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"Latar belakang: Akne vulgaris (AV) adalah penyakit unit pilosebasea kronis tersering yang dapat menimbulkan dampak psikologis berat dan mengganggu kualitas hidup penderitanya. Penggunaan terapi ajuvan yaitu ekstraksi lesi akne yang dikombinasikan dengan terapi standar dapat memperbaiki kondisi klinis dan kualitas hidup penderita akne. Pengukuran kualitas hidup penting dilakukan untuk menilai keberhasilan terapi. Saat ini telah tersedia kuesioner kualitas hidup spesifik akne berbahasa Indonesia (Acne-QoL- INA) yang tervalidasi, namun belum pernah ada data mengenai perbandingan kualitas hidup antara terapi kombinasi dan terapi standar.Metode: Studi uji klinis acak terkontrol tersamar tunggal ini dilakukan pada subjek akne vulgaris dewasa derajat sedang berdasarkan kriteria Lehmann yang dibagi ke dalam kelompok terapi kombinasi standar dan ekstraksi lesi akne (terapi kombinasi) serta terapi standar tanpa ekstraksi lesi akne (terapi standar). Skor kualitas hidup berdasarkan kuesioner Acne-QoL-INA dinilai pada baseline, minggu ke-4, dan minggu ke-8 setelah terapi. Selain itu, penilaian jumlah lesi dan derajat keparahan akne diukur pada setiap kunjungan oleh seorang evaluator secara tersamar melalui foto klinis.Hasil: Sebanyak 40 subjek dengan median usia 24 tahun (18–48), 17,5% laki-laki dan 82,5% perempuan berpartisipasi dalam penelitian ini. Skor Acne-QoL-INA baseline untuk kelompok kombinasi dan kelompok terapi standar masing-masing adalah 41 (37,5– 57) dan 45,5 (37–63), meningkat menjadi 79 (67,5–94,5) dan 72,5 (59,25–98,5) pada minggu ke-8 namun tidak berbeda bermakna secara statistik antar kedua kelompok (p=0,602). Jumlah lesi baseline pada kedua kelompok masing-masing 35 dan 32, menurun menjadi 18 dan 13 pada minggu ke-8 (p<0,0001) dan perbaikan derajat keparahan menjadi akne ringan pada 100% subjek di minggu ke-8.Kesimpulan: Tidak ada perbedaan dalam skor Acne-QoL-INA dan perbaikan klinis antara kelompok terapi kombinasi dan terapi standar pada pasien AV sedang. Namun, terapi kombinasi cenderung meningkatkan kualitas hidup dan pengurangan lesi lebih baik daripada terapi standar.

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Background: Acne Vulagis (AV) is the most commom chronic disease of the pilosebaceous unit that can have a significant psychological impact and reduce the quality of life. The use of adjuvant therapy such as acne lesion extraction, in combination with standard therapy could better improve clinical outcomes and quality of life. Assessing quality of life is crucial to evaluate the success of therapy. Currently, there has been a validated acne-specific quality of life questionnaire in Indonesian (Acne-QoL-INA), but there is no existing data on the comparison of quality of life between combination therapy and standard therapy.

Method: This single-blinded randomized controlled study was conducted on adult subjects with moderate acne vulgaris based on Lehmann criteria, who were divided into combinations of standard therapy with acne lesion extraction (combination therapy) group, and standard therapy without acne lesion extraction (standard therapy) group. Quality of life score based on the Acne-QoL-INA questionnaire was assessed at the baseline, 4th, and 8th week after therapy. Additionally, the assessment of lesion number and acne grading is also measured at each visit by a blinded evaluator through clinical photos.

Results: A total of 40 subjects with a median age of 24 years old (18–48), comprising 17.5% males and 82.5% females, participated in this study. The baseline Acne-QoL-INA scores for the combination therapy and the standard therapy group were 41 (37.5–57) and 45.5 (37–63), respectively. These scores increased to 79 (67.5–94.5) and 72.5 (59.25– 98.5) at week 8 but did not show statistically significant differences between the two groups (p=0.602). The baseline lesion count in both groups was 35 and 32, respectively, and decreased to 18 and 13 at week 8 (p<0.0001), with an improvement in the severity to mild acne in 100% of subjects by week 8.

