scholarly journals Analisis Cost Of Illness Drug Reaction With Eosinophilia Systemic Symptoms Di RSUP Dr.Sardjito Yogyakarta

2020 ◽  
Vol 7 (1) ◽  
pp. 43
Author(s):  
Vicryanto Halid ◽  
Dyah Aryani Perwitasari ◽  
Sri Awalia Febriana

ABSTRAK Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) adalah reaksi alergi kulit dengan demam, kenaikan eosinofil darah dan komplikasi organ. Sulitnya diagnosa dan lama terapi serta berpotensi kekambuhan membuat DRESS menjadi masalah karena mempengaruhi ekonomi. Cost of illness (COI) merupakan analisis menentukan beban ekonomi penyakit yang terdiri dari beberapa perspektif. Penelitian ini bertujuan mengetahui total COI dari perspektif Rumah sakit berdasarkan jenis DRESS, jenis obat, dan jumlah obat penyebab DRESS. Penelitian non-experimental dengan desain cross-sectional retrospektif. Subyek penelitian 21 pasien. Parameter biaya komponen biaya medis langsung yaitu biaya instalasi gawat darurat, pengobatan, monitoring, penunjang dan rawat jalan. Hasil analisis data berupa median (range). Median total COI DRESS dengan komplikasi organ adalah Rp.13.194.963 dan Rp.10.123.495 untuk pasien DRESS tanpa komplikasi organ. Antibiotik menjadi obat penyebab DRESS terbanyak (55,55%) dengan range total biaya tertingginya Rp.53.576.350. Kesimpulan: Total COI DRESS di RSUP Dr.Sardjito tahun 2014-2018 satu pasien adalah Rp.13.546.700.Kata Kunci: Drug Reaction with Eosinophilia and Systemic Symptom, Cost OF illness, biaya medis langsung, komplikasi organ, perspektif Rumah sakit.  ABSTRACT Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) are allergic skin reactions with fever, elevated blood eosinophils and organ complications. Difficult diagnosis and duration of therapy and potential recurrence make DRESS a problem because it affects the economy. Cost of illness (COI) is an analysis determining the economic burden of a disease consisting of several perspectives. This study aims to determine the total COI from the perspective of the hospital based on the type of DRESS, the amount and type of causative drug of DRESS. Non-experimental research with a retrospective cross-sectional design. Study subjects 21 patients. The cost parameters of the direct medical component costs are the costs of the emergency department, treatment, monitoring, support and outpatient care. The results of data analysis are in the form of a median (range). Results: The total median of COI DRESS with organ complications was Rp.13,194,963 and Rp.10,123,495 for DRESS patients without organ complications. Antibiotics became the most common drug causing DRESS (55.55%) with the highest total cost range of Rp.53,576,350. Conclusion: Total COI DRESS at Dr.Sardjito General Hospital in 2014-2018 one patient was Rp.13,546,700. Keywords: Drug Reaction with Eosinophilia and Systemic Symptom, Cost of Illness, direct medical costs, organ complications, perspective of the hospital.

Author(s):  
Rahul R. Damor ◽  
Amita R. Kubavat ◽  
Kiran G. Piparva

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, potentially life-threatening acute adverse drug reaction (ADR), typically characterized by a long latency period (2-6 weeks to 3 months) from drug exposure. DRESS syndrome is defined by the presence of fever, cutaneous eruption, lymphadenopathy, systemic or asymptomatic internal organ involvement (e.g. Hepatitis, carditis, interstitial nephritis, interstitial pneumonitis, etc.) and haematological abnormalities, mainly leucocytosis, eosinophilia and sometimes atypical lymphocytosis. There are around 50 culprit drugs which cause DRESS syndrome e.g. carbamazepine, phenytoin, allopurinol, sulfa derivatives, antidepressants, antiepileptics, non-steroidal anti-inflammatory drugs and antimicrobials. The incidence of DRESS syndrome has been estimated to be between 1 in 1,000 and 1 in 10,000 drug exposures. There are many reported cases of DRESS syndrome due to carbamazepine, phenytoin, vancomycin, levitiracitam, ceftriaxone etc. Author presented a case of DRESS syndrome by carbamazepin. RegiSCAR and Japanese consensus group have developed specific criteria for making the diagnosis of DRESS syndrome. The patient described here met the majority of criteria according to RegiSCAR scoring guidelines for a diagnosis of DRESS syndrome induced by carbamazepine. As per RegiSCAR diagnostic criteria author had concluded that this was a “Definite” case of DRESS (Drug Reaction with Eosinophilia and Systemic Symptom) syndrome induced by carbamazepine. Carbamazepine is most common broad-spectrum antiepileptic drugs so, this case report will raises awareness among physician to suspect DRESS syndrome in patients who present unusual complaints and skin findings after starting antiepileptic drugs.


