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"Artritis reumatoid ialah penyakit poliartritis kronik progresif yang menimbulkan deformasi, meliputi multisistem dan disertai morbiditas yang nyata. Obat-obatan imunosupresif telah digunakan untuk mengurangi/menghambat progresi penyakit. Penelitian ini diadakan untuk membandingkan keberhasilan azatioprin dan siklosporin pada penderita artritis reumatoid. Penelitian meliputi 100 penderita artritis reumatoid (sesuai kriteria American Rheumatism Association, 1987) yang dibagi atas dua kelompok: kelompok I mendapat azatioprin 1 mg/kg/h dan kelompok II mendapat siklosporin 2,5-3,0 mg/kg/h selama 16 minggu. Penilaian keberhasilan berdasarkan parameter klinis, biokimiawi dan radiologis. Semua penderita menunjukkan perbaikan nyata (nilai p < 0.001) pada semua parameter klinis, yaitu hilangnya nyeri, berkurangnya kekakuan pagi hari, sendi yang nyeri/membengkak dan waktu yang diperlukan untuk berjalan sejauh 50 kaki serta menguatnya kekuatan genggaman. Semua penderita menunjukkan penurunan LED (p < .001) tanpa perubahan apapun pada titer faktor reumatoid. Kedua obat menunjukkan keberhasilan yang sama (nilai p tidak bermakna) dalam hal perbaikan parameter klinis dan biokimiawi. Tetapi dengan siklosporin erosi tulang dan osteoporosis yukstaartikular lebih banyak berkurang. Sepuluh penderita menunjukkan nefrotoksisitas dengan siklosporin. Siklosporin lebih baik dari azatioprin dalam hal mengurangi derajat progresi kelainan sendi pada artritis reumatoid, tetapi insidens efek samping lebih tinggi, yang pada umumnya dapat diatasi. (Med J Indones 2002; 11: 153-7)

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Rheumatoid Arthritis (RA) is a chronic progressive deforming polyarthritic disease involving multisystems and associated with considerable morbidity. Immunosuppressive drugs have been used to reduce/arrest the progression of the disease. The present study was undertaken to compare the efficacy of Azathioprine and cyclosporin in Rheumatoid Arthritis patients. Study consisted of 100 patients of Rheumatoid Arthritis (as per criteria of American Rheumatism Association, 1987) divided into two groups : group I received Azathioprine 1 mg/kg/d and group II received cyclosporin 2.5-3.0 mg/kg/d for 16 weeks. Assessment of efficacy was based on clinical, biochemical and radiological parameters. All patients showed marked improvemen (p value < 0.001) in all clinical parameters i.e. relief in pain, reduction in morning stiffness, painful/swollen joint along with walking time for 50 feet and increase in grip strength. All patients showed reduction (p < 0.001) in ESR without any change in rheumatoid factor titres. Both drugs showed equal efficacy (p value = NS) in improvement of clinical and biochemical parameters. But cyclosporin showed more reduction in bony erosions and juxtaarticular osteoporosis. Ten patients showed nephrotoxicity with cyclosporin. Cyclosporin has an edge over azathioprine in reducing the rate of progression of joint change in Rheumatoid Arthritis but is associated with increased incidence of side effects that are generally manageable. (Med J Indones 2002; 11: 153-7)"

"ABSTRAKBackground Rheumatoid arhtirtis is a chronic autoimmune disease that mainly attacks joints. It may causes joint deformities which leads to lower quality of life of RA patients. RA is treated with metothrexate which inhibiting disease progression. MTX is known for its hepatotoxicity side effect, which is described by an elevation of aspartate aminotransferase and/or alanine aminotransferase beyond the upper normal limit. Factors that may enhance hepatotoxicity are gender, age, cummulative dose of MTX, and duration therapy of MTX. Prevalence of hepatotoxicity caused by MTX therapy in RA patients in Indonesia is still unknown. The objective of this research is to know the proportion of hepatotoxicity and its associations with the factors that may enhance hepatotoxicity caused by MTX therapy in RA patients in RSCM.Method Data about gender, age, cummulative dose and duration therapy of MTX are obtained from 115 RA patients medical records.Result Proportion of hepatotoxicity in RA patients treated with MTX in RSCM is 42.60 percent. Gender, age, cummulative dose and duration therapy of MTX do not significantly enhance hepatotoxicity p>0.05. Conclusion In conclusion gender, age, cummulative dose and duration therapy of MTX do not have association with hepatotoxicity in RA patients treated with MTX."