Conclusion: There was no difference in Acne-QoL-INA scores and clinical improvement between the combination therapy and standard therapy groups in moderate AV patients. However, combination therapy tended to improve the quality of life and lesion reduction better than standard therapy."

"[Latar Belakang : Jumlah usia lanjut (Usila) makin meningkat dan tumbuh cepat, yang membawa konsekuensi meningkatnya gangguan terkait usia, termasuk penurunan fungsi kognitif. Penelitian ini bertujuan untuk mengetahui efek pemberian aktivitas berjalan kaki terstruktur, yaitu minimal 6000 langkah/hari, terintegrasi dalam aktivitas sehari-hari dengan kecepatan yang nyaman selama 12 minggu, dalam memelihara fungsi kognitif pada usia lanjut dengan fungsi kognitif normal di komunitas.Metode : Desain penelitian ini adalah studi ekperimental, berupa uji klinis acak tersamar tunggal. Subyek terdiri dari 20 orang Usila pada kelompok perlakuan yang diberikan aktivitas berjalan kaki terstruktur, dan 19 orang Usila pada kelompok kontrol yang beraktivitas sebagaimana biasanya, selama 12 minggu. Subyek dinilai fungsi kognitifnya menggunakan MoCA Ina pada awal dan akhir perlakuan. Aktivitas berjalan kaki diukur menggunakan pedometer.Hasil : Aktivitas berjalan kaki terstruktur yang mampu dilakukan oleh kelompok perlakuan adalah 7531 langkah/hari, dan kelompok kontrol adalah 3527 langkah/hari (p=0,000). Pada akhir penelitian, skor total MoCA pada kelompok perlakuan (median=29) adalah lebih tinggi (p=0,022) dibandingkan kelompok kontrol (median=27), dan begitu pula untuk selisih skor MoCA antara awal dan akhir penelitian (rerata selisih pada kelompok perlakuan adalah 3,35; kelompok kontrol adalah 1,47; p=0,003). Efek perlakuan pada domain fungsi kognitif menunjukkan skor Visuospasial/Fungsi Eksekusi secara siknifikan (p=0,08) lebih tinggi pada kelompok perlakuan dibandingkan kelompok kontrol. Selisih skor domain MoCA pada awal dan akhir penelitian ditemukan lebih besar pada kelompok perlakuan pada domain Visuospasial/Fungsi Eksekusi, Bahasa, dan Abstraksi.Kesimpulan : Aktivitas berjalan kaki terstruktur 7500 langkah/hari memiliki efek positif dalam memelihara fungsi kognitif usia lanjut secara umum, dengan domain yang paling dipengaruhi adalah Visuospasial/Fungsi Eksekusi. Aktivitas ini juga memberikan peningkatan yang lebih besar pada fungsi kognitif secara umum dan pada domain Visuospasial/Fungsi Eksekusi, Bahasa, dan Abstraksi.;Background : Fast growing of elderly population increases disorders related to aging, including decreasing of cognitive function. The objective of this study is to evaluate the effect of structured walking activity, that characterized by minimally 6000 steps/day, integrated to daily activities, with comfortable pace, for 12 week, in maintaining cognitive function in elderly with normal cognitive function in community.Method : This study design was experimental, single-blind randomized controlled trial. The subjects were 39 elderly, consist of 20 subjects in intervention group and 19 subject in control group. Intervention group were given structured walking activity, and control group did their usual activity, for 12 weeks. Cognitive function were assessed using MoCA Ina in the beginning and end of the study. Walking activity was measured using pedometer.Results : Amount of walking activity that was able to do was 7531 steps/day in intervention group, and 3527 steps/day in control group (p=0,000). In the end of study, total MoCA score in intervention group (median=29) is significantly better (p=0,022) than control group (median=27), and so did the improvement of MoCA score in the end of study (mean of increasing score in intervention group was 3,35, and in control group was 1,47, p=0,003). Effect on domain of cognitive function showed Visuospatial/Executive function score in intervention group was signifantly better than control group. Improvement in Visuospatial/Excecutive function, Language, and Abstraction domains‟ score was also found larger in intervention group.Conclusion : Structured walking activity, about 7500 steps/day had a positive effect in maintaining general cognitive function in elderly, and Visuospatial/Executive function was the most influenced domain. The effect of this activity also showed larger improvements in general cognitive function and Visuospatial/Excecutive function, Language, and Abstraction domains., Background : Fast growing of elderly population increases disorders related to aging, including decreasing of cognitive function. The objective of this study is to evaluate the effect of structured walking activity, that characterized by minimally 6000 steps/day, integrated to daily activities, with comfortable pace, for 12 week, in maintaining cognitive function in elderly with normal cognitive function in community.Method : This study design was experimental, single-blind randomized controlled trial. The subjects were 39 elderly, consist of 20 subjects in intervention group and 19 subject in control group. Intervention group were given structured walking activity, and control group did their usual activity, for 12 weeks. Cognitive function were assessed using MoCA Ina in the beginning and end of the study. Walking activity was measured using pedometer.Results : Amount of walking activity that was able to do was 7531 steps/day in intervention group, and 3527 steps/day in control group (p=0,000). In the end of study, total MoCA score in intervention group (median=29) is significantly better (p=0,022) than control group (median=27), and so did the improvement of MoCA score in the end of study (mean of increasing score in intervention group was 3,35, and in control group was 1,47, p=0,003). Effect on domain of cognitive function showed Visuospatial/Executive function score in intervention group was signifantly better than control group. Improvement in Visuospatial/Excecutive function, Language, and Abstraction domains‟ score was also found larger in intervention group.Conclusion : Structured walking activity, about 7500 steps/day had a positive effect in maintaining general cognitive function in elderly, and Visuospatial/Executive function was the most influenced domain. The effect of this activity also showed larger improvements in general cognitive function and Visuospatial/Excecutive function, Language, and Abstraction domains.]"

