Retrospective Data Retrieval Research Articles

Vitiligo is associated with an increased risk of cardiovascular diseases: a large-scale, propensity-matched, US-based retrospective study

Vitiligo is an autoimmune disease, characterized by specific destruction of melanocytes. While associations with numerous comorbid conditions, which potentially increase the risk of cardiovascular diseases have been described, data on the risk for cardiovascular disease is inconclusive. To address this relevant knowledge gap, this study aims to identify the risk of cardiovascular disease in vitiligo. The US Collaborative Network was accessed using the TriNetX platform, allowing retrospective data retrieval from electronic health records (EHRs) from 57 US based health care organizations (HCOs). Patients with vitiligo and controls were identified by their respective ICD10 codes. Risk of onset of several cardiovascular diseases was determined in patients within 15 years after diagnoses. A total of 94 diagnoses with a prevalence of ≥1% in both cohorts, which consisted of 96,581 individuals per group after propensity-score-matching, were identified. Of those, 54 displayed an increased risk in vitiligo. None of the cardiovascular diseases investigated were associated with a decreased risk in patients with vitiligo. Specifically, cerebral infarction occurred in 1.3% of patients with vitiligo, and 1.0% in controls. This difference translated into a hazard ratio (HR) of 1.21 (95% confidence interval [CI] 1.11-1.32, padj<0.001). Venous thromboembolism was recorded in 1.34% of cases and 1.02% of controls without vitiligo, resulting in an increased HR of 1.27 (95% CI 1.171-1.38, padj<0.001). Further, major adverse cardiovascular events (MACE) as a composite endpoint was evaluated. The risk for MACE was increased following a vitiligo diagnosis (HR 1.28, 95% CI 1.22-1.35, padj<0.001), which persisted in both sensitivity analyses. Patients with vitiligo display an increased risk of onset of cardiovascular diseases as compared to healthy individuals. Thus, vitiligo might require more precise monitoring and systemic treatment. This research was supported by the Schleswig-Holstein Excellence-Chair Program from the State of Schleswig Holstein, by the Excellence Cluster Precision Medicine in Chronic Inflammation (DFG, EXC 2167), and by DFG Individual Grant LU 877/25-1.

Clinical and functional outcome of total transanal endorectal pull-through procedure for the management of Hirschsprung’s disease

ObjectiveThe aim of the study is to evaluate the complications and long-term bowel function in Hirschsprung’s disease (HD) patients following total transanal endorectal pull-through (TERPT) surgery operated in a tertiary hospital in Oman.MethodsA retrospective data retrieval was done for patients diagnosed with Hirschsprung’s disease and underwent total transanal endorectal pull-through procedure during the period from December 2008 to June 2019 with concomitant prospective phone call questionnaire interview to assess the long-term functional outcome of children aged 3 years and older.ResultsTotal transanal endorectal pull-through was performed in 61 patients. The mean age at the time of operation was 7.71 ± 8.26 months. The most common late complication was anal excoriation (19.7%). Of the patients, 61.5% had a normal to fair score, and the remaining 38% had a poor score in their functional outcome questionnaire. The majority had no social problems (65.4%), while 15.4% had problems causing varying degrees of social restrictions.ConclusionThe short-term outcomes of total transanal endorectal pull-through are found to be acceptable. In addition, the long-term functional outcome post total transanal endorectal pull-through was found to be satisfactory; however, longer follow-up studies with larger sample sizes are needed for more accurate functional outcome evaluation.

Reggio Emilia (Northern Italy) Interdisciplinary Uveitis Clinic: What We Have Learned in the Last 20 Years

