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Abstrak :
Pelayanan kesehatan di rumah sakit lebih ditekankan pada pelayanan yang bersifat kuratif dan rehabilitatif dimana obat-obatan merupakan salah satu faktor penting dalam penyembuhan penderita, sehingga perlu penanganan yang baik yang menjadi tugas instalasi farmasi. Untuk menjalankan tugas dan fungsinya dengan baik instalasi farmasi memerlukan sistem pendistribusian, dalam hal ini adalah prosedur distribusi obat yang cepat dan efisien. Depo farmasi ruang 11 merupakan bagian dari instalasi farmasi yang berfungsi mengendalikan distribusi obat sehingga penyediaan obat di ruangan senantiasa sesuai dengan perencanaan dan kebutuhan. Pasien ruang 11 terdiri dari pasien umum, pasien kontraktor dan pasien askes. Ruang 11 mempunyai kapasitas sebanyak 43 tempat tidur, terdiri dari VIP A, VIP B dan kelas 1. Sistem distribusi yang digunakan di ruang 11 adalah sistem distribusi persediaan di ruang dan sistem distribusi unit dosis parsial. Sistem distribusi obat tersebut dituangkan dalam bentuk depo farmasi. Penelitian ini bertujuan untuk menganalisis situasi sistem dan prosedur yang dilaksanakan kaitannya dengan peningkatan pelayanan farmasi di RSHS; mengkaji masalah-masalah yang menghambat dalam pelaksanaan prosedur; serta mencari alternatif yang diharapkan untuk mengurangi masalah tersebut. Metodologi yang digunakan dalam penelitian ini adalah metode telaah kasus dengan pendekatan deskriptif dengan cara penelusuran proses sejauhmana prosedur tetap yang ada dijalankan. Menggunakan data primer, yaitu melalui observasi dan wawancara. Sedangkan data sekunder diperoleh melalui catatan dan laporan farmasi bulan Juli 2000, protap, kebijakan, standar pelayanan farmasi, dan lain-lain. Dari hasil penelitian diperoleh prosedur tetap yang ada kurang mendukung terhadap pelayanan dan tidak memberikan kepuasan pasien, sehingga perlu dikembangkan. Dari hasil pembahasan dapat disimpulkan, apabila sistem distribusi obat didukung oleh prosedur yang baik dan mudah dilaksanakan, personal yang cukup, jumlah dan kemampuan kefarmasiannya meningkat, serta sarana bagi prosedur distribusi yang lengkap, diharapkan dapat mendukung terhadap pelayanan kesehatan secara efektif dan efisien. ...... Analysis of Medicine in In-Patient Care of Interne Unit, Hasan Sadikin Hospital, BandungThe health service served by hospital is more emphasized on curative and rehabilitation service, there for drugs is one of essentiale factors in the cure process of the patients. Consequently, management of drugs have to be organized effectively as the main job of pharmacy installation. In applying its job and its function effectively, pharmacy installation requires good distribution system. In this case, the procedure of drugs distribution must be fast and efficient. Pharmacy stand in Room 11 is a part of pharmacy installation which has function to contrail distribution of drugs, so that drugs supply in that room is suitable to the plan and requirement. There are three types of patient in Room 11, namely general patient, contractor patient and helath insurance patient. Room 11 has capacity; 43 beds contains VIP A, VIP B dan first class. Distribution system used in Room 11 is room supply distribution system and partial dose unit distribution system. The form of that distribution system is pharmacy stand. This research is aimed to analyze the application of permanent procedure in relation to the improvement of pharmacy service in RSHS (Hasan Sadikin Hospital); to recite problems obstruct in procedure application; and to observe expected alternative in reducing those problems. Methodology used in this research in case observation method with descriptive approach which try to measure how far the process of permanent procedure has been held by using primary data, that is through observation and interview. Mean while, secondary data is obtained through notes and pharmacy report in July 2000, permanent procedure, policy, pharmacy service standard etc. The best assumed from the investigation is; if the drug distribution system supported by good procedure and easy to be applied, adequat personnel, increasing in amount and capability of its pharmacy, and sufficient in facility of distribution procedure, so we can expect that all of above factor can develop the health service efficiency and effectively.

