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"ABSTRACTBackground: urinary tract infection (UTI) is often treated in daily practice as overactive bladder (OAB) by giving anticholinergic, the recommended treatment options of OAB. However, anticholinergic application for UTI symptoms relief has never been investigated. To our knowledge, this study was the first randomized trial which investigate anticholinergic use for UTI treatment. This study aimed to evaluate whether additional anticholinergic is beneficial alongside an empiric antibiotic therapy in reducing symptoms and tolerable for females with uncomplicated UTI. Methods: this was a randomized double-blind controlled trial that included female aged >18 y.o with uncomplicated lower UTI. Patients were randomly assigned to either solifenacin succinate 5 mg (group 1) or placebo (group 2) in addition to empiric levofloxacin 500 mg treatment for 3 days. Those with structural and/or functional abnormalities of the urinary tract and allergic reaction history were excluded. We observed changes in overactive bladder symptom score (OABSS), patient perception of bladder condition (PPBC) score, patient-reported symptoms and adverse events. Results: a total of 126 patients, 63 for each group, initiated the trial with median age of 44 (19-67) y.o. There were no differences of age, OABSS, and PPBC score between the 2 groups at baseline. We found significant (p<0.05) reduction of OABSS and PPBC score in both groups at the end of therapy; however the amount of reduction were not different between groups. In group 1 we found 22.2% of patients complained of dry mouth and 25.4%, 4.7%, 3.2% of patients complained of nausea, somnolence and constipation respectively. In group 2 we found 20.0%, 21.7% and 3.3% patients who complained of dry mouth, nausea, and somnolence respectively. One patient in group 2 experienced allergic reaction and was dropped out. Conclusion: we found no significant difference in OABSS and PPBC score reduction by adding anticholinergic to antibiotic therapy for females with uncomplicated UTI. There was no serious adverse event recorded."

"Peningkatan PSA dapat ditemukan pada semua kelainan terkait prostat, baik keganasan kanker prostat maupun non-keganasan prostatitis . Terdapat hipotesis bahwa pemberian antibiotik diperkirakan dapat menurunkan kadar PSA. Penelitian ini bertujuan melihat pengaruh pemberian antibiotik terhadap penurunan kadar PSA pada pasien yang menderita LUTS yang memiliki kadar PSA tinggi. Penelitian ini menggunakan metode randomisasi-terkontrol yang dibagi menjadi 2 kelompok, kelompok yang mendapat terapi antibiotik dan kelompok yang mendapat plasebo diberikan selama 2 minggu. Nilai PSA diperiksa saat awal dan saat selesai obat. Biopsi prostat dilakukan pada saat selesai konsumsi obat. Tidak terdapat pengaruh yang signifikan antara penggunaan antibiotik dengan penurunan kadar PSA pada penderita LUTS.

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To see the effect of antibiotic administrations on PSA level reduction in patients with LUTS who have high PSA level, subjects were collected from urology outpatient clinic of Cipto Mangunkusumo National Hospital using consecutive sampling. Patients who have LUTS went through a selection process using inclusion and exclusion criteria. Selected patients were randomized into two different groups control who receive antibiotics and placebo group. Both groups were then given two weeks length of therapy, assessments for PSA levels before and after drug administrations, and a prostate biopsy at the end of drug administrations.There is no significant association between antibiotic and PSA level reduction in LUTS patients."

"This study's aims were (a) to investigate the feasibility of a school-based motivational enhancement therapy (MET) intervention in voluntarily attracting adolescents who smoke marijuana regularly but who are not seeking formal treatment and (b) to evaluate the efficacy of the intervention in reducing marijuana use. Ninety-seven adolescents who had used marijuana at least 9 times in the past month were randomly assigned to either an immediate 2-session MET intervention or to a 3-month delay condition. Two thirds of the sample characterized themselves as in the precontemplation or contemplation stages of change regarding marijuana use. Participants' marijuana use and associated negative consequences were assessed at baseline and at a 3-month follow-up. Analyses revealed that both groups significantly reduced marijuana use at the 3-month follow-up ( p = .001); however, no between-group differences were observed. Despite the absence of a clear effect of MET, this study demonstrated that adolescents could be attracted to participate in a voluntary marijuana intervention that holds promise for reducing problematic levels of marijuana use."