"Latar belakang. Bersihan kolon yang adekuat berkaitan dengan persiapan kolonoskopi yang baik namun hingga saat ini belum ada penelitian mengenai dua preparat bersihan kolon yang paling umum digunakan di Indonesia yaitu polyethylene glycol (PEG) dan sodium phosphate (SP).Tujuan. Mengetahui perbandingan bersihan kolon antara PEG dan SP pada pasien yang akan dilakukan kolonoskopi di Indonesia. Metode. Uji klinis acak tersamar tunggal, satu sentral penelitian di pusat endoskopi saluran cerna (PESC) RS. Cipto Mangunkusumo (RSCM) pada pasien usia lebih dari 18 tahun yang menjalani kolonoskopi periode Maret ? September 2014. Randomisasi manual, teknik sampling konsekutif dilakukan untuk mengalokasikan preparat PEG dan SP, kemudian penilaian bersihan kolon secara tersamar tunggal dilakukan oleh dua orang dengan Boston Bowel Preparation Scale (BBPS). Nilai adekuat bila skor ≥ 5. Analisis dilakukan dengan intention to treat.Hasil. Dari 135 subyek yang dirandomisasi, dieksklusi 14 subyek sehingga yang dianalisis 121 subyek (PEG n=62; SP n=59). Semua subyek menjalani penelitian hingga selesai. Bersihan adekuat pada PEG 88,7% dengan rerata skor BPPS 5,89, sedangkan pada SP 89,8% dengan rerata skor BPPS 6,34 (nilai p=0,84). Didapatkan nilai Control Event Rate (CER) 11,3%, Experiment Event Rate (EER) 10,17%, Absolute Risk Reduction (ARR) 1,13%, Relative Risk Reduction (RRR) 9,92%, dan Number Needed to Treat (NNT) untuk SP sebesar 90 subyek. Efek samping pada PEG adalah mual (19,4%), rasa tidak enak (3,2%), muntah (1,6%) sedangkan pada SP hanya rasa tidak enak (5,1%). Kedua kelompok tidak mengalami alergi.Kesimpulan. Tidak ada perbedaan bermakna secara statistik dan klinis antara PEG dan SP dalam bersihan kolon yang adekuat menggunakan skor BPPS.