ABSTRACT Purpose To analyze the referral patterns and the clinical and therapeutic features of patients diagnosed with uveitis in an Italian tertiary referral center to provide a comparison with previously published series from the same center. Methods Retrospective retrieval of data on all new referrals to the Ocular Immunology Unit in Reggio Emilia (Italy) between November 2015 and April 2022 and comparison with previously published series from the same center. Results Among the 1557 patients, the male-to-female ratio was 1:1.27. Anterior uveitis was the most common diagnosis (53.7%), followed by posterior (21.6%), pan- (18.5%), and intermediate (6.2%) uveitis. The most identifiable specific diagnoses were anterior herpetic uveitis (18.4%), Fuchs uveitis (12.8%), and tuberculosis (6.1%). Infectious etiologies were the most frequent (34.1%) and were more diffuse among non-Caucasian patients (p < 0.001), followed by systemic disease-associated uveitis (26.5%), and ocular-specific conditions (20%). Idiopathic uveitis accounted for 19.4% of cases. Fuchs uveitis presented the longest median diagnostic delay (21 months). Immunosuppressants were administered to 25.2% of patients. Antimetabolites, calcineurin inhibitors, and biologicals were prescribed to 18.4%, 3%, and 11.4% of cases, respectively. Compared to our previous reports, we observed a significant increase in foreign-born patients and in infectious uveitis, a decrease in idiopathic conditions, and an increasing use of non-biological and biological steroid-sparing drugs. Conclusions The patterns of uveitis in Italy have been changing over the last 20 years, very likely due to migration flows. Diagnostic improvements and a more widespread interdisciplinary approach could reduce the incidence of idiopathic uveitis as well as diagnostic delay.

Comparison of clinical and laboratory characteristics between severe and non-severe dengue in paediatrics.

The timely identification of severe dengue in peadiatric patients is of utmost importance, as any delay in diagnosis could lead to an irreversible state of shock potentially leading to fatal consequences. The primary aim of our study was to characterize dengue severity in paediatric patients based on initial symptoms, signs, and laboratory investigation of their presentation in the emergency department. We conducted a retrospective data retrieval from the medical records of 254 paediatric patients who had been diagnosed with confirmed cases of dengue fever. The clinical characteristics were compared between severe and non-severe dengue. Multiple logistic regression analysis was utilised to elucidate the variables that exhibited associations with severe dengue. A total of 254 paediatric patients were included, among whom 15.4% (n = 39) were diagnosed with severe dengue. Multiple logistic regression analysis identified lethargy, systolic blood pressure (SBP) below 90 mmHg, capillary refilled time (CRT) longer than 2 seconds, ascites, and hepatomegaly were independently associated with severe dengue. In paediatric patients, severe dengue is associated with specific clinical indicators, including lethargy, low systolic blood pressure, prolonged capillary refill time (CRT), and the presence of ascites and hepatomegaly. Identifying these clinical features early is crucial for primary care physicians, as it enables accurate diagnosis and timely intervention to manage severe dengue effectively.

Analysis of polypharmacy events and drug-drug interaction in COVID-19 therapy

Background: Polypharmacy is the use of five or more types of drugs in a therapy simultaneously. The use of polypharmacy therapy increases the potential for drug-drug interactions. In COVID-19 therapy, the use of varied antiviral and non-antiviral medications allow for increased polypharmacy and potential drug interactions. Objective: To determine the relationship between polypharmacy and drug-drug interactions in COVID-19 therapy. Method: This is an analytical observational study with retrospective data retrieval using secondary data sources. The sampling technique used purposive sampling with a total of 91 samples. Tracing potential drug interactions was reviewed through the Micromedex 2.0 application and the results obtained were analysed with the Spearman correlation analysis test. Result: The results of data obtained from non-polypharmacy events was 3.20% and polypharmacy events was 96.80%. The potential for drug interactions was at the Contraindicated category (3.78%), the Major Category (66.19%), the Moderate category (27.87%) and the Minor category (2.16%). The results from the test showed a very strong positive correlation between polypharmacy and potential drug interactions characterised by a p-value of 0.0001 and a correlation coefficient of 0.874. Conclusion: The higher the increase in polypharmacy, the higher the potential for drug interactions. Handling of drug interactions that occur can be given by giving a pause in the time of drug use, dose adjustment, and drug turnover.

