The mutations of the KRAS gene at codons 12, 13, and 61 have been widely reported with different prognosis. In silico is one approach to explain the characteristics of the mutant genes. This study aimed to reveal the potential energy and fluctuations of the binding site and active site of wildtype KRAS (KRAS Wt) and mutant KRAS (KRAS Mt) at codons 12, 13, and 61. The samples used in this study were the sequences of KRAS Wt and KRAS Mt genes, which were subjected to in-silico analysis that included molecular homology, docking, and dynamics using MOE, PyMOL, and online CABS servers. The results showed that fluctuations in the binding site of all KRAS Mt were lower than that of KRAS Wt. On the contrary, the active site (switch I and switch II) of KRAS Mt fluctuated more widely than KRAS Wt. The potential energy of KRAS Mt before forming a complex with GTP was higher (p<0.01) than KRAS Wt. After this formation, it remained higher at codons 12 and 61 but lower at codons 11 and 13 (p <0.001). Mt G12A did not show any changes. The higher fluctuations in the switch I and switch II regions and the post energy of KRAS-GTP complexes may explain why types of cancers with mutations at codons 11 and 13 have a better prognosis than those with mutations at codons 12 and 61.
Rumah Sakit wajib memberikan pelayanan yang berkualitas sesuai dengan Standar Pelayanan Minimal (SPM) yang telah di tetapkan. Upaya untuk meningkatkan kualitas pelayanan kefarmasian di rumah sakit dapat dilakukan dengan penerapan peresepan elektronik. Penelitian bertujuan untuk mengetahui perbedaan kualitas pelayanan kefarmasian antara peresepan konvensional dan peresepan elektronik. Desain penelitian adalah observasional analitik dengan rancangan cross sectional study. Sampel berjumlah 431 resep diambil dengan teknik random sampling. Uji statistik pada variabel waktu tunggu dan kepuasan pasien yaitu uji t–independen sedangkan variabel kesalahan pemberian obat dan kesesuaian resep dengan formularium digunakan uji chi_square dengan tingkat kemaknaan 0,05. Hasil penelitian menunjukan terdapat perbedaan waktu tunggu (p value:0,000), kepuasan pasien (p value:0,000) dan kesesuaian resep dengan formularium (p value:0,000) antara peresepan elektronik dengan peresepan konvensional. Namun tidak terdapat perbedaan kejadian kesalahan pemberian obat antara peresepan elektronik dengan peresepan konvensional (p value:0,063). Penelitian ini menunjukkan bahwa kualitas pelayanan kefarmasian pada peresepan elektronik lebih baik dibandingkan dengan peresepan konvensional. Pimpinan dan manajerial RSUD M.Natsir hendaknya mengimplementasikan peresepan elektronik ini pada instalasi rawat jalan dan rawat inap sehingga kualitas pelayanan kefarmasian dapat ditingkatkan.
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