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"Background: Hypokalemia is one of the most common electrolyte disorders in hospitalized patients. If hypokalemia were found, the underlying cause should be identified and treated. The incidence study of hypokalemia in Indonesia hospitalized patients is rarely reported.Objective: To investigate the incidence of hypokalemia in medical patients at the medical wards of department of internal medicine Gatot Soebroto Army Hospital.Method: Patients who required administration of parenteral fluid for various indications, irrespective of diagnosis, length of stay and types of infusion or medications were included in this study. Serum sodium and potassium concentration were checked twice, first at their admission and the second at discharge. The study form contained data record of patient's initials, age, gender, dates of admission and discharge, medical record number, laboratory findings of serum sodium and potassium concentration at admission and discharge.Result: 103 subjects were enrolled with mean age 49 years old (ratio of female: male = 70:30). Serum sodium concentration at admission and discharged were not significantly different. Incidence of hypokalemia was 26%. Furthermore, serum potassium concentration at admission and discharge showed significant reduction from mean concentration of 4.06 mmoUL to 3.83 mmol/L (with P=0.02). The number of patients with hypokalemia increased significantly during hospitalization (from 27 to 45 patients.with p= 0.023). Additional data showed that the types of infusion solutions given to patients are as follows: ringer's lactate (52 patients), normal saline (22 patients), D5W (20 patients) and asering/ringer's acetate (9 patients).Conclusion: The incidence of hypokalemia in medical patients at the medical wards of department of internal medicine Gatot Soebroto Army Hospital was 26%. These patients did not have sodium abnormalities. Number of patients with hypokalemia increased during hospitalization. Most infusion solutions administered contain very low concentration of potassium (ringer's lactate and ringer's acetate 4 mmol/L) or no potassium at all (normal saline, D5W)."

"Pemantauan terapi obat adalah kegiatan untuk memastikan terapi obat yang aman, efektif, dan rasional bagi pasien dengan mengkaji pemilihan obat, dosis, cara pemberian obat, respons terapi, reaksi obat yang tidak dikehendaki, dan rekomendasi perubahan atau alternatif terapi. Kondisi pasien yang perlu dilakukan pemantauan terapi obat antara lain pasien hamil dan menyusui, pasien yang menerima regimen yang kompleks (polifarmasi) serta pasien geriatri dan pediatri. Tujuan laporan PKPA ini adalah untuk menganalisa dan mengevaluasi drug related problem (DRP) pada pasien dan diklasifikasikan sesuai kategori Hepler dan Strand. Kegiatan dilakukan melalui pengambilan data pasien dengan diagnosis syok kardiogenik dengan gagal jantung, gangguan ginjal akut, DM tipe 2, dan hipokalemia. Data yang diambil merupakan kombinasi data primer dan sekunder. Berdasarkan hasil analisis, diketahui bahwa pengobatan yang diterima oleh pasien hampir seluruhnya tepat indikasi dan dosis kecuali dosis pada sukralfat dan allopurinol yang melebihi rentang dosis seharusnya. Selain itu, ditemukan DRP berupa interaksi obat yang bersifat potensial, pemilihan obat tidak tepat, serta indikasi tanpa obat. DRP tersebut telah diatasi dengan pemberian terapi yang sesuai.

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Drug therapy monitoring is an activity to ensure safe, effective, and rational drug therapy for patients by reviewing the selection of drugs, dosages, methods of drug administration, therapeutic response, unwanted drug reactions, and recommendations for changes or alternative therapies. Patients who need to be monitored for drug therapy include pregnant and lactating patients, patients receiving complex regimens (polypharmacy), as well as geriatric and pediatric patients. The purpose of this PKPA report is to analyze and evaluate drug-related problems (DRP) in patients and classify them according to the Hepler and Strand categories. Activities are carried out through the data collection of patients with a diagnosis of cardiogenic shock with heart failure, acute kidney disorder, type 2 DM, and hypokalemia. The data was took is a combination of primary and secondary data. Based on the results of the analysis, it was known that the treatment received by the patients was almost entirely in accordance with the right indication and dosage, except for the doses of sucralfate and allopurinol, which exceeded the proper dosage range. In addition, DRP was found in the form of potential drug interactions, inappropriate drug selection, and indications without drugs. The DRP has been overcome by administering appropriate therapy."