"ABSTRAKBackground Aim of this research is to assess the efficacy and safety of tocilizumab in combination with methotrexate in Indonesian patients with moderate to severe active rheumatoid arthritis who have an inadequate response to non biologic DMARDs.Methods This was a interventional, prospective, single arm, multicenter, study in Indonesian male or female patients aged > 18 years old, with a diagnosis of RA for > 6 months based on ACR 1987 revised criteria with moderate to severe disease activity DAS28 score > 3.2 after > 12 weeks of non biologic DMARDs treatment. The treatment consisted of tocilizumab, 8 mg/kg, intravenous, every 4 weeks for a total of 6 infusion in combination with oral MTX 10 until 25 mg every week. Efficacy was assessed based on the percentage of patients achieving low disease activity state DAS28 < 3.2, percentage of patients achieving reduction > 1.2 point of DAS28, percentage of patients achieving remission DAS28 < 2.6, and percentage of patients with ACR20, ACR50, and ACR70 responses. Descriptive statistics will be used for presentation of results.Results 100 percent patients reached low disease activity DAS28 < 3.2 at last study visit week 24 and clinically significant improvement reduction at least 1.2 units at every visit in DAS28, both for ITT or PP patients. Remission DAS28 < 2.6 was observed in 82.1 percent ITT patients and 93.1 percent PP patients on last study visit. ACR20, ACR50, and ACR70 were achieved in 20 percent, 34 percent, and 34 percent ITT patients, and 7 percent, 24 percent, and 62 percent PP patients on week 24. There were 3 out of 39 patients 7.69 percent with adverse events and serious adverse events that resulted in discontinuation of TCZ treatment, consisting of 1 patient with SAE of sepsis ec acquired community pneumonia, 1 patient with SAE of pneumonia tuberculosis, and 1 patient with AE of candidiasis. Most common adverse events were hepatic dysfunction 30.7 percent, hypercholesterolemia 23.1 percent, followed by arthralgia 20.5 percent Twelve percent of patients needed dose modification due to elevated liver enzyme elevated ALT/SGPT level. Conclusion Tocilizumab seems to be efficacious and likely to have good safety profile in non biologic DMARD nonresponsive RA patients of PICTURE INA study. "

"Ketoprofen merupakan obat antiinflamasi non-steroid (OAINS) yang banyak digunakan sebagai obat pilihan untuk mengobati penyakit sendi seperti rheumatoid arthritis (RA) dan osteoarthritis (OA). Industri farmasi selaku pihak yang memiliki wewenang atas kegiatan produksi obat harus membuat obat yang sesuai dengan tujuan penggunaannya dan tidak menimbulkan risiko membahayakan bagi penggunanya. Salah satu cara untuk menjamin mutu obat adalah dengan melakukan pengawasan mutu selama proses produksi berlangsung. Setiap metode yang digunakan untuk pengujian mutu obat harus mampu memberikan hasil terpercaya sehingga diperlukan adanya proses validasi ataupun verifikasi sebelum metode analisis tersebut digunakan sebagai pengujian rutin. Pada penelitian ini, dilakukan verifikasi metode analisis penetapan kadar bahan baku Ketoprofen secara titrimetri berdasarkan Farmakope Indonesia Edisi VI. Rangkaian kegiatan verifikasi metode analisis penetapan kadar bahan baku Ketoprofen meliputi pengumpulan informasi, pembuatan dan pelaksanaan protokol, pengumpulan dan pengolahan hasil, serta pembuatan dan penyusunan laporan hasil verifikasi metode analisis. Metode analisis penetapan kadar bahan baku Ketoprofen menggunakan metode titrimetri berdasarkan Farmakope Indonesia Edisi VI telah diverifikasi di Laboratorium Pengawasan Mutu PT. Kalbe Farma Tbk., dilakukan sesuai dengan prosedur dan peraturan yang berlaku, serta memberikan hasil analisis yang konsisten dan sesuai dengan kriteria penerimaan sehingga dapat digunakan sebagai metode analisis yang sesuai dengan tujuannya, yaitu untuk penetapan kadar bahan baku Ketoprofen.