Hubungan Rasionalitas Penggunaan Antibiotik terhadap Luaran Klinis Pasien Pneumonia Komunitas Rawat Inap

Pneumonia is a lung parenchyma disease caused by bacteria, fungi, viruses, and parasites. Irrational use of antibiotics will lead to antibiotic resistance, so the goal of therapy has yet to be achieved. This study evaluates the rationality of using community antibiotics for the clinical outcome of community pneumonia patients in RSUD. Dr. H. Abdul Moeloek.This research is descriptive-analytic with a cross-sectional design and retrospective data retrieval from medical records in 2019. The data analysis was carried out descriptively, and the correlation analysis of the rationale of antibiotic use with clinical outcomes using the Spearman test. The study's results of 144 analyzed showed the characteristics of community pneumonia patients, 78 male, and 66 female patients. The evaluation of the use of antibiotics using the ATC/DDD method showed that Ceftriaxon DDD was 46.80 DDD/100 patient-days, Azithromycin (23.91 DDD/100 patient-days), Levofloxacin (22.70 DDD/100 patient-days). With the Gyssen method, patients used antibiotics correctly (category 0) by 72.91% and incorrectly (categories I – VI) by 27.09%. Statistical analysis showed a significant relationship (p-value=0.003) between the rational use of antibiotics and patient clinical outcomes. Further research is needed regarding the incidence of Drugs Related Problems on the clinical effects of community pneumonia patients.

Evaluasi Penggunaan Obat dan Kesesuaian Dosis Kemoterapi Body Surface Area (BSA) Pasien Kanker Payudara di RSUD Sekayu

Research has been conducted on the description of the use of chemotherapy drugs and evaluation of the suitability of doses with the method of body surfeace area (BSA) in breast cancer patients (ca.mamae) at the Sekayu Regional General Hospital. The purpose of this study is to find out an overview of the use of drugs and doses given in chemotherapy patients. This research is descriptive with retrospective data retrieval method where data is obtained from the medical records of patients diagnosed with breast cancer in the period January-December 2019. Data retrieval technique in the form of total sampling, obtained 18 samples according to inclusion criteria.The results of the study obtained is on the use of chemotherapy drugs all patients get fac drug regimen as many as 18 patients (100%) and evaluation of dose conformity calculation obtained by 17 patients (94.44%) obtained an inappropriate dose and 1 patient (5,56%) get the appropriate dosage. From the results of the study obtained that the chemotherapy drug used is a first-line chemotherapy drug is in accordance with the treatment guidelines and the dose used has not been in accordance with the calculation based on the body surface area (BSA).

Kajian DRPs dan pola peresepan pada pasien rawat inap anak dengan asma

The incidence of drug-related problems (DRPs) is very common occur in pediatric inpatients where treatment must be prioritized because their physiological conditions are not yet perfect so metabolism and drug absorption cannot be equated. The risk of developing DRPs results in a decrease in the patient's quality of life, increases the rate of death and disability and increases costs. Asthma is a chronic disease, the prevalence of asthma in children is high enough that it requires serious attention. In Indonesia, the prevalence of asthma in elementary school children (0-14 years) is 9.6%. This study aims to identify drug related problems and determine treatment patterns in pediatric patients with asthma at X Hospital. This research was a non-experimental study conducted with a descriptive design through retrospective data retrieval of the medical records of children with asthma who were hospitalized in January-July 2017 at X hospital. DRPs and treatment patterns were assessed from the patient's medical record data and then analyzed using percentages. DRPs were entered in bullet points while treatment patterns were in the table. The results of this study were the class of drugs used. Corticosteroids, beta-2 agonists, beta-2 agonists and anticholinergic combinations, beta-2 agonist combinations with corticosteroids, antihistamines, antihistamine and decongestant combinations and methylxanthine. Types of drugs used are salbutamol, procaterol, dexamethasone, methylprednisolone, triamcinolone, budesonide, aminophylline, and a combination of albuterol and ipratropium bromide. The results of the DRPs study were, that there was no indication that there was no treatment, drugs with inappropriate indications in 50%, the wrong drug was 66.6%, the dose was too high at 61.1%, drug interactions amounted to 22.2%, and non-compliance does not exist.Â

