaluated at the beginning and the end of the study and were analyzed with unpaired t-test, Mann Whitney test, and Wilcoxon Signed Rank test. Result: After zinc supplementation, only 18 of 28 subjects in the zinc group recovered normal zinc serum levels. There were no significant changes after zinc supplementation in all parameters of cellular immune response (p > 0.05) between the two groups. This might be due to the subjects' adherence, which was lower in the zinc group (75.82%) than in the placebo group (83.19%). Conclusion: The effect of zinc supplementation on cellular immune response in splenectomized thalassemia major patients had not been proven yet.
Analysis of Medication, Cost, and Clinical Outcome of Human and Analogue Insulins of Type 2 Diabetes Mellitus at MMC Hospital 2016-2017 Jayati, Turpuk Mannaria; Anggriani, Yusi; Laksmitawati, Dian Ratih; Waspadji, Sarwono
Health Information : Jurnal Penelitian Vol 13 No 2 (2021): Juli-Desember
Publisher : Poltekkes Kemenkes Kendari

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36990/hijp.v13i2.273

Abstract

Human insulin and analog insulin are available at RS.MMC. The use of analog insulin was more prevalent among doctors between 2016 and 2017. The data collection was conducted retrospectively, taking samples of 132 outpatients type 2 DM using insulin, of which 74 were evaluated for their clinical outcome. The study's goal is to provide information for developing insulin usage guidelines. The medication profile data were collected from the medicine administration at the Hospital Pharmacy Installation. The clinical outcome data, such as fasting plasma glucose (FPG), two-hour postprandial plasma glucose (2HPP), and Hemoglobin A1c (HbA1c), were garnered from the patients’ medical records. The cost data were collected from the outpatients’ payment receipts provided by the Hospital’s Financial Department. Kolmogorov Smirnov normality test was applied in this research. Statistical trials of differences in clinical outcomes and costs using the Kruskal-Wallis test, showed there was a significant difference between human insulin and insulin analogues in terms of clinical outcomes of GDP, GDPP, HbA1c, and cost after follow-up testing with Mann Whitney, showed average cost of using human insulin for 30 days was Rp1,597,066, and analogue was Rp2,497,535 shows that human insulin and analogues differ significantly in terms of cost (p = 0.015).
Co-Authors A. M. Rahman A.A. Ketut Agung Cahyawan W Adang Bachtiar Ali I. Mukhsin Andi A. Victor Anwar Jusuf Arifin Suyardi Arman A. Abdullah Arwin AP Akib, Arwin AP Asman B. Ranakusuma Bambang Sutrisna Bastaman Basuki Budhi Setianto Chairil Hamdani Cholid Badril Christopher S. Suwita Dante S. Harbuwono Dasnan Ismail David H. Garabrant DEDDY MUCHTADI Dian Ratih Laksmitawati Djajadiman Gatot Em Yunir, Em Felix F. Widjaja Franciscus D. Suyatna H.M. Sjaifoellah Noer Habibah Muhiddin Harahap, Alida Roswita Harmani Kalim Herdiman T Pohan Idrus Alwi Ina Susanti Timan, Ina Susanti Ivan R. Widjaja Jayati, Turpuk Mannaria Jimmy Posangi Judo Prihartono Khomimah Khomimah, Khomimah Kumalawati, July Laurentius A. Pramono Lukman Hakim Makmun MADE ASTAWAN Minarma Siagian Muchlis Ramli Muhamad Firdaus Murdani Abdullah Murjiah Dinarto Nurlela Bujang Nurul Akbar Oedijani Santoso Ponpon S Idjradinata Pradana Soewondo Purnawan Junadi Rustadi Sosrosumihardjo S. Harun Satrio Sukmoko Septelia I. Wanandi Setiabudy, Rahajuningsih D Setyawati S. Karyono Shufrie Effendi, Shufrie Sidartawan Soegondo Sirowanto Inneke Slamet Suyono Soehardjono Soehardjono Sri Rezeki S Hadinegoro, Sri Rezeki S Starry H. Rampengan Suharko Soebardi Suhendro Suhendro Suhendro Suwarto, Suhendro Sukartini, Ninik Sumarjo, Kusmardi Suzanna Immanuel Taniawati Supali Telly Kamelia Teny Tjitra Sari, Teny Tjitra Tjahjono D. Gondhowiardjo Tonny Loho Tutik Wresdiyati Venna, Venna Victor, Andi A Yuni Astria Yusi Anggriani