"COVID-19 adalah penyakit yang disebabkan oleh Severe Acute Respiratory Syndrome-related Coronavirus 2 (SARS-CoV-2) yang telah ditetapkan sebagai pandemik sejak tanggal 11 Maret 2020 oleh World Health Organization (WHO). Diketahui bahwa paru-paru yang terinfeksi langsung oleh virus dapat mengakibatkan manifestasi klinis berupa pneumonia virus. Sistem kekebalan tubuh dapat mengalami perubahan imunologis dalam tubuh seperti leukopenia, limfopenia, dan inflamasi badai sitokin, sehingga dapat menyebabkan peningkatan risiko infeksi lainnya. Maka dari itu, diperlukan adanya Pemantauan Terapi Obat (PTO) untuk mengoptimalkan efek terapi dan menekan angka morbiditas pasien COVID-19. Pada penulisan ini akan dibahas mengenai PTO pada pasien COVID-19 dengan pneumonia, hipokalemia berulang, dan anemia defisiensi zat besi di ruangan Melati COVID di RSUD Tarakan, Jakarta. Hal ini diharapkan dapat menggambarkan peran apoteker klinis dalam Pemantauan Terapi Obat sehingga mampu meminimalisasi risiko masalah terkait obat, progresivitas penyakit, serta dapat meningkatkan kualitas hidup pasien. Pengambilan data dilakukan dengan pemantauan data rekam medik pasien dari sejak pertama kali masuk rumah sakit hingga pasien dapat dipulangkan. Selanjutnya, dilakukan penetapan asesmen dan rencana yang akan didiskusikan bersama apoteker penanggung jawab ruangan tersebut. Hasil analisis PTO yang dilakukan terhadap pasien tersebut ialah terdapat satu obat yang tidak tepat dosis, yaitu urotractin. Selain itu, terdapat masalah terkait kegagalan penerimaan vitamin C yang diresepkan dan interaksi antarsuplemen kalsium karbonat dan vitamin D3 yang dapat meningkatkan risiko hiperkalsemia pada pasien.

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COVID-19 is a disease caused by Severe Acute Respiratory Syndrome-related Coronavirus 2 (SARS-CoV-2) which has been comes up as a pandemic since March 11, 2020 by World Health Organization (WHO). It is known that lungs directly infected by viruses can result in clinical manifestations in the form of viral pneumonia. The immune system can experience immunological changes in the body such as leukopenia, lymphopenia, and inflammatory cytokine storms, which can cause an increased risk of other infections. Therefore, there is a need for Monitoring Drug Therapy (MDT) to optimize the therapeutic effect and reducing the morbidity rate of COVID-19 patients. In this article, we will discuss MDT in COVID-19 patients with pneumonia, recurrent hypokalemia, and iron deficiency anemia in the Melati COVID room at Tarakan Hospital, Jakarta. It is hoped that this will illustrate the role of clinical pharmacists in MDT so that they can minimize the risk of drug-related problems (DRPs), disease progression, and can improve the patient's quality of life. Data collection is carried out by monitoring the patient's medical record data from the time they are first admitted to the hospital until the patient can be discharged. Next, an assessment and plan is carried out which will be discussed with the pharmacist in charge of the room. The results of the MDT analysis carried out on this patient were that one drug was not dosed correctly, urotractin. In addition, there are problems related to failure to receive prescribed vitamin C and interactions between calcium carbonate and vitamin D supplements which can increase the risk of hypercalcemia in patients.