Myeloid sarcoma: experience from a hematology care centre of Eastern India

Objectives: To describe the case series of patients with myeloid sarcoma with their clinicopathological characteristics, cytogenetics, molecular markers, prognosis, and outcome. Material and Methods: Retrospective retrieval of data of myeloid sarcoma cases in acute myeloid leukemia was done from the electronic health records of our hospital and this case series includes the data of three years starting from January 2018 and the follow-up information was assimilated until December 2020. Results: We present twelve patients in this case series with myeloid sarcoma and all these patients had bone marrow involvement at presentation. Most of the cases were less than 20 years of age and orbit (66.7%) was the commonest site of presentation in this series. Aberrant CD 19 expression on immunophenotyping was a common associate (66.9%) and t(8;21) was the commonest cytogenetic abnormality reported in our case series. Despite of high dose intensive therapy with daunorubicin and cytarabine followed by high-dose cytarabine (HiDAC) consolidation, patients had a median relapse-free survival and median overall survival of 160 days and 299.5 days respectively. Local radiotherapy for consolidation in two of our patients had no additional benefit. Conclusion: Myeloid sarcoma is extramedullary collection of myeloid blasts with or without bone marrow involvement. They were commonly seen in young patients and t(8;21) being a common cytogenetic abnormality associated with it. The treatment outcome of patients with myeloid sarcoma seems dismal and systemic therapy remains the modality of choice.

Comparison of disease activity in patients with ankylosing spondylitis under TNFi or NSAID treatment, is there any difference? An observational study

ObjectiveTo assess whether there are any real-life differences between ankylosing spondylitis (AS) patients treated with NSAID or TNF inhibitors (TNFi) regarding disease activity. MethodsThis is an observational transversal unicentric study with retrospective retrieval of data from clinical records of all AS patients attended in our hospital. We compared clinical activity measured by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores between patients treated with NSAID and those treated with TNFi, in terms of low disease activity defined as BASDAI<4, and inactivity when BASDAI≤2. As secondary variables, we also collected epidemiological, clinical and radiological data from all those patients. ResultsA total of 152 AS patients (81% male), with an average age of 49.45±12.38 years and a disease duration of 13.5±9.79 years were included in the study. Eighty-nine patients (58.6%) were treated with NSAID and 63 (41.4%) with TNFi. The proportion of patients with low disease activity and inactive disease was significantly higher in the TNFi treatment group compared to the NSAID group (81 vs. 47, P=.0001) and (44 vs. 24, P=.007), respectively. Patients treated with NSAIDs also showed significantly more global pain and night pain than those under TNFi therapy. The BASFI score and especially the type of treatment (NSAID or TNFI) were the only variables independently associated with low disease activity or inactive disease. ConclusionIn real world practice, AS patients under TNFi treatment show a better control of clinical symptoms than those under NSAIDs.

Evaluation of Drug Planning and Procurement at the Pharmacy Installation of Regional General Hospital Dr. M. Haulussy Ambon

Pharmacy Installation is part of the hospital responsible for implementing drug management which includesselection, procurement, distribution and use of the drug. This research aims to evaluate the planning andprocurement of medicines in Dr. M. Haulussy Ambon Hospital Pharmacy Installation. Research usesdescriptive design with retrospective and concurrent data retrieval. Retrospective data is data obtained bytracing the previous year’s documents (secondary data) in 2018 including financial statements, drug planningand use reports, drug procurement reports, and invoices. Retrospective data retrieval is carried out on, thepercentage of conformity between drug planning and the reality of use for each drug. Concurrent data is dataobtained at the time of research or is primary data with in-depth interviews with IFRS officers as well asdiscussions with officers/employees related to drug management. The results showed the Procurement stageof the procurement of funds for each drug item already met the standards. The suitability of planning with thewear reality for each item is not in accordance with the standard (less than 100%). It is expected to cooperatewell with related parties, especially pharmaceutical installations in drug planning and management so thatthe use of existing funds can be more efficient and effective.

Outbreak of Burkholderia cepacia Complex Due to Multiple Brands of Contaminated Aqueous Chlorhexidine in Hong Kong

