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"ABSTRAKCidera hati yang di induksi obat atau drug induced liver injury DILI adalah kerusakan hati yang ditimbulkan oleh obat atau metabolitnya. Isoniazid INH dan Rifampisin RMP merupakan salah satu obat yang menimbulkan DILI. Terapi DILI hanya bersifat suportif. Deteksi dini dan penarikan obat yang di curigai merupakan langkah penting dalam pencegahan kegagalan hati yang lebih berat. Penelitian ini bertujuan untuk melihat efek protektif dari tindakan akupunktur terutama antioksidan Glutathione pada tikus dengan DILI. Penelitian ini dilakukan pada 24 ekor tikus Sprague Dawley, yang di bagi 4 kelompok yaitu kelompok akupunktur, kelompok sham, kelompok kontrol dan kelompok kontrol sehat. Pada kelompok akupunktur dan sham dipasang press needle pyonex, selama 5 hari di stimulasi dan 2 hari dilepas, terapi dilanjutkan sampai 21 hari. Kelompok akupunktur dipasang press needle pada titik GB34 Yanglingquan, ST36 Zusanli dan BL18 Ganshu, kelompok sham pada daerah diluar titik akupunktur. Efek akupunktur pada DILI diperiksa melalui kadar serum glutamate pyruvate kinase SGPT , serum glutamate oxaloasetat transaminase SGOT , antioksidan glutathione GSH plasma dan jaringan. Hasil penelitian didapatkan penurunan kadar SGPT pada kelompok akupunktur dengan p

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ABSTRACT<>br>Drug-induced liver injury (DILI) is liver damaged caused by drugs or its metabolites. Isoniazid(INH) and Rifampicin (RMP)are among the drugs that caused DILI. The therapy for DILI is only supportive. Early recognition and prompt withdrawal of the drug is essential in preventing serious hepatic failure. This study aims to see the protective effects of acupuncture, through antioxidants Glutathione on liver injury. This study was conducted on 24 Sprague Dawley rats which were divided into 4 groups: acupuncture group, sham group, control group and healthy control group. In acupuncture and sham group was needling with press needle pyonex for 5 consecutive days and release needle for 2 days, the treatment continues for 21 days. Acupuncture effect for DILI was investigated from serum glutamate pyruvate kinase (SGPT), serum glutamate oxaloacetate transaminase (SGOT), plasma and tissue glutathione (GSH) antioxidant levels. The result showed significant decrease in SGPT levels in the acupuncture group (p <0.001) and no decrease in SGOT level with (p=0.321). There was no significant increase in GSH levels of tissue with (p=0.321). There was no significant increase in plasma GSH levels (p=0.021). Acupuncture have a protective effect on the liver with a significant decrease in SGPT levels, but antioxidant GSH plasma and GSH tissue did not showed a significant increase."

"Tuberkulosis (TB) dan Human Immunodeficiency Virus (HIV) menjadi beban utama penyakit menular terutama di negara-negara berpenghasilan rendah. Pada pasien penderita Tuberkulosis dengan adanya infeksi penyerta seperti koinfeksi HIV, diestimasikan akan meningkatkan risiko terjadinya drug-induced liver injury (DILI) akibat OAT sebanyak 4 kali lipat. Dilakukan pemantauan terapi obat ini untuk menganalisis masalah terkait obat (MTO)/ Drug’s Related Problem (DRP) yang terjadi pada pengobatan pasien dan memberikan rekomendasi tindak lanjut menggunakan metode SOAP. Diperoleh hasil bahwa pasien memiliki diagnosis ikterus obstruktif, anemia normositik normokrom, hiponatremia hipoosmolar euvolemik, Dili et causa OAT, HIV on ARV, TB on OAT dan terdapat interaksi obat kategori antara sukralfat dengan dolutegravir yang menyebabkan Sukralfat menurunkan efek dari dolutegravir dengan pengikatan kation dlm saluran GI. Hasil analisis DRP disajikan dalam SOAP sebagai komunikasi tertulis untuk menyampaikan rekomendasi kepada dokter penanggung jawab (DPJP).......Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) are the main burden of infectious diseases, especially in low-income countries. In patients suffering from Tuberculosis with accompanying infections such as HIV co-infection, it is estimated that the risk of drug-induced liver injury (DILI) due to OAT will increase by 4 times. This drug therapy monitoring is carried out to analyze drug-related problems (MTO)/Drug-Related Problems (DRP) that occur during patient treatment and provide follow-up recommendations using the SOAP method. The results showed that the patient had a diagnosis of obstructive jaundice, normochromic normocytic anemia, euvolemic hypoosmolar hyponatremia, Dili et causa OAT, HIV on ARV, TB on OAT and there was a major category of drug interaction between sucralfate and dolutegravir which caused Sucralfate to reduce the effect of dolutegravir by binding cations in GI tract. The results of the DRP analysis are presented in SOAP as written communication to convey recommendations to the doctor in charge (DPJP)."