"ABSTRAKPendahuluan: Asam pipemidat efektif pada 94 kasus infeksi saluran kemih akut, 87,5 infeksi saluran kemih kronis. Asam pipemidat diekskresi di urin sebanyak 85 dosis dalam bentuk aktif sehingga memberikan efek uroseptik. Metodelogi: Penelitian ini dibagi 2 kelompok masing-masing 20 pasien, terdiri dari pasien yang menjalani operasi TURP, litotripsi batu buli dan urethrotomi interna di RSU Kardinah April 2016 - Mei 2016. Kelompok intervensi diberikan asam pipemidat, pada kelompok kontrol diberikan ceftazidime. Hasil: Asam pipemidat memiliki efektivitas yang tidak berbeda dengan antibiotik kontrol sebagai profilaksis infeksi pasca operasi. Asam pipemidat terbukti memberikan waktu perawatan yang lebih singkat. Kesimpulan: Asam pipemidat dapat digunakan sebagai profilaksis pada operasi endourologi traktus urinarius bawah dan memberikan waktu perawatan yang lebih singkat.

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ABSTRACTIntroduction Pipemidat acid effective 94 in acute urinary tract infection case, 87,5 chronic urinary tract infection. Pipemidat excretion in urine approximately 85 of total doses in active form so that give uroseptic effect. Methods Study divided into 2 groups, each group have 20 patients that were done TURP, bladder stone lithotripsy and internal urethrotomy in Kardinah General Hospital on April 2016 ndash Mei 2016. Intervention group was given pipemidat acid while control group used ceftazidime. Result pipemidat acid have no significant effectivity with control antibiotic as prophylaxis to prevent infection after operation. Pipemidat acid gives in short length of stay. Conclusion pipemidat acid can be used as prophylactic therapy in lower urinary tract endourology surgery and give a short time in length of stay."

"Pengantar: Batu saluran kencing adalah salah satu penyebab yang paling sering dari nyeri kolik yang muncul pada layanan kesehatan primer. Penanganan dari kasus batu saluran kemih dibagi menjadi beberapa kelompok yaitu operatif dan juga konservatif. Cystone adalah salah satu terapi tambahan yang dapat ditambahkan pada regimen penanganan konservatif untuk ukuran batu dan memudahkan pengeluaran batu saluran kemih. Penelitian ini bertujuan untuk melihat keamanan dan efektivitas dari pemberian Cystone ini pasca tindakan ESWL. Metodologi : Penelitian ini dilakukan antara bulan Mei 2014-November 2015, jumlah sampel yang berpartisipasi dalam penelitian ini adalah 81 sampel, 42 berada pada grup cystone dan 39 dalam grup placebo. Setelah dilakukan ESWL, satu grup diberikan tablet cystone 2 x 2 setiap hari selama 4 minggu, grup lain diberikan placebo. Penanganan lanjutan seperti KUB radiografi, CT urografi dan juga pemeriksaan USG dilakukan setelah mengkonsumsi obat-obatan ini.Hasil: Dari 84 sampel yang berpartisipasi dalam penelitian ini, karkteristik demografik dan baseline antara grup tatalaksana dan grup placebo mirip satu sama lain. Tidak ada perbedaan statistic yang signifikan antara besar batu sebelum dan sesudah konsumsi cystone baik pada grup cystone ataupun placebo. Satu kejadian efek samping yang serius dilaporkan pada grup cystone, tidak ada kejadian efek samping yang berat terlihat pada grup placebo. Diskusi: Penelitian sebelumnya memperlihatkan bahwa cystone ini secara signifikan dapat memperkecil besar batu ginjal dan mengubah komposisi batu ginjal. Hasil yang berbeda ini kemungkinan disebabkan oleh perbedaan besar batu ginjal baik pada riset ini maupun literature-literatur sebelumnya. Berdasarkan penelitian ini, kami tidak merekomendasikan penggunaan cystone sebagai terapi adjunctive- management conservative dari batu ginjal ini.

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Introduction: Urinary stone is one of the most common cause of colicky pain in primary care. Management of urinary stone is divided into operative management and conservative management. Cystone is one of the traditional adjunctive therapy that may added to conservative management regiment to reduce kidney stone size and speed-up the stone passing. This study aims to see the efficacy and safety of Cystone after Extracorporeal Shock Wave Lithotripsy. Methods : This clinical trial was conducted from May 2014-November 2015, the total sample for this research are 81 samples, 42 in cystone group and 39 in placebo group. After undergoing ESWL procedure, one group were given 2 x 2 cystone tables daily for 4 weeks, and the other were given placebo. Further examination such as KUB radiography, CT urography, USG examination were conducted after consumption of the drugs. Results : Among 84 subjects that participated in this research, demographic charcteristics and baseline disease were comparable. No statistically significant changes on the stone size in both cystone and placebo group. One serious adverse event appeared in cystone group compared to none in the placebo group. Discussion: Previous research showed that cystone made significant changes on the renal stone size and composition. This differing results may be caused by different stone sizes in both this research and previous literature. Based on this research’s result we do not recommend using cystone as an adjunctive conservative management of renal stone"

