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Health services in hospitals require consumable medical materials and devices, sufficient stock to provide flexibility in carrying out the actions or treatment needed by patients, especially for consumable medical materials and devices related to Covid 19 which are included in the AV group, it is hoped that this will never happen stock void. Special analysis is needed to classify Ingredients and Medical Consumables into groups that can be seen the process of controlling their supplies. This study aims to classify consumable medical materials and devices into the right groups, then choose the inventory control method. Design of this research is Operational Research, the analysis used is descriptive analytic. The results of this study indicate that from the ABC Critical Index and VEN analysis, it is found that the AV group consists of 23 items, of which 13 items are consumable medical materials and devices for Covid 19 related needs. The results of the calculation of inventory control using the Economic Order Quantity (EOQ) and Reorder Point (ROP) methods show the results of numbers that can be used as a reference in keeping stocks in check. Awal Bros Hospital in Ujung Batu does not yet have an accurate inventory control system, so it is necessary to use an inventory control method so that there is never a shortage or empty stock
Tuberculosis (TB) is an infectious disease caused by the bacteria Mycobacterium tuberculosis. TB consists of 2 types, namely Drug Sensitive TB (SO) and Drug Resistant TB (RO). number of tuberculosis case discoveries in 2022 724,309; 711,778 cases of drug-sensitive TB (TB SO) and 12,531 cases of drug-resistant TB (TB RO). MDR TB is a type of RO TB which has an increasing number of new cases every year, estimated at 12% of MDR TB cases. Depression is a health problem where according to WHO depression is number 4 disease in the world. The prevalence of depression in TB and MDR TB patients was 43.4% (AOR, 10.8; 95% CI, 2.8–41.5). This study aims to analyze the relationship between TB classification and the incidence of depression using a retrospective cohort study design. The research results showed that the proportion of TB patients who experienced depression during treatment was higher in the MDR TB group, 93.1%, compared to the SO TB group, 17.0%. Multivariate results: MDR TB patients with MDR TB were 4.88 times more likely to experience depression during treatment compared to SO TB patients after controlling for comorbid variables. The p-value <0.001. This figure is smaller than alpha 0.05 so that the classification of MDR TB cases is statistically significantly related to the incidence of depression during treatment. Suggestions for implementing integration of mental health services in TB control programs so that it will be easy to do if an effective and low-cost integrated service model is available. Program and expansion of TB services with a guide to TB RO and TB SO treatment services through mental screening as one of the methods in TB treatment to minimize depression in TB patients.
Industri farmasi merupakan industri yang memiliki risko kebakaran dan ledakan yang sangat besar karena penanganan beragam bahan kimia cair, padatan, dan gas yang mudah terbakar serta bahan kimia berbahaya lainnya. Tujuan umum dari penelitian ini adalah untuk mengklasifikasikan area berbahaya berdasarkan standar IEC 60079-10-2 serta menganalisis tingkat risiko kebakaran dan ledakan debu dalam proses granulasi pada fasilitas Non Betalactam (Multi Product Facility). Penelitian ini merupakan penelitian deskriptif semi kuantitatif yang bertujuan untuk mengklasifikasikan area berbahaya pada proses granulasi berdasarkan standar IEC 60079-10-2 dan menentukan tingkat risiko kebakaran dan ledakan debu dalam tahapan pencampuran (mixing) dengan menggunakan metode Dow’s Fire Explosion Index. Populasi ini melibatkan semua bahan kimia berbahaya dan peralatan yang digunakan pada proses pembuatan obat di PT. X. Combustible dust yang digunakan dalam proses granulasi pada fasilitas Non Betalactam Facility (Multi Product Facility) berupa bahan aktif farmasi dan eksipien, seperti methyldopa hydrate, paracetamol, loperamide hydrochloride, diazepam, domperidone, prednisolone micronised, magnesium stearate. polyvidone 30, sodium starch glycolate, dan amylum maydis. Minimum Ignition Energy (MIE) yang dimiliki oleh semua bahan aktif berbeda-beda nilainya sesuai hasil uji laboratorium eksternal dengan nilai yang paling sensitif terhadap penyalaan, yaitu diazepam, methyldopa hydrate, loperamide hydrochloride, domperidone dan prednisolone micronised yang mempunyai nilai MIE 1-3 mj yang dapat menyebabkan ledakan kuat hingga sangat kuat jika memenuhi konsentrasi Minimum Explosive Concentration (MEC). Sehubungan dengan hal itu, sebelum menentukan klasifikasi area berbahaya, sangat penting untuk mengidentifikasi sumber penyalaan di area proses tersebut. Adapun sumber penyalaan tersebut bersumber dari peralatan listrik, listrik statis, dan friction/mechanical spark. Klasifikasi area berbahaya dengan kategori zona dalam proses granulasi pada fasilitas Non Betalactam (Multi Product Facility) terdiri dari zona 20 di setiap dalam chamber/container peralatan, zona 21 di setiap bukaan hopper/charging unit, tempat perilisan debu dengan radius satu meter dan zona 22 di luar zona 21 di dalam ruangan proses granulasi. Tingkat risiko kebakaran dan ledakan debu pada proses granulasi (mixing) dengan menggunakan metode granulasi basah (hybrid mixture) berdasarkan metode Dow’s Fire and Explosion Index adalah risiko sedang (moderate) dengan total skor 95,1762 dengan radius paparannya sebesar 29,010 meter dan estimasi kerugiannya mencapai Rp 1.467.276.735.672. Oleh karenanya, sangat penting untuk melakukan mitigasi risiko sehingga risiko kebakaran dan ledakan debu di area proses ini berada pada risiko yang rendah.