2020 ◽  
Vol 11 ◽  
pp. 204209862093374
Author(s):  
Paulo Henrique Santos Andrade ◽  
Amanda Carvalho Barreiros de Almeida ◽  
Ana Keilla Santana dos Santos ◽  
Iza Maria Fraga Lobo ◽  
Francilene Amaral da Silva ◽  
...  

Aims: The aim of this study was to present the needs of hospital pharmacists in pharmacovigilance practices. Methods: This study has a cross-sectional design and was carried out with hospital pharmacists in Brazil. The sample was obtained by voluntary recruitment. Pharmacists who worked at Brazilian hospitals and were registered in their respective regulatory councils were invited to participate in the present study. A personalized questionnaire was developed by the authors and was electronically filled out by the respondents on the platform ‘Google forms’. The questionnaire was nationally available on the digital platform of the Pharmacy Federal Council, the Brazilian Society of Hospital Pharmacy and Health Services, four Pharmacy regional councils and the social network farmacêuticoclínico®. Quantitative variables were analyzed by mean and standard deviation. The qualitative variables were analyzed by means of absolute and relative frequency. Difficulties related to pharmacovigilance activities are presented in an Ishikawa diagram in the Supplemental Material online. Results: Of the 27 federative units of Brazil, we obtained answers from pharmacists located in 85.2% ( n = 23) of them. Among the pharmacovigilance practices developed by Brazilian pharmacists, the adverse drug reaction investigation (55.4%) and notification activities (47.0%) were worthy of note. Numerous difficulties were reported by the pharmacists, highlighting the difficulty in monitoring the medication and imputation of causality (27.7%). After categorizing the difficulties reported, it was observed that the category ‘people involved’ (45.1%) stood out from the others. Conclusion: This study pointed out numerous challenges to pharmacovigilance practices involving pharmacists in Brazil. It is believed that the correction of certain difficulties may impact on the better consolidation of pharmacovigilance activities in the country. However, regulatory agencies at all hierarchical levels of pharmacovigilance must work together to make it possible. Plain language Summary Challenges to the consolidation of pharmacovigilance This is a study that seeks to present the needs of Brazilian hospital pharmacists in relation to pharmacovigilance activities. Through online interviews, pharmacists answered a questionnaire, presented the pharmacovigilance activities they develop and expressed their anxieties and difficulties for the development of these activities. With this study, it was concluded that numerous activities of active search, investigation and notification of adverse drug reaction are developed by Brazilian pharmacists. However, each pharmacist performs a different method of pharmacovigilance. In addition, it was observed that among the interviewees there was a perception of insufficient professional training and a shortage of professionals to assist in pharmacovigilance activities. These were the main difficulties reported. Therefore, the search for models or agile solutions to solve problems involving adverse drug reactions seems necessary for a better consolidation of pharmacovigilance services in Brazil.


2020 ◽  
Vol 7 (1) ◽  
pp. 84
Author(s):  
Qarriy Aina Urfiyya ◽  
Dyah Aryani Perwitasari ◽  
Sri Awalia Febriana