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Ketoprofen is a non-steroidal anti-inflammatory drug (NSAID) widely used as a preferred medication for treating joint diseases such as rheumatoid arthritis (RA) and osteoarthritis (OA). Pharmaceutical industries, as authorities responsible for drug production, must create medicines that are appropriate for their intended use and do not pose any risks to users. One way to ensure the quality of drugs is by conducting quality control during the production process. Every method used for testing the quality of drugs must provide reliable results, necessitating a validation or verification process before the analytical method can be employed for routine testing. In this study, the verification of the analytical method for determining Ketoprofen raw material content through titration was conducted based on the Indonesian Pharmacopoeia VI Edition. The activities involved in verifying the analytical method for determining the Ketoprofen raw material content included gathering information, protocol preparation, implementation, data collection and processing, and preparing and compiling the verification method results report. The analytical method for determining the Ketoprofen raw material content using titration based on the Indonesian Pharmacopoeia VI Edition has been verified in the Quality Control Laboratory of PT. Kalbe Farma Tbk., performed according to the applicable procedures and regulations and provided consistent analysis results that meet the acceptance criteria. Therefore, it can be used as an appropriate analytical method to determine the content of Ketoprofen raw material."

"Background Rheumatoid arthritis is the most prevalent from of inflammatory arthritis. One of the key components for its multidimensional outcome is the disease activity, measured by DAS28 ESR. The phsycal, emotional, and social aspect of RA contribute to the quality of life, and SF 36 questionaire can be used to measure it. This study aims to ascertain the correlation between the disease activity (DAS28 ESR) and the quality of life (SF 36) in RA pantients."

"Artritis Reumatoid AR merupakan salah satu penyakit yang berhubungan dengan sistem imun yang menyebabkan kerusakan sendi dan mengakibatkan terjadi penurunan kualitas hidup pasien. Nilai DAS28 CRP menggambarkan aktivitas penyakit AR. Titer Anti-CCP merupakan pemeriksaan yang sangat spesifik digunakan untuk memberikan gambaran prognosis penyakit pasien AR. Penelitian tentang korelasi titer Anti-CCP dengan nilai DAS28 CRP belum pernah dilakukan di Indonesia. Oleh karena itu, penelitian ini bertujuan untuk mengetahui korelasi antara titer Anti-CCP dengan nilai DAS28 CRP di RSCM. Pada peneltian ini desain penelitian yang digunakan adalah cross-sectional dengan sampel berjumlah 43 data. Data mengenai titer Anti-CCP dan DAS28 CRP didapatkan melalui rekam medis pasien. Hasil menyatakan bahwa tidak terdapat korelasi p=0,582 antara titer Anti-CCP dengan DAS28 CRP dengan nilai r yang menunjukkan korelasi sangat lemah r=0,086.

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Rheumatoid arthritis is one of a disease relating with immunity that causes destruction in joints which affects quality of life of its patients. DAS28 CRP score represents the activity of the disease. Anti CCP titer is a specific test to portray the prognosis for the patients. Study about correlation between DAS28 CRP score and Anti CCP titer has not been done in Indonesia. Therefore, this study rsquo s done to understand the correlation between DAS28 CRP score and Anti CCP titer in RSCM. The design of this study is cross sectional study with 43 samples. Data of Anti CCP score and DAS28 CRP score are collected from patients rsquo medical records. The result of this study shows that there is no correlation between Anti CCP titer and DAS 28 CRP score in Rheumatoid Arthritis patients in RSCM with a very low correlation p 0,582 r 0,086."

