Effectiveness of permethrin standard and modified methods in scabies treatment Abstrak Latar belakang: Permetrin adalah obat pilihan untuk terapi skabies tetapi memiliki efek samping eritema, nyeri, gatal dan rasa menusuk. Pengobatan standar dengan mengoleskan permetrin ke seluruh tubuh menimbulkan ketidaknyamanan sehingga timbul pemikiran memodifikasi metode pengobatan skabies dengan cara mengoleskan permetrin di lesi saja diikuti mandi dua kali sehari memakai sabun. Tujuan penelitian ini untuk mengetahui efektivitas permetrin metode standar dibandingkan dengan metode modifikasi dalam pengobatan skabies. Metode: Penelitian eksperimental ini dilakukan di sebuah pesantren, Jakarta Timur dan pengambilan data dilakukan pada bulan Mei-Juli 2012. Diagnosis skabies ditetapkan dengan anamnesis dan pemeriksaan kulit. Subyek positif skabies dibagi menjadi tiga kelompok: satu kelompok metode standar (permetrin dioleskan ke seluruh tubuh) dan dua kelompok modifikasi (permetrin hanya dioleskan di lesi diikuti mandi memakai sabun biasa dan sabun antiseptik). Ketiga kelompok dievaluasi setiap minggu selama tiga minggu berturut-turut. Data diolah dengan SPSS versi 20 dan dianalisis dengan uji Kruskal-Wallis.

Background, aims and objectives: One of the roles of a family physician is as a care coordinator. This study aimed to develop a care coordinator measurement tool for family physicians in Indonesia. The instrument development method was conducted using Expert Judgement, the Delphi Technique and Factor Analysis. Thirteen themes relevant to the work of a care coordinator were obtained from 19 experts. Eighty-eight items were drafted from thematic definition and a literature search. Fifty-four items were selected through 2 rounds of Delphi Technique. No significant characteristic difference were found in both Delphi samples. The items considered very relevant to the work of a care coordinator (Likert scale 8-9) from more than 75% respondents were selected for factor analysis. A factor analysis was conducted on 249 samples. It showed an adequate number of samples and correlation for all items (KMO of Sampling 0.936 and Bartlett’s Test < 0.001). Eleven factors were derived from the results of eigenvalue > 1. Thirty-three items were filtered after determined loading factor > 0.4. Cronbach's alpha for each factor varied from 0.7-0.91. Cronbach's alpha for a total of 33 items was 0.94 with total variation documented as high as 77%. Conclusion: A valid and reliable care coordinator measurement tool for Indonesian Family Physicians has been developed, consisting of 11 factors and 33 items.

<p><strong>Objective</strong>. Clopidogrel is a common antiplatelet used as secondary prevention of ischemic stroke, known to have better efficacy than aspirin, with a equivalent safety profile. However, clopidogrel resistance is not uncommon but has not been widely studied in Asia. This study will further assess clopidogrel resistance and its risk factors.</p><p><strong>Materials and Methods</strong>. A cross-sectional study was conducted at Rumah Sakit Universitas, Indonesia, and Rumah Sakit Cipto Mangunkusumo, Indonesia in 2020-2021. All patients had had at least one episode of ischemic stroke. Clopidogrel resistance was assessed using a VerifyNow assay.</p><p><strong>Results</strong>. 57 subjects were enrolled in this study. We found 15.8% of subjects were clopidogrel resistant. Gender was significantly associated with clopidogrel resistance, with males having 80% lower clopidogrel resistance (OR 0.2 (95% CI 0.022 – 0.638); P=0.006). Meanwhile, smoking was not associated with clopidogrel responsiveness (P=0.051). We found no association between haemoglobin, blood glucose, HbA1c, cholesterol, liver enzymes, serum urea concentration or creatinine levels and clopidogrel resistance.</p><p><strong>Conclusion</strong>. Clopidogrel remains an effective treatment to prevent recurrent ischemic stroke in Indonesia. Further studies are needed to assess gene polymorphism and clopidogrel resistance, which may explain the findings of this study.</p>

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