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"Traveler's Malaria is a new emerging health problem in the whole world due to (I) increasing inability of international travelers and (2) recurrence of diseases in areas that was once, partially or fully freed from the disease.We report 2 cases of severe traveler's malaria found in a man from Greece and a man from the Philippines aged 54 tears. Both patients were ship captains. They have stayed in Kenya prior to the catching the disease. In the first case, we found acute kidney failure with anuria and lung edema, pneumonia, and a progressive decline in hemoglobin concentration. In the second cases we found reduced consciousness, disorder of liver function with jaundice, disorder of kidney function, bleeding from the upper digestive tract, pneumonia, severe anemia, and signs of DIC (Disseminated Intra-va.icttlar Coagulation). The second patient was admitted to the ICU( Intensive Care Unit). Peripheral blood smears found ring forms and growing Plasmodiumfalc.iparum trophozoits. Both cases were assumed to be resistant to Chloroquine and Fansidar. Both of them were treated with oral Quinine Sulphate {we could hardly find Quinine injection in Medan), With such treatment for seven days, we found significant clinical and laboratory improvements. Asexual parasites were no longer found in the peripheral blood smear. During the hospitalization, both patients required Packed Red Cell (blood) transfusion to overcome the progressive drop in hemoglobin level. With the disappearance of the parasites from the patients' blood, the disorders of the organs mentioned above, gradually became normal. The conditions of the patients also showed satisfactory improvement."

"Malaria berat yang disebabkan oleh infeksi Plasmodium falciparum memiliki angka mortalitas yang tinggi dan merupakan penyebab utama kematian pada malaria. Pada kematian akibat malaria jarang dilakukan pemeriksaan otopsi karena belum populernya otopsi klinis di Indonesia. Dilaporkan seorang perempuan berusia 43 tahun dari daerah non endemik dengan penyebab kematian malaria berat. Diagnosis ditegakkan melalui otopsi, pemeriksaan histopatologi, dan toksikologi.

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AbstractSevere malaria, caused by Plasmodium falciparum infection, has a high mortality rate and is the main cause of death in malaria. Since clinical autopsy is unpopular in Indonesia, autopsy examination in malaria cases is rarely done. We reported a forty three year old woman from non endemic area that was dead because of severe malaria. Diagnosis was concluded from autopsy, histopathology, and toxicology."

"Radiation recall is an acute inflammatory reaction that can be triggered when systemic agents are administered long time after radiotherapy. Because radiotherapy is now indicated for many types of cancer, care should be taken regarding possible toxic events relating to radiotherapy in combination with radio-sensitizing agents. Gemcitabine, one such anti-cancer agent, is widely used, especially for urologic cancers. We report an intriguing case of possible radiation recall in the rectum caused by gemcitabine administration 37 years after radiation therapy. From a review of the literature, it appears that there have been no reported cases of radiation recall in the rectum with such a long interval be- tween radiation therapy and chemotherapy. Here, we describe the case and provide a literature review."

"Penelitian ini dilakukan untuk mengetahui apakah bioavailabilitas formulasi ibuprofen suppositoria 125 mg yang diproduksi oleh PT Kalbe Farma,Tbk. (Ibukal®) bioekivalen dengan produk yang sama dari komparatornya (Proris®). Parameter farmakokinetik yang dinilai dalam studi ini ialah luas daerah di bawah kurva kadar - waktu selama 10 jam (AUC0-t), luas daerah di bawah kurva kadar - waktu sampai waktu tak terhingga (AUC0-inf), kadar puncak (Cmax), dan waktu untuk mencapai kadar puncak (tmax). Penelitian ini menggunakan rancangan menyilang acak, tersamar tunggal yang mengikutsertakan 12 sukarelawan dewasa sehat. Sukarelawan dipuasakan semalam dan keesokan harinya diberi 1 suppositoria obat uji (produk PT.Kalbe-Farma) atau 1 suppositoria obat pembanding (produk komparatornya). Contoh darah diambil pada jam ke 0 (kontrol), 20 min; 40 min; 1; 1,5; 2; 2,5; 3; 4; 6; 8; dan 10 jam setelah pemberian obat. Setelah 1 minggu periode washout, prosedur ini diulang dengan memberikan obat pembandingnya. Kadar obat ditentukan dengan kromatografi cair kinerja tinggi dengan detektor ultraviolet. Pada penelitian bioavailabilitas ini, rerata (SD) AUC0-t, AUC0-inf, Cmax dan tmax dari obat uji masing-masing adalah 28,59(3,37) µg.jam.mL-1, 30,47(3,56) µg.jam.mL-1,8,24(1,44)µg/mL, dan 1,33(0,44) jam. Rerata (SD) AUC0-t, AUC0-inf, Cmax dan tmax dari obat pembanding masing-masing adalah 28,13(8,14) µg.jam.mL-1, 30,56(8,05) µg.jam.mL-1, 8,27(2,88) µg/mL, dan 1,79(0,33) jam. Rasio rerata geometrik obat uji terhadap obat pembandingnya ialah 104,38% untuk AUC0-t, 101,97% untuk AUC0-inf, dan 104,02% untuk Cmax, Nilai 90% confidence intervals(CI) nya ialah 90,38-120,54% untuk AUC0-t, 89,51-116,16% untuk AUC0-inf, dan 85,73-126,16% untuk Cmax. Tidak ada efek samping yang dijumpai dalam penelitian ini. Dari hasil penelitian ini disimpulkan bahwa Ibuprofen suppositoria 125 mg produksi PT. Kalbe Farma,Tbk. (Ibukal®) bioekuivalen dengan produk yang sama dari komparatornya (Proris®). (Med J Indones 2007; 16:181-6).