Abstrak :
Pencegahan parut ginjal di kemudian hari pada tata laksana PNA belum memuaskan. Mekanisme vitamin E dalam menekan inflamasi dan sebagai antioksidan pada tata laksana anak dengan febrile UTI belum diteliti. Penelitian ini menelaah efek inhibisi vitamin E terhadap IL-6, IL-8, dan MDA urin. Efek perancu seperti usia, ASI, riwayat ibuprofen, dan infeksi E. coli, juga diteliti. Uji klinis acak tersamar ganda (n = 40) dilakukan di RS Fatmawati pada anak berusia 6?60 bulan dengan febrile UTI. Kelompok kasus diberikan 40 UI DL-α- tocopherol dan kelompok kontrol diberikan saccharum lactis selama 10 hari. Kedua kelompok mendapat terapi antibiotik yang sama. Pemantauan demam, leukosit darah, IL-6, IL-8, dan MDA urin dilakukan pada H0, H3 dan H10. Analisis IL-6 dan IL-8 dan MDA urin dilakukan di Laboratorium Biokimia FKUI. Kadar IL-6 urin lebih rendah pada kelompok vitamin E. Vitamin E menurunkan IL-8 urin namun tidak berbeda bermakna dibanding plasebo. Vitamin E tidak terbukti menurunkan demam lebih baik dibanding plasebo. Leukosit darah pada kelompok vitamin E lebih menurun dibanding kelompok plasebo, namun keduanya dalam batas normal. Perubahan MDA urin kedua kelompok tidak berbeda. Pemberian ASI menurunkan IL-6 dan IL-8 urin secara bermakna. Riwayat ibuprofen meningkatkan IL-6 dan IL-8 urin secara bermakna. Infeksi E. coli lebih meningkatkan MDA urin dibanding uropatogen lain. Manfaat penambahan vitamin E pada tata laksana febrile UTI masih perlu diteliti lebih lanjut.

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Prevention of subsequent renal scarring in APN treatment has not been encouraging. The mechanism of vitamin E in suppressing inflammation and as an anti-oxidant in pediatric febrile UTI patients has not been studied. This study aimed to examine the inhibitory effects of vitamin E on urinary IL-6, IL-8, and MDA. Confounding effects of age, breastfeeding, previous treatment with ibuprofen, and E. coli infection were studied. A randomized double blind placebo controlled clinical trial (n = 40) was conducted in Fatmawati Hospital on 6 to 60 months old subjects with febrile UTI. The intervention group received 40 IU DL- α-tocopherol while the control received saccharum lactis as placebo for 10 days. Both groups were treated with antibiotics equally. Fever monitoring as well as blood leukocyte, urinalysis, and urinary IL-6, IL-8, and MDA were performed on day 0, day 3 and day 10. Analyses of urinary IL-6, IL-8 and MDA levels were conducted at Biochemistry Laboratory of Faculty of Medicine University of Indonesia. Urinary IL-6 levels were lower in the vitamin E group. Vitamin E suppressed urinary IL-8 but this result was not statistically significant compared to that of the placebo group. Vitamin E was not proven to reduce fever better than placebo. Leukocyte was lower in the vitamin E group compared to the placebo group, but both counts were within normal limit. Changes of urinary MDA levels between the two groups was statistically insignificant. Breastfeeding significantly lowered urinary IL-6 and IL-8 levels. Ibuprofen withdrawal significantly increased urinary IL-6 and IL-8 levels. E. coli infection increased urinary MDA more than any other uropathogens. The supplementation of vitamin E in the treatment of febrile UTI in children needs to be further investigated.