The pharmaceutical industry is an industry that has a very large risk of fire and explosion due to the handling of a variety of flammable liquid, solid and gaseous chemicals as well as other hazardous chemicals. The general objective of this study is to classify hazardous areas based on IEC 60079-10-2 standards and to analyze the risk level of fire and dust explosion in the granulation process at the Non Betalactam facility (Multi Product Facility). This research is a semi-quantitative descriptive study that aims to classify hazardous areas in the granulation process based on IEC 60079-10-2 standards and determine the risk level of fire and dust explosion in the mixing stage using the Dow's Fire Explosion Index method. This population includes all hazardous chemicals and equipment used in the drug manufacturing process at PT. X. Combustible dust used in the granulation process at the Non Betalactam Facility (Multi Product Facility) is in the form of active pharmaceutical ingredients and excipients, such as methyldopa hydrate, paracetamol, loperamide hydrochloride, diazepam, domperidone, micronised prednisolone, magnesium stearate. polyvidone 30, sodium starch glycolate, and amylum maydis. The Minimum Ignition Energy (MIE) that all active ingredients have a different value according to the results of external laboratory tests with values that are most sensitive to ignition, namely diazepam, methyldopa hydrate, loperamide hydrochloride, domperidone and micronised prednisolone which have an MIE value of 1-3 mj which can cause a strong to very strong explosion if it meets the Minimum Explosive Concentration (MEC) concentration. In this regard, before determining the classification of a hazardous area, it is very important to identify the source of ignition in the process area. The ignition sources come from electrical equipment, static electricity, and friction/mechanical spark. Classification of hazardous areas with the category of zones in the granulation process at Non Betalactam facilities (Multi Product Facility) consists of zone 20 in each equipment chamber/container, zone 21 in each opening of the hopper/charging unit, a dust release area with a radius of one meter and zone 22 outside zone 21 in the granulation process room. The risk level of fire and dust explosion in the granulation process (mixing) using the wet granulation method (hybrid mixture) based on the Dow's Fire and Explosion Index method is moderate risk with a total score of 95.1762 with an exposure radius of 29.010 meters and an estimated loss of IDR 1,467. 276,735,672. Therefore, it is very important to carry out risk mitigation so that the risk of fire and dust explosion in this process area is at a low risk.
Latar Belakang Indonesia merupakan daerah hyper-endemic dengue dengan siklus epidemik yang rutin terjadi. Kriteria klasifikasi WHO tahun 2009 mendefinisikan kumpulan gejala, tanda dan hasil laboratorium yang dapat mendeteksi mayoritas kasus dengue namun untuk konfirmasinya membutuhkan tambahan pemeriksaan laboratorium seperti pemeriksaan NS1 maupun Immunoglobulin M.
Metode Penelitian Penelitian cross-sectional dengan data sekunder dari pasien demam akut di tiga lokasi Kabupaten Tangerang yaitu RSUD Kabupaten Tangerang, Puskesmas Kelapa Dua dan Puskesmas Bojong Nangka. Reference test berupa pemeriksaan RT-PCR, sedangkan index test adalah kriteria klasifikasi WHO tahun 2009 dan pemeriksaan RDT NS1. Analisis data dilakukan dengan uji diagnostik berupa uji reabilitas dan validitas.