"Latar Belakang : Neuropati perifer merupakan manifestasi ekstraartikular pada Artritis Reumatoid AR yang sudah lama diketahui dan ditemukan pada sekitar 50-57,4 pasien AR dengan patogenesis yang belum jelas hingga saat ini. Nerve Growth Factor NGF, yang dilaporkan berhubungan dengan kejadian neuropati perifer pada pasien Diabetes Mellitus ditemukan dengan kadar yang lebih tinggi pada pasien AR dibandingkan orang normal. Berdasarkan hal tersebut, diperlukan penelitian yang bertujuan mengetahui hubungan antara kadar NGF dengan kejadian neuropati perifer pada pasien AR. Tujuan : Untuk mengetahui rata-rata kadar NGF darah dan ada tidaknya hubungan antara kadar NGF dengan kejadian Neuropati Perifer pada pasien AR. Metode : Penelitian potong lintang dengan metode consecutive sampling pada pasien AR rawat jalan di poli reumatologi Rumah Sakit Cipto Mangunkusumo dilakukan dalam kurun waktu Juli 2015-Maret 2016. Pemeriksaan laboratorium dan fisiologi yang dilakukan adalah NGF dan Elektromiografi-Kecepatan Hantar Saraf EMG-KHS. Subjek kemudian dikelompokkan menjadi 2 kelompok berdasarkan ada atau tidaknya neuropati perifer. Analisis bivariat kemudian dilakukan untuk melihat hubungan antara NGF dengan neuropati perifer diantara 2 kelompok. Data sekunder berupa usia, jenis kelamin, Laju Endap darah LED, C-Reactive Protein CRP, Disease Activity Score DAS 28 LED dan DAS 28 CRP didapat dari rekam medis sebagai data karakteristik dasar pasien. Hasil : Sebanyak 132 pasien diikutsertakan dalam penelitian ini dan didapatkan neuropati perifer sebanyak 45,5 60 orang selama Juli 2015-Maret 2016. Median kadar NGF pada pasien AR adalah 4,11 pg/mL 0,0-24,5 pg/mL. Median NGF pasien AR dengan neuropati perifer adalah 4,11 pg/mL 1,1-20,83 pg/mL, sementara median NGF pada pasien AR tanpa neuropati adalah 3,89 pg/mL 0,0-24,5 pg/mL. Jenis neuropati yang ditemukan pada pasien AR adalah polineuropati 29 subyek/21,97, mononeuropati multipleks 20 subyek/15,15 dan Carpal Tunnel Syndrome 15 subyek/11,36. Pada penelitian ini tidak didapatkan hubungan antara kadar NGF serum dengan kejadian neuropati perifer pada pasien AR p=0,716. Simpulan : Kadar NGF serum pasien AR didapatkan median sebesar 4 pg/mL dengan median NGF serum pada kelompok neuropati perifer 4,11 pg/mL dan kelompok tanpa neuropati 3,89 pg/mL. Tidak terdapat hubungan antara NGF serum dengan kejadian neuropati perifer pasien AR.

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Background : Peripheral neuropathy is an extra articular manifestations in Rheumatoid Arthritis RA, which has been known and is found in approximately 50 to 57.4 of patients with RA with an unclear pathogenesis until now. In DM type 2 patients, Nerve Growth Factor NGF is associated with peripheral neuropathy. NGF level is also reported to be higher among RA patients than that of among healthy subjects. The correlation between NGF level and peripheral neuropathy among RA has not been concluded yet.

Aim : To find out the mean levels of NGF blood serum and the relationship between the NGF serum levels and Peripheral Neuropathy among patients with RA.