Background: Contaminated chlorhexidine produced by a single company has been implicated in the outbreak or pseudo-outbreak of Burkholderia cepacia complex (BCC). However, simultaneous occurrence of multiple brands of contaminated chlorhexidine supplied by different manufacturers resulting in a persistent outbreak for &gt;1 year has not been well described. Objective: We report an outbreak of BCC with epidemiological investigation and using whole-genome sequencing (WGS) analysis of patient and environmental isolates in Hong Kong. Methods: Upon the investigation of a cohort of renal patients undergoing peritoneal dialysis colonized or infected with BCC in their exit sites, different brands of 0.05% aqueous chlorhexidine (aqCHX) used for exit site dressing, supplied from hospital or purchased from community pharmacies by patients, were cultured. A risk factor analysis for exit-site acquisition of BCC was performed. A site visit to a local manufacturer was conducted to investigate the process of production and to collect environmental samples for culture, which were further analyzed by WGS along with the BCC isolates cultured from patients and aqCHX purchased from community pharmacies. Results: Four patients undergoing peritoneal dialysis had cultures positive for BCC in the exit site swab in September 2019. A snapshot screening revealed 88 (32.0%) of 275 renal dialysis patients colonized with BCC. Of these patients, 47 (17.1%) were newly diagnosed and 41 (14.9%) were known to be colonized or infected with BCC according to retrospective data retrieval from January 1, 2018. A significantly greater proportion of patients with newly diagnosed BCC (cases) had used contaminated aqCHX for exit-site dressing than those with culture negative for BCC (controls): 38 of 47 (80.9%) versus 54 of 187 (28.9%) (P &lt; .001). Of 161 aqCHX samples, 10 brands from 4 manufacturers (purchased from community pharmacies), 125 (77.6%) were culture positive for BCC, whereas all 77 aqCHX samples supplied by the hospital, which are different brands and are produced by different manufacturers, were proven to be sterile. Of the 28 environmental samples taken from a local manufacturer during the site visit, 19 samples (67.9%, 3 collected from the instrument for production of aqCHX and all 16 newly produced aqCHX samples) were culture positive for BCC. WGS revealed 3 major clusters characterized by B. cenocepacia genomovar IIIA ST1547 and 2 novel MLST clusters from 52 patients and 26 environmental isolates selected. Conclusions: This outbreak was terminated by product recall, and the government has decided to take regulatory actions to ensure the sterility of antiseptics, including aqCHX.Funding: NoneDisclosures: None

Profile of Antibiotic Use and Germ Map in Pneumonia Patients in Pulmonary Space (Case Study at RSUD dr. Iskak. Tulungagung)

Pneumonia is an infection of lung tissue caused by bacteria, fungi, viruses or parasites. Antibiotics is a major therapy in pneumonia. The aim of this study was to determine the amount of antibiotic use in DDD / 100 patient-days and to know the profile of germs map in pneumonia patients in Pulmonary Room Dr. Iskak Hospital, Tulungagung during January-June 2017.The design of this research is observational research method with retrospective data retrieval from patient medical record data and antibiotic usage data from Pharmacy Installation and microbiology culture result data of patient, then analyzed descriptively. The results showed the total amount of antibiotic in 130 unspecified pneumonia patients non ICU inpatient in Pulmonary Room Dr. Iskak Hospital, Tulungagung during January-June 2017 was 51.28 DDD/100 patient-days. The most antibiotic types are levofloxacin iv 40, 14 DDD/100 patient-days and ceftriaxone 8.71 DDD/100 patient-days. The profile of the pneumonia-causing germs map cannot be determined because there is no data on microbiological culture test results from the patient.

IDENTIFICATION OF DRUG-RELATED PROBLEMS IN ADULTS WITH TUBERCULOSIS AT THE TEBET SUBDISTRICT HEALTH CENTER FROM JULY TO DECEMBER 2018

Objective: Tuberculosis (TB) is a highly prevalent infectious disease caused by Mycobacterium tuberculosis. The recommended TB treatment is acombination of various antibiotics in the form of a fixed-dose combination tablet or kombipak; however, this increases the prevalence of drug-relatedproblems. Therefore, this study aimed to identify drug-related problems of patients receiving TB therapy at the Tebet Subdistrict Health Center fromJuly 2018 to December 2018.Methods: The study was designed as a cross-sectional study using the retrospective data retrieval method from prescriptions of patients withTB from July 2018 to December 2018. The classification system prepared by Cipolle, Strand, and Morley was used for the classification of drugrelatedproblems; this system includes unnecessary drug therapy, required additional drug therapy, ineffective drug, dosage error, and druginteraction.Results: The percentage of unnecessary drug therapy, required additional drug therapy, ineffective drug, dosage error, and drug interaction was2.85%, 6.89%, 1.54%, 12.46%, and 66.18%, respectively, with the occurrence of drug-related problems being the highest.Conclusion: The administration of anti-TB drugs can potentially cause drug-related problems. Therefore, the assessment needs to be optimizedbefore the administration of medications to patients and medications should be prescribed and monitored regularly to achieve rational drug use

Fine-Needle Aspiration Cytology of Salivary Gland Lesions: A Revised Classification Based on "Milan System"-4years Experience of Tertiary Care Cancer Center of South India.