"ABSTRAKPendahuluan: Polimorfisme gen N-asetiltransferase 2 NAT2 dapat mempengaruhi hasil pengobatan infeksi tuberkulosis TB dan risiko terjadinya efek samping kerusakan hati imbas obat anti tuberkulosis. Penelitian ini bertujuan untuk mengetahui distribusi polimorfisme gen NAT2 pada pasien TB naif yang mengalami kegagalan konversi sputum pada pengobatan dengan rejimen OAT standar dan untuk mengetahui apakah polimorfisme gen NAT2 berpengaruh terhadap toleransi dan keberhasilan terapi TB paru dengan INH..Metode: Analisis polimorfisme gen NAT2 dilakukan pada 54 pasien TB naif Puskesmas Kecamatan Pademangan, Jakarta Utara, menggunakan teknik polymerase chain reactions PCR dan dilanjutkan dengan sekuensing. Lima puluh empat pasien TB dikelompokkan menjadi dua kelompok observasi; 26 kelompok gagal konversi dan 28 pasien berhasil konversi.Hasil: Diantara 54 pasien TB, 11,2 adalah gen prediktor asetilator lambat membawa dua alel mutan; NAT2 5, NAT2 6, NAT2 dan 88,8 adalah gen prediktor asetilator cepat membawa satu atau dua alel NAT2 4, NAT2 12, NAT2 13 . Frekuensi asetilator cepat lebih banyak ditemukan pada penelitian ini. Sebanyak 92 pasien yang gagal konversi dan 83 pasien yang gagal pengobatan akhir mempunyai gen asetilator cepat. Tidak ditemukan hubungan yang bermakna antara gen NAT2 dengan kegagalan konversi p=0,423 dan kegagalan pengobatan p=0,415 . Tidak ditemukan satupun kejadian kerusakan hati imbas obat antituberkulosis AT-DILI pada 6 pasien asetilator lambat. Kesimpulan: Tidak ditemukan hubungan antara jenis asetilator dengan kegagalan konversi sputum, kegagalan pengobatan dan terjadinya AT-DILI.

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ABSTRACTIntroduction Polymorphisms of N acetyltransferase 2 NAT2 gene might affect the outcome of TB infection treatment and the risks of developing hepatic adverse event, known as antituberculosis drug induced liver injury AT DILI . The purpose of this study was to find the distribution of NAT2 gene polymorphisms in the naive TB patients, who experienced sputum conversion failure after conventional standard regimen and to clarify whether the NAT2 gene polymorphisms could affect the tolerability and the efficacy of multidrug therapy with INH for pulmonary tuberculosis.Methods Polymorphisms of NAT2 gene were studied in 54 TB naive patients in Pademangan District Primary Health Care, North Jakarta. Twenty six patients were assigned to the sputum conversion failure group and 28 to the conversion group. Analysis was done using polymerase chain reactions PCR followed by direct sequencing. Results Fifty four TB patients slow acetylators, 11,2 rapid acetylators, 88,8 were enrolled in this study. Two mutant alleles NAT2 5, NAT2 6, NAT2 7 were found in slow acetylator genes and NAT2 4, NAT2 12, NAT2 13 in fast acetylator genes. Among 92 patients who experienced sputum conversion failure and 83 patients who undergone treatment failure have fast acetylator genotypes. There were no significance association between NAT2 genotypes analysis associated to sputum conversion failure p 0,423 and treatment failure p 0,415 . None of the six slow acetylators experienced AT DILI.Conclusion Among patients with sputum conversion failure and treatment failure evaluated in this study, fast acetylator genotypes were more common and no relationship was found between the acetylator genotypes with antituberculosis treatment failure and the occurrence of antituberculosis drug induced liver injury."