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Background. Adequate clearance of the colon is associated with a good preparation for colonoscopy. Up until now research on colon adequate clearance by using two of the most commonly used preparations in Indonesia, namely polyethylene glycol and sodium phosphate has not been done.Aims. To compare the effectivity of PEG and SP in colon clearance for patients undergoing colonoscopy in Indonesia.Design and Methods. A single blind randomized clinical trial in one centre at gastrointestinal endoscopy centre RSCM, was conducted on patients aged over 18 years old that had colonoscopy in the period from March to September 2014. Consecutive manual randomization was performed to allocate the PEG and SP lavage and assessment of adequate colon clearance will be evaluated by two investigators using the Boston Bowel Preparation Scale (BBPS). Adequate score if > 5. Analysis was done by intention to treat.Results. From the 135 randomized subjects, 14 was excluded, and 121 subjects obtained (PEG n=62; SP n=59). All subjects completed the research. Adequate clearance in PEG was 88.7% with BPPS mean score 5.89. While, SP had adequate clearance of 89.8% with BPPS mean score 6.34 (p value=0.84). Analysis resulted in CER 11.3%, EER 10.17%, ARR 1.13%, RRR 9.92%, and NNT for SP was 90 subjects. Side effects in PEG participants were nausea (19.4%), unpleasant taste (3.2%), vomit (1.6%) while in SP participants only experienced unpleasant taste (5.1%). Both groups did not experience allergic reaction.Conclusion. There was no significant difference in terms of adequate colon clearance preparation between PEG and SP using BPPS score."

"Latar belakang: Akne vulgaris AV adalah penyakit inflamasi kronik yang ditandai adanya lesi polimorfik di area predileksi AV. Tatalaksana AV terdiri dari terapi standar dan terapi adjuvan. Salah satu terapi adjuvan yang selalu diberikan pada pasien AV adalah frekuensi cuci wajah AV. Sampai saat ini, rekomendasi frekuensi cuci wajah pasien dengan AV di negara tropis adalah berdasarkan rekomendasi umun dan pendapat ahli. Tujuan: Mengetahui efektivitas frekuensi cuci wajah sebagai terapi adjuvan pada akne vulgaris derajat ringan dan sedang. Metode: Uji klinis acak buta tunggal dilakukan terhadap mahasiswa AV di Klinik UI Makara pada bulan Mei hingga Juni 2018. Mahasiswa yang memenuhi kriteria penerimaan dan tidak memenuhui kriteria penolakan serta bersedia ikut dalam penelitian mendapat perlakuan berupa frekuensi cuci wajah 2 kali dan 3 kali per hari sesuai hasil randomisasi. Seluruh SP memperoleh terapi standar dan pembersih wajah yang sama. Jumlah lesi AV, kadar sebum, nilai TEWL, serta efek samping pada wajah SP akan dinilai selama 6 minggu dan evaluasi dilakukan pada minggu ke-3 dan minggu ke-6. Analisis hasil penelitian dilakukan dengan metode intention to treat. Hasil: Diperoleh total 36 subjek penelitian. Pada penelitin ini terdapat 1 SP drop out yaitu SP pada kelompok cuci wajah 2 kali per hari. Efektivitas frekuensi cuci wajah 3 kali per hari tidak berbeda bermakna dengan 2 kali per hari dalam penurunan jumlah lesi AV dengan median 23 (0-62) dibandingkan 20 (0-37), p = 0,341. Tidak terdapat perbedaan bermakna antara frekuensi cuci wajah 3 kali dibandingkan 2 kali per hari dalam hal penurunan kadar sebum, peningkatan nilai TEWL dan efek samping yang terjadi. Kesimpulan: Tidak terdapat perbedaan efektivitas frekuensi cuci wajah 3 kali per hari dibandingkan 2 kali per hari sebagai terapi adjuvan dalam hal penurunan jumlah lesi AV pada wajah mahasiswa AVR dan AVS yang mendapat terapi standar.

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Background: Acne vulgaris (AV) is a chronic inflammatory disease characterized by polymorphic lesions in the predilection area. Management of AV consists of standard therapy and adjunctive therapy. One of the adjunctive therapies that must be given to AV patients is the frequency of face washing. Recently, the recommendation of face washing frequency for AV patients in tropical countries is based on the general recommendation and expert opinion. Objective: To evaluate the effectiveness of face washing frequency as an adjuvant therapy on mild and moderate AV. Methods: A single blind randomized clinical trial was conducted on AV students at UI Makara Clinic from May to June 2018. Students who met the criteria of acceptance and did not meet the criteria of rejection and were willing to join the study were treated 2 and 3 times per day according to randomization. All participants were given standard therapy and same cleanser. AV lesions counts, sebum level, TEWL scores, and side effects on participant face would be assessed within six weeks by evaluating at week-3 and week-6. The analysis of study result was done by intention-to-treat method. Result: The total of 36 participants was recruited. In this study, there was 1 participant dropped out from the twice-per-day face washing group. There was no significant difference from the thrice-per-day and twice-per-day groups in terms of decreasing of total AV lesions with median 23 (0-62) versus 20 (0-37), p = 0,341. In addition, there was no significant difference in terms of decreasing sebum level, increasing of TEWL score, and adverse events. Conclusion: There was no difference in effectiveness of face washing frequency 3 times per day compared to 2 times per day with regard to decrease AV lesions in the face of mild and moderate AV students receiving standard therapy. "