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"Epilepsi merupakan suatu kondisi kronis yang disebabkan oleh gangguan fungsi otak. Keadaan ini merupakan penyulit yang biasa ditemukan pada berbagai gangguan neurologis seperti kelumpuhan otak (cerebral palsy: CP) yang dapat mengakibatkan kerusakan otak lebih lanjut, terutama apabila disertai dengan serangan kejang yang berlangsung lama. Insidens epilepsi pada penyandang CP berkisar antara 25 ? 35%. Insidens epilepsi yang sering pada pasien penyandang CP menunjukkan bahwa kedua kelainan tersebut agaknya mempunyai penyebab yang sama atau saling berhubungan. Kami melaksanakan suatu studi retrospektif untuk menentukan apakah insidens epilepsi berbeda tergantung pada tipe CP. Data diambil dari rekam medik, meliputi: nama, jenis kelamin, paritas, usia ibu, penatalaksanaan pra, peri dan pasca lahir serta hasil rekaman EEG. Pengolahan data menggunakan uji statistik X2 pada P < 0,05. Didapatkan di antara 67 kasus dengan CP, 53 bertipe CP spastik, 13 kasus campuran dan 1 CP diskinetik. Lelaki 47,8%, Perempuan 52,2% dengan usia rerata 50,3 (SD 36,3) bulan. Pada 25 pasien dengan CP yang berhubungan dengan epilepsi ditemukan 72% dengan kejang umum, 20% dengan kejang parsial, dan 8% dengan spasme infantil. Insidens epilepsi ternyata menunjukkan perbedaan yang bermakna (P < 0,05) tergantung tipe CP dan usia kehamilan saat pasien dilahirkan. Disimpulkan bahwa insidens epilepsi pada pasien penyandang CP di YPAC medan ialah 37,3%, dan terdapat perbedaan bermakna sesuai tipe CP dan usia kehamilan saat pasien dilahirkan. (Med J Indones 2002; 11: 158-63)

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Epilepsy is a chronic condition due to cerebral function disorders. Epilepsy occurs as a common complication of many neurological disorders such as cerebral palsy (CP) that can cause further brain damage if especially they are accompanied with prolonged seizure. The incidence of epilepsy among patients with CP varies, 25-35%. The high incidence of epilepsy among patients with CP suggests that these disorders has common or related origins. We carried out a retrospective study to determine the incidence of epilepsy among patients with CP registered July 1988 to June 1998 in YPAC Medan and to determine whether the incidence of epilepsy was different according to type of CP. Data was compiled from medical records, including name, sex, parity, mothers age, prenatal, perinatal, and postnatal history, and EEG resuts. Data were analysed using statistical computer program and its significance was evaluated by chi square test at p < 0.05. There were 67 cases with CP, 53 cases spastic CP, 13 cases mixed CP and one case dyskinetic CP. Of the 67 cases CP, 47.8% were male, 52.2% female with the mean age of 50.3 (SD 36.9) months. There were 25 (37.3%) patients CP associated with epilepsy, 72% general seizures, 20% partial seizures, and 8% infantile spasm. The incidence of epilepsy was significantly different among patients with CP associated with the type of CP and gestational age, p < 0.05. We concluded that the incidence of epilepsy among patient with CP in YPAC Medan was 37.3% and showed significant difference in CP according to type and gestational age. (Med J Indones 2002; 11: 158-63)"

"AbstrakVenous thromboembolism (VTE) is a fatal yet potentially preventable complication of surgery. Routine thromboprophylaxis is still unequivocal prescription is problematic due to perception of low VTE incidence among Asian population. This study aims to investigate the incidence of VTE and thromboprophylaxis prescription among patients undergoing major surgery in a Singapore hospital.Methods: This was a cross-sectional study. Data were obtained from medical record of 1,103 patients who had underwent major orthopaedic or abdominal surgery in 2011-2012 at Khoo Teck Puat Hospital, Singapore. Incidence of VTE events either in the same admission or re-admission in less than one month time were noted as study parameters.Results: Incidence of VTE was 2.1% (95% CI: 1.67 - 2.53) of which 1.3% and 0.8% were DVT and PE cases respectively. Age, gender, history of VTE, ischemic heart disease, and mechanical prophylaxis were associated with VTE incidence based on bivariate analysis. The prescription of pharmacological thromboprophylaxis was associated with prior anticoagulant medication, type of surgery, and incidence of new bleeding.Conclusion: Subsequent to major surgeries, VTE is as common in Asian patients as published data in other populations. Pharmacologic thromboprophylaxis should be considered as recommended in non-Asian guidelines."