ABSTRAK SJS/TEN merupakan reaksi yang melibatkan kulit dan mukosa yang berat dan mengancam jiwa. SJS dan TEN merupakan kejadian yang jarang terjadi, yaitu 1,4 – 12,7 kasus per 1 juta orang per tahun mengalami SJS dan TEN, dengan angka mortalitas 5% pada SJS dan 30-35% pada TEN. Obat merupakan penyebab utama SJS (50-80% dari kasus) dan TEN (80%). Tujuan: Mengetahui median total biaya per hari pasien SJS/TEN, serta pengaruh lama rawat inap terhadap total biaya SJS/TEN. Penelitian observasional analitik dengan sudut pandang masyarakat. Pengambilan data secara retrospektif menggunakan total sampling pasien rawat inap SJS dan TEN di RSUP Dr. Sardjito Yogyakarta tahun 2014-2018. Analisis data dengan menghitung median (range) dan regresi linear pada SPSS IBM versi 22.0 untuk mengetahui pengaruh lama rawat inap terhadap biaya SJS/TEN. Terdapat 29 pasien yang dianalisis. Median total biaya per hari pasien SJS/TEN Rp 1.139.963 (Rp 665.294-Rp 8.776.895), dengan Rp 1.139.963 (Rp 740.267-Rp 8.776.895) pada SJS dan Rp 1.166.084 (Rp 665.294-Rp 1.514.607) pada TEN. Hasil signifikansi uji regresi linear lama rawat inap terhadap total biaya SJS/TEN adalah 0,093 (p>0,05). Median biaya per hari SJS/TEN adalah Rp 1.139.963 (Rp 665.294-Rp 8.776.895), dan lama rawat inap tidak mempengaruhi total biaya SJS/TEN.  Kata Kunci—Stevens Johnson Syndrome, Toxic Epidermal Necrolysis, analisis biaya, cost of illness  ABSTRACT SJS/TEN is a reaction that involves heavy and life-threatening skin and mucosa. SJS and TEN are rare events, 1,4 – 12,7 cases per 1 million people per year experiencing SJS and TEN, with a mortality rate of 5% in SJS and 30-35% in TEN. Drugs are the main cause of SJS (50-80% of cases) and TEN (80%). Objective: To determine the median total cost per day of SJS and TEN patients, and the effect of length of stay on the total cost of SJS/TEN. This study used an observational analytic with cross sectional design and societal perspective. The data was collected retrospectively using total sampling of SJS and TEN inpatients at RSUP Dr. Sardjito Yogyakarta in 2014-1018. The data was analyzed by calculating the median (range) and linear regression in IBM SPSS version 22.0, to determine the effect of length of stay on SJS/TEN costs . There were 29 patients analysed. The median total cost per SJS/TEN patient was IDR 1.139.963 (IDR 665.294-8.776.895), with IDR 1.139.963 (IDR 740.267-8.776.895) on SJS and IDR 1.166.084 (IDR 665.294-1.514.607) on TEN patients. The significance linear regression of the length of stay in SJS/TEN was 0,093 (p> 0,05). The median cost per SJS/TEN day was IDR 1.139.963 (665.294-8.776.895), and the length of stay does not affect the total cost of SJS/TEN. Keywords— Stevens Johnson Syndrome, Toxic Epidermal Necrolysis, cost analysis, cost of illness


Crisis ◽  
2020 ◽  
pp. 1-7
Author(s):  
Laura R. Umphrey ◽  
John C. Sherblom ◽  
Paulina Swiatkowski

Abstract. Background: Cultivating positive feelings of self in relationships with others can affect perceptions of belongingness and burdensomeness. Aims: The present study examines the relationships of self-compassion, hope, and emotional control to thwarted belongingness, perceived burdensomeness, and suicidal ideation. Method: Participants were 481 college students who completed scales measuring self-compassion, hope, emotional control, thwarted belongingness, perceived burdensomeness, and suicidal ideation. Results: Correlation and parallel mediation analysis results show relationships between self-compassion, hope, and emotional control with perceived burdensomeness, thwarted belongingness, and suicidal ideation. Limitations: The study is limited by its cross-sectional design, sample demographics, and inability to distinguish between individuals with suicidal ideation and those who attempt suicide. Conclusion: The results show that the relationships of self-compassion, hope, and emotional control to perceived burdensomeness, thwarted belongingness, and suicidal ideation are worth further investigation.


Author(s):  
Caspar C. Berghout ◽  
Jolien Zevalkink ◽  
Abraham N. J. Pieters ◽  
Gregory J. Meyer

In this study we used a quasiexperimental, cross-sectional design with six cohorts differing in phase of treatment (pretreatment, posttreatment, 2-year posttreatment) and treatment type (psychoanalysis and psychoanalytic psychotherapy) and investigated scores on 39 Rorschach-CS variables. The total sample consisted of 176 participants from four mental health care organizations in The Netherlands. We first examined pretreatment differences between patients entering psychoanalysis and patients entering psychoanalytic psychotherapy. The two treatment groups did not seem to differ substantially before treatment, with the exception of the level of ideational problems. Next, we studied the outcome of psychoanalysis and psychoanalytic psychotherapy by comparing the Rorschach-CS scores of the six groups of patients. In general, we found significant differences between pretreatment and posttreatment on a relatively small number of Rorschach-CS variables. More pre/post differences were found between the psychoanalytic psychotherapy groups than between the psychoanalysis groups. More research is needed to examine whether analyzing clusters of variables might reveal other results.