"Pendahuluan: Enhanced Recovery After Surgery (ERAS) bertujuan untuk menstandardisasi manajemen perioperatif dan meningkatkan luaran klinis. Implementasi ERAS pada total knee replacement (TKR) mengurangi mortalitas, transfusi, komplikasi, dan length of stay (LOS) tanpa mempengaruhi readmisi. Studi ini bertujuan mengevaluasi ERAS pada pasien TKR unilateral di Indonesia.Metode: Penelitian ini menggunakan desain klinis acak tersamar tunggal di RSUPN Dr. Cipto Mangunkusumo dan RS Fatmawati, Jakarta, dengan 55 pasien TKR unilateral berusia 60-70 tahun dengan OA grade III-IV sebagai subjek. Metode analisis data melibatkan SPSS dengan uji normalitas, Chi-square, T tidak berpasangan, dan Mann Whitney untuk menilai efektivitas ERAS dibandingkan dengan protokol konvensional.Hasil: Hasil menunjukkan bahwa protokol ERAS meningkatkan skor Knee Special Score (KSS) (p=0,001, mean difference=4,09) dan Oxford Knee Score (OKS) (p<0,001, mean difference=4,98), serta mengurangi durasi rawat inap (p<0,001, mean difference=-2,15 hari) dan nyeri pascaoperasi (p<0,001, mean difference=-2,01) dibandingkan protokol konvensional. Faktor pre-operatif dan post-operatif seperti usia, komorbiditas, dan mobilisasi dini memberikan pengaruh terhadap durasi lama rawat inap. ERAS efektif menurunkan nyeri pascaoperasi dan meningkatkan skor KSS serta OKS. Integrasi edukasi praoperatif, manajemen nyeri, mobilisasi dini, dan perawatan perioperatif komprehensif meningkatkan hasil fungsional.Kesimpulan: Program ERAS secara signifikan memperbaiki skor KSS, OKS, mengurangi durasi rawat inap, dan menurunkan nyeri pascaoperasi pada pasien TKR unilateral dibandingkan protokol konvensional.

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Introduction: Enhanced Recovery After Surgery (ERAS) aims to standardize perioperative management and improve clinical outcomes. ERAS implementation in total knee replacement (TKR) reduces mortality, transfusions, complications, and length of stay (LOS) without affecting readmissions. This study aims to evaluate ERAS in unilateral TKR patients in Indonesia.

Methods: This study utilized a single-blind randomized clinical trial design at RSUPN Dr. Cipto Mangunkusumo and RS Fatmawati, Jakarta, involving 55 unilateral TKR patients aged 60-70 years with grade III-IV OA. Data analysis methods included SPSS, normality tests, Chi-square, independent T-tests, and Mann Whitney tests to evaluate the effectiveness of ERAS compared to conventional protocols.

Result: The results show that the ERAS protocol improves Knee Society Score (KSS) (p=0.001, mean difference=4.09) and Oxford Knee Score (OKS) (p<0.001, mean difference=4.98) scores, reduces length of stay (p<0.001, mean difference=-2.15 days), and decreases postoperative pain (p<0.001, mean difference=-2.01) compared to conventional protocols.

Discussion: Pre-operative and post-operative factors such as age, comorbidities, and early mobilization influence the length of stay. ERAS effectively reduces postoperative pain and improves KSS and OKS scores. Integrating preoperative education, pain management, early mobilization, and comprehensive perioperative care enhances functional outcomes.

Conclusion: The ERAS program significantly improves KSS, OKS scores, reduces length of stay, and decreases postoperative pain in unilateral TKR patients compared to conventional protocols."