"Tujuan: Memperoleh data prevalensi perempuan dengan gejala saluran kemih bawah di RS Cipto Mangunkusumo, Indonesia. Metode: Studi deskriptif dan analitik dengan pengumpulan data menggunakan kuesioner. Subjek penelitian yakni perempuan yang berada di poliklinik Ginekologi RS Cipto Mangunkusumo Jakarta, menjalani wawancara menggunakan metode konvensional dan menggunakan International Consultation on Incontinence Questionnaire (ICIQ) Female LUTS long form yang divalidasi ke Bahasa Indonesia. Hasil: Metode konvensional hanya menanyakan sebuah pertanyaan tentang gangguan berkemih tanpa menanyakan gejala yang lebih detail, menghasilkan prevalensi LUTS yang rendah sebanyak 17.3%. Pada sisi lain, dengan menggunakan kuesioner yang terstruktur menggunakan ICIQ- FLUTS long form, luaran prevalensi LUTS total adalah 95.3% pada populasi penelitian. Hal ini menunjukkan bahwa LUTS mempunyai prevalensi yang tinggi pada populasi studi dengan faktor resiko yang teridentifikasi berupa persalinan pervaginam. Kesimpulan: LUTS adalah kondisi yang dengan prevalensi tinggi pada populasi penelitian. Untuk mendapatkan prevalensi yang lebih akurat, metode skrining sangat penting. Penggunaan kuesioner terstruktur secara signifikan menapis LUTS lebih tinggi dari metode konvensional. Kuesioner ICIQ FLUTS long form adalah alat yang direkomendasikan untuk digunakan pada penelitian epidemiologi dan dan juga pada praktek klinik sehari- hari. Penelitian lanjutan dengan basis komunitas direkomendasikan untuk mendapatkan prevalensi nasional LUTS di Indonesia.

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Objective: To obtain the prevalence of women with Lower Urinary Tract Symptoms (LUTS) in Cipto Mangunkusumo National Hospital, Indonesia.

Method: Descriptive and analytic study with questionnaire- based data collection. All of the subjects were interviewed using the conventional method and International Consultation on Incontinence Questionnaire (ICIQ) Female LUTS long form validated in Indonesian language at Gynecology outpatient clinic in Cipto Mangunkusumo Hospital.

Results: The conventional method which pose only one single question of urination disturbance without asking the detailed symptoms, low prevalence of LUTS obtained i.e. 17.3%. On the other hand, with a well structured questionnaire using ICIQ- FLUTS long form, the prevalence of LUTS was 95.3% prevalence of LUTS. This result revealed that LUTS was a common condition among Indonesian women in the study population with identified risk factor of vaginal delivery.

Conclusion: LUTS is a frequent condition in this population. To obtain a more accurate prevalence, method of screening is important. A structured questionnaire screened LUTS significantly higher than the conventional method. The ICIQ FLUTS long form questionnaire validated in Indonesian language is a robust questionnaire that recommended to be used in epidemiological research as well as routine clinical practice. Further community based research is warranted to obtain the national prevalence of LUTS."