Methods : A cross sectional study using consecutive sampling method including patient of rheumatology clinic at Cipto Mangunkusumo hospital was performed between July 2015 to March 2016. The laboratory and physiology measurement incude NGF level and Electromyography Nerve Conduction Velocities EMG NCV were examined to the subjects. Patients were classified into 2 groups based on the diagnosis of Peripheral Neuropathy PN PN positive and PN negative. Bivariate analysis were done to investigate the relationship between NGF and PN among groups. Secondary data such as age, sex, Erythrocyte Sedimentation Rate ESR, CRP, Disease Activity Score DAS 28 ESR and CRP obtained from their medical record as a basic characteristic data of patients.

Results : Among 132 subjects, PN was found in 60 subjects 45,5. The median level of NGF in RA patients was 4.11 pg mL 0.0 to 24.5 pg mL. The median NGF level of RA patients with peripheral neuropathy was 4.11 pg mL 1.1 to 20.83 pg mL, while the median of NGF level in RA patients without neuropathy was 3.89 pg mL 0.0 to 24.5 pg mL. Types of neuropathy among patients with AR were polyneuropathy 29 subjects 21.97, mononeuropathy multiplex 20 subjects 15.15 and Carpal Tunnel Syndrome 15 subjects 11.36. In this study we found no association between NGF serum level and peripheral neuropathy among patients with RA p 0.716.

Conclusion : The median of NGF serum level among RA patients was 4 pg mL. The median of NGF serum level among peripheral neuropathy group was 4.11 pg mL while the median of NGF level in RA patients without neuropathy was 3.89 pg mL. There was no relationship between NGF serum level and peripheral neuropathy among patients with RA."

"Apotek merupakan suatu sarana pelayanan kefarmasian tempat dilakukan praktik kefarmasian oleh Apoteker. Dalam melakukan pelayanan kefarmasian diperlukan suatu standar pelayanan kefarmasian yang meliputi 2 dua hal yaitu pengelolaan sediaan farmasi, alat kesehatan, dan bahan medis habis pakai serta pelayanan farmasi klinik. Kegiatan Praktek kerja profesi di Apotek Kimia Farma berguna sebagai sarana pembelajaran bagi mahasiswa dalam mengetahui tugas dan tanggung jawab seorang apoteker di Apotek dari segi teknis kefarmasian seperti pengadaan barang, penerimaan barang, penyimpanan barang hingga penjualan, maupun segi non teknis kefarmasian seperti pencatatan dan pelaporan dimana hal tersebut telah berjalan di Apotek Kimia Farma. Tugas khusus yang diberikan adalah melakukan kajian resep terkait penyakit reumatik dimana hal yang dilakukan adalah mencari resep yang terkait penyakit reumatik yang diterima oleh Apotek Kimia Farma 07 dan melakukan kajian terkait pengkajian administratif, persyaratan kesesuaian farmasetik, persyaratan pertimbangan klinis. Berdasarkan hasil pengkajian resep dapat disimpulkan bahwa secara umum sudah cukup baik dan sesuai persyaratan.

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Pharmacy is a means of pharmaceutical service where pharmaceutical practice is undertaken by the Pharmacist. In performing pharmaceutical services, a pharmacy service standard is required, covering 2 two matters, such as management of pharmaceutical preparations, medical devices, and medical consumables as well as clinical pharmacy services. Internship at Kimia Farma rsquo s Pharmacy is a way of learning about a pharmacist job description at pharmacy such as Procurement of goods, receipt of goods, storage of goods until the sale, as well as non technical aspects of pharmaceutical such as recording and reporting where it has been running in Pharmacy Kimia Farma. The specific task given is to conduct a prescription study related to rheumatic diseases related to administrative assessment, pharmaceutical conformity requirements, clinical consideration requirements. Based on the results of prescription assessment can be concluded that in general is quite good and in accordance with the requirements. "