"Pendahuluan: Pengobatan analgesik yang ideal pasca operasi harus dapat membantu untuk menghilangkan rasa nyeri yang cepat dan efektif. Metode Penelitian: 80 pasien yang menjalani tindakan endoskopi urologi di Rumah Sakit Kardinah. Efek analgesik dinilai menggunakan Skala Analog Visual VAS. Hasil Penelitian: Pada kelompok eksperimen, tidak ada perbedaan antara kelompok B phenazopyridine HCl dan C natrium diklofenak p> 0,05. Grup A asam pipemidat menunjukkan efek analgesik yang lebih menguntungkan daripada B dan C p

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Introduction: The ideal postoperative analgesic treat ment should provide rapid and effective pain relief.

Methods: The 80 patients who underwent endoscopic urological surgery at Kardinah Hospital. The analgesic effects were assessed using the Visual Analog Scale VAS.

Results: In the experimental group, there was no difference between groups B phenazopyridine HCl and C sodium diclofenac p 0.05. Group A pipemidic acid demonstrated a more favourable analgesic effect than B and C p"

"Leukemia limfoblastik akut (LLA) adalah keganasan yang paling sering terjadi pada anak-anak. Angka kesembuhan yang besar terjadi akibat terapi kanker saat ini, namun respon toksik yang terkait dan pembentukan radikal bebas meningkatkan angka kematian akibat pengobatan daripada kematian akibat penyakitnya itu sendiri. Komplikasi kemoterapi meningkatkan rasa ingin tahu dokter untuk mempelajari penggunaan antioksidan sebagai pengobatan tambahan pada kanker. Penelitian ini bertujuan untuk mengevaluasi peran N-asetilsistein ​​(NAS) sebagai terapi antioksidan pada anak-anak dengan LLA SR (standard risk) selama fase induksi kemoterapi, dan kemungkinan peran mereka dalam pencegahan dan pengendalian komplikasi hati terkait dengan penggunaan agen kemoterapi. Sebuah uji klinis acak tersamar tunggal NAS dibandingkan dengan plasebo yang dilakukan pada pasien anak Departemen Ilmu Kesehatan Anak Divisi Hematologi dan Onkologi di Rumah Sakit Cipto Mangunkusumo, Jakarta. Penelitian ini dilakukan pada 11 pasien anak-anak usia mereka berkisar antara 2 dan 10 tahun dengan LLA SR yang menjalani kemoterapi fase induksi dan memenuhi kriteria inklusi. Pasien secara acak dialokasikan ke dalam dua kelompok, NAS atau kelompok plasebo. Mereka dievaluasi secara klinis untuk terjadinya komplikasi dan sampel darah dikumpulkan sebagai parameter laboratorium (plasma malondialdehid (MDA), enzim transaminase, dan bilirubin). Sebanyak 11 subjek dilakukan analisis yang terdiri dari 6 pada kelompok n-asetilsistein dan 5 pada kelompok plasebo. Karakteristik subjek didominasi oleh anak laki-laki dengan status gizi kurang. Kadar rerata MDA cenderung mengalami penurunan, sebanyak tiga subjek dari enam subjek pada kelompok perlakuan dan tiga subjek dari lima subjek pada kelompok plasebo. Insidens peningkatan kadar enzim transaminase sebesar 25%. Tidak terjadi kejadian kolestasis pada subjek penelitian. Pengobatan NAS ​​berdasarkan dosis antioksidan cenderung menurunkan kadar MDA, dan mencegah peningkatan enzim transaminase, dan bilirubin.

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Acute lymphoblastic leukemia (ALL) is the most commonly malignancy in children. Cancer therapies have experienced great success nowadays, yet the associated toxic response and free radicals formation have resulted in significant number of treatment-induced deaths rather than disease-induced fatalities. Complications of chemotherapy increases physicians curiosity to study antioxidant use as adjunctive treatment in cancer. This study aims to evaluate the role of N-acetylcysteine (NAC) as antioxidant therapy in children with ALL during the induction phases of chemotherapy, and their possible role in prevention and control of hepatic complications associated with the use of chemotherapic agents. A randomized single-blind clinical trial of NAC in comparison with placebo conducted in hematology and oncology pediatric patient of Cipto Mangunkusumo Hospital, Jakarta. The study was performed in 11 pediatric patients with ALL with their ages ranging between 2 and 10 years, undergoing induction phase chemotherapy that fulfilled the inclusion criteria consecutively. Patient were randomly allocated into of two groups, NAC or placebo group. They were evaluated clinically for the occurance of complications and blood samples were collected as the laboratory parameters (plasma malondyaldehide (MDA), transaminase enzyme, and bilirubin). A total 11 participants were included in analysis consisted of 6 in n-acetylcysteine group and 5 in placebo group. Characteristics of subject were predominated by boys and moderate malnourished. Mean MDA levels tended to decrease, as many as three subjects from six subjects in the NAC group and three subjects from five subjects in the placebo group. Incidence of increased levels of the transaminase enzyme by 25%. There was no cholestasis events in the study subjects. NAS treatment based on antioxidant doses tends to reduce MDA levels, and prevent the increase in the transaminase enzyme and bilirubin."