"Latar belakang: SARS-CoV2, virus yang menyebabkan COVID-19 merupakan masalah kesehatan terbesar yang dihadapi dunia dewasa ini. Gangguan penghidu dan pengecap saat ini telah diakui menjadi suatu entitas gejala pada COVID-19 namun studi terkait evaluasi objektif dan tata laksana gangguan ini masih sangat terbatas. Tujuan penelitian: Mengetahui gambaran klinis gangguan penghidu pada COVID-19 berdasarkan uji penghidu alkohol (UPA) dan uji penghidu intravena (UPI) serta efektifitas terapi hidung sebagai tambahan terapi standar pasien COVID-19 dengan gangguan penghidu. Metode: Penelitian ini merupakan uji klinis acak terkontrol paralel dengan penyamaran tunggal pada 2 kelompok menggunakan 24 pasien terkonfirmasi COVID-19 yang mengalami gangguan penghidu dan dirawat di RS Cipto Mangunkusumo periode Juli-Oktober 2020. Penapisan gangguan penghidu menggunakan UPA dan dilanjutkan dengan UPI. Protokol terapi hidung yang digunakan terdiri dari steroid intranasal, cuci hidung Nacl 0,9%, dekongestan topikal dan balsam aromatik selama 2 minggu kemudian dilakukan analisis statistik perbedaan delta pada hasil pemeriksaan UPA dan UPI menggunakan Uji T independent atau Uji Mann Whitney. Hasil: Terdapat 4 subyek yang keluar dari penelitian dan analisis akhir dilakukan hanya pada 10 subyek per kelompok. Pada pengukuran awal didapatkan rerata nilai pengukuran UPA yang terganggu (kontrol 5,13 ± 3,79; terapi 2,6 ± 2,23). Pada pemeriksaan UPI didapatkan perlambatan onset UPI {kontrol 26 (8-300); terapi :131,5 (20-300)} penurunan nilai durasi {(kontrol:111 (0-182); terapi:44 (0-70)}. Uji perbedaan delta semua variabel pasca terapi didapatkan bahwa terdapat hasil perbedaan signifikan pada onset UPI kelompok terapi (p<0,001) dibandingkan kontrol. Terdapat peningkatan persentase perbaikan semua biomarka: UPA (170,13%), onset UPI (13,45%), dan durasi UPI (32,82%) pada kelompok terapi dibandingkan dengan kelompok kontrol dengan keunggulan persentase >10%. Kesimpulan: Karakteristik gambaran gangguan penghidu pada subyek COVID-19 pada penelitian ini sesuai dengan jenis gangguan penghidu sensorineural. Subyek pada kedua kelompok mengalami perbaikan gangguan penghidu pasca follow up 2 minggu. Pemberian terapi hidung memberikan nilai tambah dengan bukti awal perbaikan pada nilai onset UPI dibanding pemberian terapi standar saja.

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Background: SARS-CoV2, the virus that causes COVID-19, makes the disease biggest health problem the world facing today. Smell and taste disorders are currently recognized as a symptom entity in COVID-19, but studies related to objective evaluation and management of this disorder are still very limited. Aim : To evaluate the clinical presentation of olfactory disorders in COVID-19 based on the alcohol sniff test (AST) and the intravenous olfaction test (IOT) and the effectiveness of the nasal therapy protocol as an adjunct to standard therapy in COVID-19 patients with olfactory disorders. Methods: This study was a two-group single-blind randomized trial of 24 COVID-19 patients with olfactory disorders in Cipto Mangunkusumo General Hospital from July to October 2020. Assestment of olfactory function in this study was performed using AST and IOT. Screening for olfactory disorders performed using AST and followed by IOT. The nasal therapy used consisted of intranasal steroids, Nacl 0,9% nasal washing, topical decongestants and aromatic balms for 2 weeks. Statistical analysis of delta differences was carried based on the results of AST and IOT using independent T test or Mann Whitney test. Results: Four subject were lost to follow up. The final analysis was performed on each 10 subjects per group. The initial measurement showed all subjects included in this study have decreased AST value (control: 5.13 ± 3.79; therapy: 2.6 ± 2.23). Late onset IOT {control: 26 (8-300); therapy: 131.5 (20-300)}, decreased duration {(control: 111 (0-182); therapy: 44 (0-70)}. Statistical tests of delta differences of all post-therapy variabel found that there were significant results on delta IOT latency in the treatment group (p <0.001). There were difference of the percentage improvement of AST (170.13%), IOT onset (13.45%), and duration of IOT (32.82%) in the therapy group compared to the control group. with a percentage advantage >10% Conclusion: The characteristics of the olfactory disorder in COVID-19 subjects in this study were in accordance with the type of sensorineural olfactory disorders. Both subject of two groups have showed improvement in two weeks follow up. The administration of a nasal therapy provides early evidence of improvement in the IOT onset value compared to standard therapy alone."