2018 ◽  
Vol 1 (2) ◽  
pp. 58
Author(s):  
Setia Budi ◽  
Ria Dila Syahfitri

The rate of stroke incidence is about 200 per 100,000 people throughout the world. This study aims to determine the Relation Suffer Stroke With Independence Level In Neurology Polyclinic TK II DR Ak Gani Palembang Year Hospital 2017. The research method used is descriptive quantitative with cross sectional design that is done by interviewing techniques with questionnaires on 42 respondents with Accidental sampling technique. This research was conducted in August 2017. Data analysis used is univariate data analysis and bivariate data analysis with one way anova test result. The results of univariate analysis showed that the duration of the respondents suffering from stroke was between 2.10 years to 3.38 years. Also found that most respondents were at the level of independence f; independent, except bathing, dressing, moving, and one other function with a total of 12 respondents. The results showed that there was a significant relationship between the long suffering stroke with the level of independence with the value of p value 0.025. For that the need for rehabilitation to patients and families of patients in order to help improve the independence of stroke patients in doing their daily activities. Keywords : Long Suffer Stroke, Level of Independence


2020 ◽  
Vol 3 (3) ◽  
pp. 88-96
Author(s):  
Ine Sintia ◽  
Nyimas Fatimah

Background: Frozen shoulder is a condition of the shoulder joint that experiences inflammation, pain, adhesions, atrophyand shortening of the joint capsule resulting in limited motion. In frozen shoulder patients, the limited range of motion ofthe shoulder joint can affect and reduce functional ability. This study aims to analyze the correlation between the limitedarea of motion of the shoulder joint with the functional ability of frozen shoulder patients at the Medical RehabilitationInstallation Dr. Mohammad Hoesin Palembang. Methods: This study was an observational analytic study, correlationtest, with a cross sectional design. There were 29 frozen shoulder patients who met the inclusion criteria in the MedicalRehabilitation Installation Dr. Mohammad Hoesin Palembang in November 2018 was taken as a sample using consecutivesampling techniques. Functional ability was assessed using the quickDASH questionnaire and the area of motion wasmeasured using a goniometer, then analyzed. Results: The results of the correlation test showed significant resultsbetween functional abilities and the area of motion of the shoulder joints. Active flexion (p = 0.000; r = -0.669), activeextension (p = 0.004; r = -0.520), active abduction (p = 0.000; r = -0.663), active adduction (p = 0.022; r = -0.423 ), passiveflexion (p = 0.001; r = -0.589), passive extension (p = 0.002; r = -0.543), passive abduction (p = 0.000; r = -0.676), passiveadduction (p = 0.038; r = -0.388). Conclusion: There is a significant correlation between limited joint motion andfunctional ability in frozen shoulder patients at the Medical Rehabilitation Installation of Dr. Mohammad HoesinPalembang


2020 ◽  
Vol 4 (1) ◽  
pp. 1-6
Author(s):  
NINDY VARA MEIGIA

Minimum Standards Service is basic service quality regulation that is entitled to be obtained by every citizen. Elderly people must obtain 100% health services. Various factors can lead to low visits to the elderly posyandu in the Gading Puskesmas area in 2017. Objective: to find out the relationship between family support, knowledge, and elderly activities in the elderly posyandu in Gading Surabaya puskesmas. Method: The type of research is observational analytic with a cross-sectional design. Data processing and analysis is done by univariate and bivariate. Data collection techniques by conducting simple random sampling with a sample of 94 elderly people. Location and time of research from December 2018 at the posyandu in the Gading Surabaya health center area. Results: There is a significant value of 0,000 <0,05, so it can be concluded is have a relationship with family support, knowledge of elderly with activity following the elderly posyandu at Gading Surabaya health center


2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Marselli Widya Lestari ◽  
Tri Wahyuni Bintarti

Gout or Gouty Arthritis is a degenerative disease. Gouty arthritis is a clinical syndrome that is caused by deposition of purine crystals in the tissues, due to levels of uric acid (hyperuricemia) in the extracellular fluid that passes through saturation. The etiology of gout arthritis included age, sex, history of medication, obesity, consumption of purine and alcohol. Aging is an important risk factor for men and women. This study uses an analytical-descriptive approach with cross-sectional design. This study was conducted to obtain a relationship between nutritional status and uric acid levels in the community in the area of ​​Al-Hidayah Islamic Boarding School, Ngawi. This research was conducted in Majasem Village, Kendal District, Ngawi Regency, starting from 7 June - 31 August 2018. The results showed that there was a relationship between nutritional status and uric acid levels in the community in the area of ​​Al-Hidayah Islamic Boarding School, Ngawi (p=0,008). Suggestions for further research are bivariate analysis based on gender, knowledge and attitude to response to diet so that other factors that influence can be seen clearly


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