"Leukemia limfoblastik akut (LLA) adalah keganasan yang paling sering terjadi pada anak-anak. Angka kesembuhan yang besar terjadi akibat terapi kanker saat ini, namun respon toksik yang terkait dan pembentukan radikal bebas meningkatkan angka kematian akibat pengobatan daripada kematian akibat penyakitnya itu sendiri. Komplikasi kemoterapi meningkatkan rasa ingin tahu dokter untuk mempelajari penggunaan antioksidan sebagai pengobatan tambahan pada kanker. Penelitian ini bertujuan untuk mengevaluasi peran N-asetilsistein ​​(NAS) sebagai terapi antioksidan pada anak-anak dengan LLA SR (standard risk) selama fase induksi kemoterapi, dan kemungkinan peran mereka dalam pencegahan dan pengendalian komplikasi hati terkait dengan penggunaan agen kemoterapi. Sebuah uji klinis acak tersamar tunggal NAS dibandingkan dengan plasebo yang dilakukan pada pasien anak Departemen Ilmu Kesehatan Anak Divisi Hematologi dan Onkologi di Rumah Sakit Cipto Mangunkusumo, Jakarta. Penelitian ini dilakukan pada 11 pasien anak-anak usia mereka berkisar antara 2 dan 10 tahun dengan LLA SR yang menjalani kemoterapi fase induksi dan memenuhi kriteria inklusi. Pasien secara acak dialokasikan ke dalam dua kelompok, NAS atau kelompok plasebo. Mereka dievaluasi secara klinis untuk terjadinya komplikasi dan sampel darah dikumpulkan sebagai parameter laboratorium (plasma malondialdehid (MDA), enzim transaminase, dan bilirubin). Sebanyak 11 subjek dilakukan analisis yang terdiri dari 6 pada kelompok n-asetilsistein dan 5 pada kelompok plasebo. Karakteristik subjek didominasi oleh anak laki-laki dengan status gizi kurang. Kadar rerata MDA cenderung mengalami penurunan, sebanyak tiga subjek dari enam subjek pada kelompok perlakuan dan tiga subjek dari lima subjek pada kelompok plasebo. Insidens peningkatan kadar enzim transaminase sebesar 25%. Tidak terjadi kejadian kolestasis pada subjek penelitian. Pengobatan NAS ​​berdasarkan dosis antioksidan cenderung menurunkan kadar MDA, dan mencegah peningkatan enzim transaminase, dan bilirubin.

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Acute lymphoblastic leukemia (ALL) is the most commonly malignancy in children. Cancer therapies have experienced great success nowadays, yet the associated toxic response and free radicals formation have resulted in significant number of treatment-induced deaths rather than disease-induced fatalities. Complications of chemotherapy increases physicians curiosity to study antioxidant use as adjunctive treatment in cancer. This study aims to evaluate the role of N-acetylcysteine (NAC) as antioxidant therapy in children with ALL during the induction phases of chemotherapy, and their possible role in prevention and control of hepatic complications associated with the use of chemotherapic agents. A randomized single-blind clinical trial of NAC in comparison with placebo conducted in hematology and oncology pediatric patient of Cipto Mangunkusumo Hospital, Jakarta. The study was performed in 11 pediatric patients with ALL with their ages ranging between 2 and 10 years, undergoing induction phase chemotherapy that fulfilled the inclusion criteria consecutively. Patient were randomly allocated into of two groups, NAC or placebo group. They were evaluated clinically for the occurance of complications and blood samples were collected as the laboratory parameters (plasma malondyaldehide (MDA), transaminase enzyme, and bilirubin). A total 11 participants were included in analysis consisted of 6 in n-acetylcysteine group and 5 in placebo group. Characteristics of subject were predominated by boys and moderate malnourished. Mean MDA levels tended to decrease, as many as three subjects from six subjects in the NAC group and three subjects from five subjects in the placebo group. Incidence of increased levels of the transaminase enzyme by 25%. There was no cholestasis events in the study subjects. NAS treatment based on antioxidant doses tends to reduce MDA levels, and prevent the increase in the transaminase enzyme and bilirubin."