"Background: the use of statin to lower blood cholesterol is often associated with bothersome adverse effects such as myopathy and liver dysfunction. NC120 is herbal lipid lowering drug containing red yeast rice (RYR) extract, guggulipid, and chromium picolinate, and expected to have better safety profile. The aim of this study was to evaluate the efficacy and safety profiles of NC120 in lowering blood lipid. Methods: this was a double blind randomized clinical trial comparing NC120 with placebo in subjects with hypercholesterolemia. Two capsules of NC120 or placebo were administered twice a day for 28 days. Blood total-cholesterol, LDL-cholesterol, and triglyceride were measured on day-0, day-7, and day-28. Unpaired t-test was used to compare study parameter between groups, and one-way ANOVA was used to compare within group. Results: 25 subjects received NC120 and 24 subjects received placebo. Significant decrease of total cholesterol and LDL-cholesterol were observed since day-7 in NC120 group, while the changes in placebo group were not significant at all time of observation. No significant decrease of triglyceride was observed in NC120 group and in placebo group. Side effects were minor and comparable between the two groups. Conclusion: NC120 is effective in reducing total cholesterol and LDL-cholesterol, but not triglyceride. This drug shows a good safety profile, and thus can be considered for patients who can not tolerate statin drugs."

"A new cognitive therapy (CT) program was compared with an established behavioral treatment. Sixty-two patients meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria for social phobia were randomly assigned to CT, exposure plus applied relaxation (EXP = AR), or wait-list (WAIT). CT and EXP = AR were superior to WAIT on all measures. On measures of social phobia, CT led to greater improvement than did EXP = AR. Percentages of patients who no longer met diagnostic criteria for social phobia at posttreatment-wait were as follows: 84% in CT, 42% in EXP = AR, and 0% in WAIT. At the 1-year follow-up, differences in outcome persisted. In addition, patients in EXP = AR were more likely to have sought additional treatment. Therapist effects were small and nonsignificant. CT appears to be superior to EXP = AR in the treatment of social phobia."

"Material dan Metode: Kami mendapatkan 50 pasien terpasang DJ stent perendoskopi dan dibagi menjadi kelompok kontrol terdiri dari 25 pasien dan kelompok yang mendapat obat antimuskarinik terdiri dari 25 pasien. Kedua kelompok tersebut kami bandingkan keluhan LUTS dan kualitas hidup pasca pemasangan DJ stent yang dinilai pada saat satu hari setelah lepas kateter dan dua minggu pasca pemasangan DJ stent. Penilaian LUTS pasien dilakukan dengan total skor IPSS dan kualitas hidup pasien dengan pertanyaan QoL. Hasil: Satu hari pasca lepas kateter antara kelompok kontrol dengan kelompok yang mendapat obat antimuskarinik, tidak didapatkan perbedaan yang bermakna secara statistik pada total skor IPSS, skor IPSS komponen storage symptoms dan voiding symptoms, dan nilai QoL. Dua minggu pasca pemasangan DJ stent pada kedua kelompok didapatkan perbedaan yang bermakna total skor IPSS, skor IPSS komponen storage symptoms dan voiding symptoms, dan nilai QoL, yaitu lebih rendah pada kelompok pasien yang mendapat obat antimuskarinik. Perbandingan antara satu hari setelah lepas kateter dengan dua minggu pasca pemasangan DJ stent pada kelompok obat antimuskarinik, terdapat penurunan dengan perbedaan bermakna pada total skor IPSS, skor IPSS komponen storage symptoms dan voiding symptoms, dan nilai QoL. Kesimpulan: Pemberian obat antimuskarinik selama jangka waktu tertentu, memberikan perbaikan gejala LUTS, baik voiding symptoms maupun storage symptoms, dan peningkatan kualitas hidup pada pasien-pasien yang terpasang DJ stent.

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Objective: To analyze the effect of antimuscarinic drug on LUTS and Quality of Life (QOL) in patients with DJ stent.

Materials and Methods: We analyzed 50 patients who have DJ stent inserted endoscopically and divided the subjects into two groups, 25 patients had anti- muscarinic and 25 patients as the control group. LUTS and QoL were compared in both groups one day after catheter released and at the second week after DJ stent insertion. The severity of LUTS was examined based on total IPSS score and quality of life based on QoL questionnaire.

Results: In day 1 after the catheter released, there were no statistically significant differences on the total IPSS score, storage and voiding symptoms score on IPSS, and QoL score between two groups. Two weeks after DJ stent insertion, there were significant differences on total IPSS score, storage and voiding symptoms score on IPSS, and QoL score between two groups, where the group with anti- muscarinic had lower score than the control group. Group with antimuscarinic drug showed significant decrease of total IPSS score, storage and voiding symptoms score on IPSS and QoL score at the second week after DJ stent insertion compared to the first day.

Conclusion: Antimuscarinic administration for a period of time, improved LUTS symptoms and increased quality of life in patients with DJ stent."