Hasil Penelitian Kekuatan tingkat kesepakatan pada kriteria klasifikasi WHO tahun 2009 terhadap pemeriksaan RT-PCR maupun RDT NS1 adalah fair sedangkan pemeriksaan RDT NS1 terhadap RT-PCR didapatkan tingkat kesepakatan substantial. Sensitivitas kriteria klasifikasi WHO tahun 2009 didapatkan sebesar 72% (95%CI 65-78.2) lebih tinggi daripada pemeriksaan RDT NS1 65.6% (95%CI 58.4-72.4), namun spesifisitasnya sangat rendah (52.4% vs 97.6%). Kombinasi kriteria klasifikasi WHO tahun 2009 dan RDT NS1 secara serial memiliki sensitivitas 50.8% dan spesifisitas 98.1% dibandingkan kombinasi paralel menunjukkan hasil sensitivitas 86.8% dan spesifisitas 51.9%.
Kesimpulan Berdasarkan uji reabilitas hanya pemeriksaan RDT NS1 yang memiliki tingkat kesepakatan substantial. Berdasarkan uji validitas sensitivitas kriteria klasifikasi WHO tahun 2009 tidak cukup baik dalam skrining kasus dengue sehingga penggunaannya sebaiknya digantikan kombinasi paralel agar kasus dengue yang tidak terdiagnosis dapat berkurang.
Background Dengue is hyperendemic with frequent epidemic cycles in Indonesia. Tangerang district is among the regions with a high dengue burden. The 2009 WHO dengue case classification has a set of symptoms, signs, and laboratory findings that can identify most dengue cases; however, dengue cases need to be confirmed by additional laboratory diagnostic tests, such as NS1 and Immunoglobulin M testing. Method A cross-sectional study using secondary data from acute fever patients in three different locations in Tangerang District: Bojong Nangka PHC, Kelapa Dua PHC, and Tangerang District Hospital. The 2009 WHO dengue case classification and the NS1 RDT as index test, whereas the reference test is RT-PCR. Validity and reliability tests are used to analyze data. Results The observed agreement on the 2009 WHO dengue case classification for RT-PCR and NS1 RDT examinations was fair, although among NS1 RDT and RT-PCR was substantial. The sensitivity of the 2009 WHO dengue case classification was 72% (95%CI 65-78.2) higher than the NS1 RDT 65.6% (95%CI 58.4-72.4), but the specificity was considerably lower (52.4% vs 97.6%). The serial combination of the 2009 WHO dengue case classification and NS1 RDT in this study had a sensitivity of 50.8% and a specificity of 98.1%, while the parallel combination showed a sensitivity of 86.8% and a specificity of 51.9%. Conclusion Based on the reliability test, only the NS1 RDT has a substantial level of agreement. Based on the validity test, the sensitivity of the 2009 WHO dengue case classification is insufficient for screening dengue cases; therefore, a parallel combination can be used instead to lower the number of undiagnosed dengue cases.
The aim of this study is to determine the percentage of food supplement consumption behavior and its correlates among production worker at PT Akebono Brake Astra Indonesia. This study uses cross-sectional design, accidental sampling methode, and analyzed using the independent t test and chi-square test. The study sample consist of 180 workers. This study was conducted on April 08-30, 2013. The result of this study shows that 45,5% of respondents was consuming food supplement. This study also found that food supplement consumption behavior has been associated with age (p value = 0,033). The researcher suggest the existence of education program such as consultation or seminar, so that respondents understand what is the meaning of food supplement, the classification of food supplement, the content of food supplement, the rules of usage, and side effects.
The petrochemical industry is a high-risk sector for fire and explosion hazards due to the involvement of flammable and toxic substances, as well as operating conditions at high temperatures and pressures. This study is a semi-quantitative descriptive research aimed at classifying hazardous areas in the production process based on the API RP 500 standard and determining the level of fire and explosion risk in the ammonia gas production process using the Dow’s Fire and Explosion Index (DF&EI) method. The methodological approach includes the identification of hazardous chemicals, hazard level assessment using DF&EI, analysis of loss estimation and exposure radius, and assessment of ammonia gas dispersion and process explosion using the ALOHA software. The analysis results show that Plant 1A has a DF&EI index categorized as severe, with an exposure radius of 223.78 meters and an actual MPPD of IDR 154 billion in the ammonia converter unit, and categorized as light, with an exposure radius of 45.78 meters and an actual MPPD of IDR 47 billion in the urea reactor unit. The hazardous area classification indicates the presence of Class I, Division 2 classified zones in several parts of the production process close to the ammonia vapor and natural gas release sources. The worst-case scenario shows a significant impact due to an explosion from the ammonia converter unit with a blast radius of up to 269 meters causing window glass breakage, and ammonia gas dispersion from the urea reactor spreading up to 10 kilometers, potentially causing respiratory issues.