"ABSTRAKBackground Rheumatoid arhtirtis is a chronic autoimmune disease that mainly attacks joints. It may causes joint deformities which leads to lower quality of life of RA patients. RA is treated with metothrexate which inhibiting disease progression. MTX is known for its hepatotoxicity side effect, which is described by an elevation of aspartate aminotransferase and/or alanine aminotransferase beyond the upper normal limit. Factors that may enhance hepatotoxicity are gender, age, cummulative dose of MTX, and duration therapy of MTX. Prevalence of hepatotoxicity caused by MTX therapy in RA patients in Indonesia is still unknown. The objective of this research is to know the proportion of hepatotoxicity and its associations with the factors that may enhance hepatotoxicity caused by MTX therapy in RA patients in RSCM.Method Data about gender, age, cummulative dose and duration therapy of MTX are obtained from 115 RA patients medical records.Result Proportion of hepatotoxicity in RA patients treated with MTX in RSCM is 42.60 percent. Gender, age, cummulative dose and duration therapy of MTX do not significantly enhance hepatotoxicity p>0.05. Conclusion In conclusion gender, age, cummulative dose and duration therapy of MTX do not have association with hepatotoxicity in RA patients treated with MTX."

"ABSTRAKStroke merupakan penyebab kematian tertinggi kedua di dunia maupun di Indonesia. Terdapat berbagai faktor risiko stroke baik yang dapat dimodifikasi maupun yang tidak. Hipertensi merupakan faktor risiko stroke yang paling penting yang dapat dimodifikasi. Namun demikian, masih belum jelas karakteristik hipertensi seperti apa yang paling berisiko terkena stroke. Penelitian ini bertujuan untuk mendapatkan hubungan antara lamanya hipertensi, tekanan darah sistolik tertinggi yang pernah dicapai, serta kategori hipertensi dengan terjadinya stroke. Penelitian dilakukan menggunakan desain studi kohort retrospektif pada pasien usia lanjut penderita hipertensi di Poliklinik Geriatri RSUPN-Ciptomangunkusumo tahun 2012-2016. Terdapat 207 subjek yang diikutsertakan dalam penelitian ini, dengan 40 di antaranya tercatat menderita stroke. Analisis bivariat menunjukkan hubungan antara lamanya hipertensi dengan stroke p=0.046 , sementara tidak ada hubungan p>0.05 antara tekanan darah sistolik tertinggi yang pernah dicapai maupun kategori hipertensi. Hasil uji multivariat dengan penyesuaian terhadap variabel perancu mendapatkan hubungan antara lamanya hipertensi dan stroke dengan OR 2.019 1.004 ndash; 4.063;IK 95 . Dari hasil tersebut dapat disimpulkan bahwa faktor yang paling berhubungan dengan terjadinya stroke adalah lamanya hipertensi.

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ABSTRAKStroke is the second highest leading cause of death both in the world and in Indonesia. There are various modifiable and non modifiable risk factors of stroke. Among them, hypertension is a well established important stroke risk factor that is modifiable. However, it is unclear which characteristics of hypertension contributes most to the incidence of stroke. This study aimed to determine the association between duration of hypertension, highest systolic blood pressure, and hypertension stages with stroke incidence. A cohort retrospective study was done among elderly hypertensive patients in Geriatric Polyclinic of Ciptomangunkusumo National General Hospital between 2012 and 2016. From 207 subjects, there are 40 stroke incidences. Bivariate analysis showed association between duration of hypertension and incidence of stroke p 0.046 , while there is no association between stroke and either highest systolic blood pressure or hypertension stages. Multivariate analysis with adjustments for confounding variables showed association between duration of hypertension and stroke with OR 2.019 1.004 ndash 4.063 95 CI . From this result, it is concluded that duration of hypertension has the strongest association to stroke."