Background:Fine-needle aspiration cytology plays role in preoperative diagnosis of any salivary gland mass lesions. Because of heterogeneity of salivary gland lesions and cytomorphology overlap, a uniform 6-tier Milan classification proposed which could be helpful in better communication of reports for patient's management.Methods:Study included 4 years (2011–2015) retrospective data retrieval from cytology department of our Institute, which is a tertiary care cancer center of South India. Histopathology correlation was done wherever possible.Result:Total 253 cases were studied. Histopathological follow-up was available in 115 cases. Cases were categorized as nondiagnostic (1.58%), nonneoplastic (13.43%), benign (30%), atypia (0.8%), and suspicious for malignancy and malignant cytology (51.8%). The risk for malignancy was high for suspicious for malignancy and malignant cytological categories ranged from 96–100%. The sensitivity, specificity, and accuracy for diagnosing malignancy varied from 86.76%, 93.75%, and 89%, respectively.Conclusion:Risk stratification approach in classifying salivary gland cytology aspirate as per Milan system provides a standardized reporting and better communication to clinician.

Distance from referral hospital as a risk factor for mortality and length of stay of neonates admitted in a tertiary care hospital

Background: Around 66% of infant and over 50% of under-five mortality occurs in newborn period. 99% of neonatal deaths occur in low and middle income countries. Most of these deaths can be prevented by suitable interventions at various levels. The premise of the study is that the neonates who require long transportation (&gt;1 hour) have higher chances of mortality or prolonged stay in the hospital.Methods: A retrospective retrieval of data and prospective interview was conducted in G.B Pant children’s hospital Srinagar, an associated hospital of Govt. Medical College Srinagar in North India.Results: During the period of study 1431 neonates from twelve districts of the state were referred to the hospital for treatment, out of whom, 102 (7.13%) could not be saved. Neonatal death rate was found highest (11.11%) in neonates referred from districts of category-III (&gt;100 kms from the referral hospital), followed by category-II (50-100 kms from the referral hospital) and category-I (&gt;50 kms from the referral hospital). Average length of stay was observed longest for the neonates referred from districts of category-III followed by category-II and category-I.Conclusions: Several other studies found that transfer of sick neonates from another health facility were associated with relatively higher probability of morbidity and mortality after controlling for other predictors. Distance no doubt is a risk factor for neonatal outcome of referred neonates as we have observed in our study. To minimize neonatal deaths it is necessary to strengthen the perinatal services sick newborn care unit {(SNCUs) in district Hospitals)}.

Comparison of disease activity in patients with ankylosing spondylitis under TNFi or NSAID treatment, is there any difference? An observational study

To assess whether there are any real-life differences between ankylosing spondylitis (AS) patients treated with NSAID or TNF inhibitors (TNFi) regarding disease activity. This is an observational transversal unicentric study with retrospective retrieval of data from clinical records of all AS patients attended in our hospital. We compared clinical activity measured by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores between patients treated with NSAID and those treated with TNFi, in terms of low disease activity defined as BASDAI<4, and inactivity when BASDAI≤2. As secondary variables, we also collected epidemiological, clinical and radiological data from all those patients. A total of 152 AS patients (81% male), with an average age of 49.45±12.38 years and a disease duration of 13.5±9.79 years were included in the study. Eighty-nine patients (58.6%) were treated with NSAID and 63 (41.4%) with TNFi. The proportion of patients with low disease activity and inactive disease was significantly higher in the TNFi treatment group compared to the NSAID group (81 vs. 47, P=.0001) and (44 vs. 24, P=.007), respectively. Patients treated with NSAIDs also showed significantly more global pain and night pain than those under TNFi therapy. The BASFI score and especially the type of treatment (NSAID or TNFI) were the only variables independently associated with low disease activity or inactive disease. In real world practice, AS patients under TNFi treatment show a better control of clinical symptoms than those under NSAIDs.