"ABSTRAK Latar Belakang : Pada studi invivo, seperti indometasin dan diklofenak,, ketoprofen menghambat aktifitas enzim fosfolipase A2 yang memainkan peran penting dalam patogenesis pankreatitis. Tujuan : Mengetahui efektifitas ketoprofen suppositoria terhadap pencegahan pankreatitis pasca ERCP Metode : Uji klinis acak tersamar ganda ini dilakukan di Pusat Endoskopi Saluran Cerna dan ruang rawat inap Rumah Sakit Pusat Nasional Dr Cipto Mangunkusumo pada bulan oktober 2016 sampai dengan Januari 2017 terhadap 74 pasien ikterus obstruktif dewasa atau dengan indikasi ERCP lainnya. Pasien yang memenuhi kriteria penerimaan diberikan ketoprofen suppositoria atau plasebo dosis tunggal sesaat sebelum tindakan ERCP dan dievaluasi tanda dan gejala pankreatitis akut serta evaluasi ulang amilase lipase 24 jam pasca tindakan untuk menentukan adanya pankreatitis pasca ERCP. Derajat pankreatitis akut dinilai berdasarkan kriteria imrie modified glasgow pada 48 jam pasca ERCP Hasil : 74 subjek yang memenuh kriteria penelitian dirandomisasi menjadi dua kelompok, masing-masing terdiri dari 37 pasien, terdapat 1 pasien dari setiap kelompok yang tidak dapat dikanulasi. Dilakukan analisis dengan prinsip intention to treat analysis, kedua kelompok sebanding dalam karakteristik demografis dan klinis termasuk faktor risiko terkait pasien dan prosedur. Insidens PPE pada kelompok ketoprofen sebanyak 13,5 5 sedangkan pada kelompok plasebo sebanyak 21,6 8 , Absolute Risk Reduction ARR = 0,081, Relative Risk RR = 0,625, Relative risk reduction RRR = 0,375, Number Needed to Treat NTT =12 95 IK=-9-25 . Terdapat laporan adverse event berupa perforasi usus pada 1 subjek. Kesimpulan: ketoprofen suppositoria menurunkan insidens pankreatitis pasca ERCP Kata Kunci : ketoprofen, insidens, pankreatitis pasca ERCP

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ABSTRACT Background An invitro study showed ketoprofen as well as indomethacin and diclofenac inhibits the activity of phospholipase A2 that is supposed to play a major role in the pathogenesis of pancreatitis. Objectives To determine the effect of rectal suppository ketoprofen to prevent post ERCP pancreatitis Methods This randomized double blind controlled trial performed at Gastrointestinal Endoscopy Center and inpatient unit in Cipto Mangunkusumo National General Hospital during October 2016 to January 2017 among patients with obstructive jaundice and patients with other indications of ERCP. All subjects with inclusion criteria were treated with rectal ketoprofen or rectal placebo suppository single dose immediately before ERCP. Sign and symptoms of acute pancreatitis and serum amylase and lipase level observed in 24 hours after ERCP to determine post ERCP pancreatitis. Acute pancreatitis was graded according to the Imrie rsquo s modified Glasgow severity criteria in 48 hours after ERCP. Result In total, 74 subjects were randomized into two groups containing 37 subjects in each group. One patient in each group was failed for cannulation. We used intention to treat analysis, both groups were comparable regarding demographic and clinical factors. The incidence of PEP was 13,5 5 in ketoprofen group and 21,6 8 in placebo group, Absolute Risk Reduction ARR 0,081, Relative Risk RR 0,625, Relative risk reduction RRR 0,375, and Number Needed to Treat NTT 12 95 CI 9 ndash 25 . Reported adverse event was bowl perforation in 1 subject. Conclusion Rectal ketoprofen reduced the incidence of post ERCP pancreatitis Key Words Ketoprofen, Incidence, Post ERCP pancreatitis"