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This study was aimed to investigate the bioequivalence of ibuprofen 125 mg suppository formulation (Ibukal®, test formulation from PT. Kalbe Farma, Tbk., Jakarta) and the ibuprofen suppository comparative formulation (Proris®, from PT. Pharos Indonesia, Jakarta) in 12 healthy volunteers. The pharmacokinetic parameters used in this study were the area under the concentration-time curve from time zero to hour 10 (AUC0-t), the area under the concentration-time curve from time zero to infinite (AUC0-inf), the maximum concentration (Cmax), and the time needed to reach the maximum concentration (tmax). The study was designed as a random cross-over fashion, single-blinded which included 12 healthy adult volunteers. The volunteers were fasted overnight and in the morning they received a suppository of the test drug (Ibukal®) or a suppository of the comparative drug (Proris®). Blood samples were withdrawn on hour 0 (control), 20 min; 40 min; 1; 1,5; 2; 2,5; 3; 4; 6; 8; and 10 time points after the administration of the drug. Following a wash-out period of 1 week, this procedure was repeated using the other drug. The serum concentration of the drug was determined by means of high-performance liquid chromatography with ultraviolet detection. The results of the study showed that, the mean (SD) of AUC0-t, AUC0-inf, Cmax and tmax of the test drug were, respectively, 28.59(3.37) µg.h.mL-1, 30.47(3.56) µg.h.mL-1, 8.24(1.44) µg/mL, and 1.33(0.44) h. The mean (SD) of AUC0-t, AUC0-inf, Cmax and tmax of the comparative drug were, respectively, 28.13(8.14) µg.h.mL-1, 30.56(8.05) µg.h.mL-1, 8.27(2.88) µg/mL, and 1.79(0.33) h. The geometric means ratio of the test to the comparative drug were 104.38% (CI 90%: 90.38-120.54%) for AUC0-t, 101.97% (CI 90%: 89.51-116.16%) for AUC0-inf, and 104.02% (CI 90%: 85.73-126.16%) for Cmax. There was no side effect of the drug detected in this study. From the results we can conclude that the 125 mg of ibuprofen suppository of PT Kalbe Farma, Tbk. (Ibukal®) is bioequivalent to that of the comparative drug (Proris®). (Med J Indones 2007; 16:181-6)"

"ABSTRAKRuang Lingkup dan Cara Penelitian: Ketoprofen dapat menimbulkan gangguan saluran cerna yang serius. Disamping itu, karena eliminasinya yang cepat, perlu diberikan beberapa kali sehari, sehingga mengurangi kepatuhan penderita. Sediaan lepas lambat telah dibuat, yang cukup diberikan 1 kali sehari dan memberikan kadar puncak lebih rendah dan dapat bertahan dalam kadar terapi selama 24 jam. Penelitian ini bertujuan untuk mengamati profit sediaan lepas lambat (Profenid® OD dan Oruvail® 200), dibandingkan dengan sediaan biasa (Profenid 50) pada sukarelawan sehat setelah pemberian dosis oral berulang, dan untuk mengembangkan metode pemeriksaan kadar ketoprofen serum dengan kromatografi lapis tipis - densitometri. Penelitian dilakukan dengan disain menyilang dan alokasi acak pada 10 orang sukarelawan sehat. Sampel darah diambil setelah dicapai kadar mantap, untuk Profenid® 50 sampai jam ke 8, dan untuk sediaan lepas lambat sampai jam ke 24 setelah dosis terakhir. Serum sampel, dengan naproksen sebagai standar dalam, diekstraksi dengan eter-kloroform (4:1 v/v) pada suasana asam.Hasil dan Kesimpulan: Ketoprofen dapat dipisahkan dengan baik dari naproksen, dan diperoleh 2 kurva kalibrasi: Y = 0,540X - 0,005 (kadar ketoprofen 0,25-1,00 ug/ml) dan Y = 0,295X + 0,314 (kadar 1,0-8,0 ug/ml). Dari parameter farmakokinetik yang digeroleh, disimpulkan bahwa Profenid® OD dan Oruvail® 200 memperlihatkan profit lepas lambat (C lebih rendah, t dan t1 lebih panjang, indeksmaxfluktuasi (FI) lebihmakecil) dlbandingkan Profenid® 50, dengan bioavailabilitas relatif (BR) } 80%, namun keduanya tidak dapat bertahan dalam kadar terapi sampai 24 jam. Profenid® OD menunjukkan profil lepas lambat yang lebih baik dari Oruvail® 200 pada orang Indonesia (Cmax lebih rendah, ti lebih panjang dan Fl lebih kecil (<,05)). Metode KET-densitometri ini dapat mengukur kadar ketoprofen serum dengan sensitivitas 0,25 ug/ml, kecermatan (KV) C 6% dan ketepatan (d) < 14%."