Gambaran Standar Perencanaan dan Pengadaan Obat di Instalasi Farmasi RSU Kota Tangerang Selatan Tahun 2017

Selection and Procurement are the crucial things in drug management system and they become primary things to do to avoid drug emptiness. The o bjective oh this research is to know the effectiveness and effec iency of drug management in Selection and Procurement stage at South Tangerang City General Hospital in 201 7. The m ethods of this research is d escriptive research design with retrospective data retrieval. Data in the form of qualitative and quantitative accompanied by interviews with related parties. Selection and Procurement Phase in the measurement of its efficiency by using the indicator that issued by MOH RI (2002). The results showed that in the selection stage of drug management at Tangerang Selatan Public Hospital in 2017 showed it has not been effective, it has seen from the measurement on the indicator of conformity of the drug item with the DOEN showed the value of 20.90% below the standard value of 49%. Then at the Procurement stage show ed effective results, it has seen from the Frequency of procurement of medicinal items each year show ed frequency results as much as 1-19x / year (Medium standard), the frequency of error invoice / order letter as much as 2 times the value of comparison 1-9 times, and the frequency of delayed payment by the hospital 15 times from the comparison value 0-25 times. Drug procurement in South Tangerang General Hospital has been effective, it showed from the Frequency of procurement of medicinal items per year , the frequency of error invoice / order letter , and the frequency of delayed payment by the hospital . Based on this results, the Drug Procurement in South Tangerang General Hospital has been effective, but the selection hasn’t effective yet.

Evaluasi Rasionalitas dan Efektifitas Penggunaan Antibiotik pada Pasien Pneumonia Pediatrik di Instalasi Rawat Inap Rumah Sakit Pusat Jawa Tengah

Pneumonia is a respiratory infections disease are caused by bacterial, viral, fungal and parasitic pathogens that cause deaths in children, especially toddlers and increasing number incidents per year. Treatment of pneumonia treated with antibiotics rational and effective because can improve clinical therapeutic effects, minimize drug toxicity, reduce the incidence of resistance that leads to treatment failure, and more economically. The purpose of this study are to determine the rationale and effectiveness of antibiotic therapy. This study was an observational study with retrospective data retrieval using medical record data of pediatric patients diagnosed pneumonia in center hospital, Central Java. The results of 90 cases studied were 60% of patients treated with single antibiotics and 40% of patients treated with combination antibiotics. The most antibiotics given in single therapy were ampicillin (22,2%), amoxicillin (16,7%), and ceftriaxone (15,6%). While antibiotics in combination therapy was ampicillin with gentamicin 31.2%. rationality result analysis was: right indication 100%; proper patients 100%; appropriate medicines 72,2%; appropriate dose 9,23% and rational antibiotics 6,67%. Giving antibiotics ampicillin with gentamycin effective in eradicating bacteria this could be seen with temperature and leukocyte rate down, antibiotics did not improve on symptoms of patients.

Cost Effectiveness Analysis Using Antibiotics of Cefixime and Cefotaxime for Diarrhea Patients at X Hospital in 2017

Diarrhea is a disease characterized by a change in the shape and consistency of stools, from soft to liquid, and increased frequency of bowel movements, which happen three times or more in a day. Different use of antibiotics by patients results in patient’s medical cost increase. The use of expensive antibiotics does not guarantee the effectiveness of patient care, therefore a research needs to be done to determine which antibiotic therapy is more cost effective between cefixime and cefotaxime antibiotics in hospitalized diarrhea patients in X hospital. This research was descriptive research with retrospective data retrieval. This research was conducted at Medical Record Installation and Fund mobilization department of X hospital from November 2017 - Maret 2018. The samples in this study were 42 patients with 21 patients using Cefixime and 21 patients were using an Cefotaxime. Data was analyzed descriptively in table form. The results showed that the more cost-effective therapy between Cefixime and Cefotaxime in the treatment of diarrhea in X hospital was therapy with Cefixime antibiotic, which can be seen from ACER (Average Cost-Effectiveness Ratio) Cefixime Rp. 323.428,14/day compared with Cefotaxime ACER value of Rp. 477.180,26/day for each increase in effectiveness. The lowest ICER value on Cefixime was Rp. -50.565,8.-