No abstract

Background: Surgery is one of the basic components of very important health care system. Therefore, the risk of any infectionin the surgical process must be known because microbes maycome in or accidentally come into the limbs that are in surgery. Microbes can cause nosocomial infections or Health Care Associated Infections (HAIs).WHO survey shows 5% -34% of HAIs are SSI while the highest prevalence of HAIs occurs intensively in care units, acute surgery and orthopedic rooms. Thisresearch aims to determine SSI and risk factors for SSI in orthopedic surgery patients at Fatmawati Hospital in July-October 2018. Method: This research was observational using cross sectional design,in whichthe data collection wasperformed prospectively. Data analysis was performed by univariate, bivariate, and multivariate analytic using total sampling from patients who performed orthopedic surgery at Fatmawati Hospital in both elective and cito surgery on July-October 2018 and SSI data collection was performed after surgery, namely in orthopedic poly outpatient care and inpatient care. Result: Data obtained in this research showed SSI level is 3.9 % of Orthopedic Surgery (3.9% cases of a total  770) in the research period. The results of the chi-square analysis showed that the diabetes mellitus, ASA score and type of surgery had a significant relationship with the incidence of SSI with significance value diabetes mellitus that is 0.024; ASA score that is 0.035 and type of surgery that is 0.001 where p <0.05, while the use of prophylactic antibiotics and other risk factors did not have a significant relationship,in which because p>0.05. Analysis with logistic regression showed that the type of operation had a significant influence with the incidence of SSI which was 0.004 (p <0.05). Conclusion: From this research, it can be inferred that this type of surgery can increase the occurrence of SSI. Therefore, it is necessary to evaluate to reduce the rate of surgical site infections.

Hipertensi adalah peningkatan tekanan darah sistolik lebih dari 140 mmHg dan tekanan darah diastolik lebih dari 90 mmHg pada dua kali pengukuran dengan selang waktu lima menit dalam keadaan cukup istirahat / tenang. Tujuan penelitian ini adalah untuk mengetahui kesesuaian jenis dan jumlah obat antihipertensi dengan standar pengobatan hipertensi, untuk mengetahui ketersediaan obat antihipertensi sesuai dengan jenis dan jumlahnya serta untuk mengetahui pengaruh ketersediaan obat antihipertensi terhadap pengobatan pasien hipertensi di puskesmas Kota Bandar Lampung. Penelitian ini menggunakan studi expost facto atau observasional yang bersifat deskriptif dengan teknik pengumpulan data secara retrospektif dan prospektif selama tahun 2017  pada 23 puskesmas di Kota Bandar Lampung. Analisa data menggunakan analisis deskriptif, analisis chi square dan analisis multivariat. Hasil uji chi square pada tingkat pendidikan dokter dan tenaga kefarmasian nilai Asymptotic Significance (2-sided) < 0,05 yaitu 0,027 dan 0,047, ketersediaan obat antihipertensi nilai Asymptotic Significance (2-sided) 0,005 dan 0,001 < 0,05, artinya variabel tersebut ada dengan kebutuhan jenis dan jumlah obat antihipertensi untuk pasien hipertensi. Pada analisis multivariat secara stimultan, ketersediaan obat antihipertensi paling berpengaruh atau dominan terhadap kebutuhan jenis dan jumlah obat antihipertensi untuk pasien hipertensi dilihat dari nilai significance yang paling kecil yaitu 0,005 dan dilihat dari nilai OR yang terbesar yaitu 5,588 .Dapat disimpulkan bahwa secara stimultan dan bersama-sama  ketersediaan obat antihipertensi berpengaruh terhadap pengobatan pasien hipertensi. Kata Kunci : Ketersediaan Obat Antihipertensi, Pasien hipertensi, Pengobatan

A pharmacy is a place where pharmacists do their pharmaceutical work, serving directly and responsibly for patients who need their professional services. One form of direct service is the provision of drug information and counseling. The purpose of this study was to describe the drug information services provided by pharmaceutical personnel in the South Tangerang area pharmacy for patients who redeemed prescriptions using antibiotics. Patient simulation method was used to collect data to 100 pharmacies that were randomly selected based on data in the city health office. Recommendations were obtained from the South Tangerang branch of the Indonesian Pharmacists Association while ethical clearance was obtained from the ethical committee of the Faculty of Medicine, University of Indonesia. The results of this study indicate that 85% percent of pharmaceutical personnel who provide drug information for simulated patients are non-pharmacists. The most widely conveyed drug information items were the frequency of drug use delivered by 82% of pharmacists, received by the intended use (61%) and time of use (44%). Not related to pharmacy officers who submit the following information: drug interactions and ways to prevent them, side effects of drugs and how to prevent them; food and drinks that must be avoided as well as how to store drugs. As many as 51% of pharmacists provide additional antibiotics requested by patients without a prescription. Drug information points provided by pharmacy staff specifically  by pharmacist had not been maximally delivered.

Objectives: To investigate the value of early lactate dynamic monitoring index in predicting prognosis of patients with sepsis and septic shock. Methods: We performed our test on 50 patients. Out of 50 patients, 28 are male, and 22 are female. Prospectively studied pediatric patients with septic shock were performed. Vital signs, Lactate clearance, were obtained at presentation 6 h, 12 h, 24 h over the first 48 h of hospitalization. The therapy received, outcome parameters of mortality and duration of hospitalization were recorded. Results: The statistical data and comparative analysis showed that an average of 16.88 days after admission, 5 patients have died, 17 patients are poorly prognosis leaves the hospital, and the remaining 28 are recovered and discharged. The primary outcome variable of mean 16 days hospitalization mortality rate was 10%. Poor prognosis 34% and fully recovery 56 % were observed. In this retrospective cohort study, a lactate level of more than 2.5mmol/L was the best threshold to predict 28-day mortality among severe sepsis and septic shock patients. In our research, we found mean LC 6 h 3.08mmol/L, and after 48 h mean it is 1.79mmol/L. Significant LC 6 h found, which is 8.08mmol/L in the death group patient where 48 h mmol/L shows significant high. Poor prognosis also presents a clinical increase of lactate level high in the LC 6 h analysis, which is 3.32mmol/L. Recovered patients showed a significant improvement after administering treatment depending on the patient organ involvement and good decrease of lactate reports achieved, which is 1.20mmol/L, where admission reports show it was 1.91mmol/L in LC 6 h. Mean Heart rate 94/51mmhg, pulse 119, temperature 39℃, respiratory rate 32.26, and urine output 456 ml recorded during our study. Death patient shows a remarkable detonation of those reports but has a significant clinical report with the recovered patients. Conclusion: The early lactate dynamic monitoring index has a high value in predicting sepsis and septic shock patients' prognosis, thus worth popularizing.