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Laporan Kasus: GAMBARAN HISTOPATOLOGI HODGKIN LIMFOMA KLASIK MENYERUPAI KARSINOMA PARU Yudanto, Hendy Setyo; Retnani, Diah Prabawati; Ervina, Rita; Wardhani, Shinta Oktya; Hermanto, Djoko Heri
Majalah Kesehatan Vol. 10 No. 3 (2023): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2023.010.03.6

Limfoma Hodgkin merupakan neoplasma limfoid berasal dari sel B dengan ciri-ciri adanya sel Reed-Sternberg dengan latar belakang sel-sel radang, Limfoma Hodgkin yang melibatkan organ paru terjadi sekitar 15% hingga 40% kasus. Angka kejadian Limfoma Hodgkin ekstra nodal khususnya paru sekitar 3,6%. Seorang pasien wanita usia 31 tahun dengan keluhan batuk lama dan sakit tenggorokan selama satu tahun, dan telah mendapatkan pengobatan rutin, didapatkan penurunan berat badan disertai benjolan pada ketiak kanan berukuran 5 cm, dan dilanjutkan dengan pemeriksaan penunjang radiologi thorak, computed tomography (CT) dengan mengesankan terdapat massa pada paru kanan, kemudian dilanjutkan dengan biopsi dan pulasan imunohistokimia dan di simpulkan sebagai Limfoma Hodgkin, serta pasien menjalani kemoterapi. Biopsi jarum halus atau Fine Needle Aspiration Biopsy (FNAB) pada aksila dapat mengetahui adanya metastasis karsinoma, sarkoma atau Limfoma. Pemeriksaan histopatologi pada sediaan biopsi paru dan dilanjutkan dengan pulasan immunohistokimia Cytokeratin (-), CD45 (-), CD20 (-), CD3 (-) pada sel tumor, Ki67 low proliferation index, CD30 (+), dan PAX5 (+), sehingga didapatkan gambaran Limfoma Hodgkin. Limfoma Hodgkin merupakan neoplasma limfoid berasal dari sel B yang sering mengenai nodul limfoid, mengandung sel mononuklear displastik besar dan sel-sel Multinucleated Reed-Sternberg cells yang dikelilingi oleh sel-sel radang campuran non neoplastik, seperti limfosit kecil, eosinophil, netrofil, histiosit dan sel plasma. Dari kasus ini disimpulkan bahwa Limpoma Hodgkin ekstranodul yang melibatkan organ paru merupakan kasus yang jarang terjadi, dengan open biopsy dan perlu dipertimbangkan pemeriksaan immunohistokimia merupakan cara definitif untuk menegakkan diagnosis Limfoma Hodgkin.

EVALUASI KUALITAS HIDUP DAN SKALA NYERI PADA LANJUT USIA PENYINTAS COVID-19 PASCA RAWAT INAP Soenarti, Sri; Sutanto, Heri; Indiastari, Dewi; Budiarti, Niniek; Hermanto, Djoko Heri; Susanto, Jefri Pratama
Majalah Kesehatan Vol. 10 No. 2 (2023): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2022.010.02.5

COVID-19 menyebabkan banyaknya kematian pada populasi lanjut usia (lansia). Di Indonesia, hingga akhir Mei 2021 terdapat 49% kematian akibat COVID-19 dan pada pasien di atas 60 tahun (lansia) hanya didapatkan 10% kasus sembuh. Lansia dikategorikan sebagai kelompok berisiko terinfeksi virus Corona. Wabah penyakit ini tidak hanya berdampak pada kesehatan fisik tetapi juga kesehatan mental. Pada saat pandemi, memahami kualitas hidup lansia yang sembuh dari COVID-19 pasca perawatan di rumah sakit adalah tantangan global yang baru. Penelitian ini dilakukan dengan mengambil data lansia yang selamat dari COVID-19 pasca rawat inap untuk dinilai kualitas hidupnya dan kesehatan diri. Penilaian dengan wawancara melalui telepon. Data demografi, sosial ekonomi, status kesehatan diambil dari rekam medis pasien. Responden memperoleh rerata skor kualitas hidup (EQ-5D) 0,911 dan rerata skor VAS 89,6. Nyeri sendi memiliki korelasi yang signifikan secara statistik dengan ketidaknyamanan (p < 0,000). Lama rawat inap kurang dari 14 hari memiliki hubungan yang bermakna dengan ketidaknyamanan (p < 0,05). Sedangkan dimensi lain seperti mobilitas, perawatan diri, aktivitas sehari-hari dan kecemasan/depresi tidak berkorelasi dengan ketidaknyamanan secara signifikan. Kesimpulannya, kualitas hidup dan kesehatan diri yang dilaporkan oleh lansia penyintas COVID-19 relatif bagus. Adanya keluhan nyeri sendi dikaitkan dengan kualitas hidup yang lebih buruk (dimensi ketidaknyamanan), sementara risiko ketidaknyamanan meningkat secara signifikan dengan lama rawat yang lebih singkat.

An Epidemiological Study Incidence Rates of Risk Factors for Colorectal Cancer's Early Symptoms in the Community in Gondanglegi District, Malang, East Java, Indonesia: An Epidemiological Study Hermanto, Djoko Heri; Nurarifah, Nina; Brahmantyo, Herwindo Pudjo; Alfiani, Nadia; Dharmesta, Naya Adi; Ardiyanti, Putri; Qhadafy, Arif; Wardhani, Shinta Oktya
Journal of Epidemiology and Public Health Vol. 9 No. 2 (2024)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2024.09.02.12

Background: Colorectal cancer (CRC) is one of the most common types of cancer worldwide. CRC is most typical symptom is hematochezia while the risk factors encompass sex, age, genetic predispositions, history of colorectal polyps or cancer, chronic inflammatory bowel diseases, physical exercise, and specific dietary choices, including high red meat intake, fried food, and low fiber consumption. This study aims to screen the risk factors of colorectal cancer.Subjects and Method: This research was conducted on residents in the Sepanjang village, Malang Regency, involved in community service by the Internist Association of Malang. Community service was carried out in July 2023 and 148 residents were involved in collecting data on risk factors for colorectal carcinoma. Data collection was carried out using a questionnaire with a cross-sectional approach. The questionnaire assesses the presence of symptoms of bloody stools and several habits related to colorectal carcinoma risk factors, including age, gender, exercise routine, and dietary history. Data presentation and analysis were carried out as in the table.Results: Among the risk factors listed assessed using the questionnaire, Men (p=0.021), lack of exercise (p= 0.008), consumption of fried food (p= 0.021), and consumption of instant noodles (p= 0.013) significantly affect the prevalence of hematochezia.Conclusion: Men, lack of exercise, consumption of fried food, and consumption of instant noodles significantly affect the hematochezia indicating CRC.

Pregnancy With Severe Thrombocytopenia Caused by HELLP Syndrome and Acute Idiopathic Thrombocytopenic Purpura: a Case Report Widowati, Ayu Rizky; Firdaus, Wildan Aulia; Hariyati, Suheni Ninik; Hermanto, Djoko Heri
Asian Journal of Health Research Vol. 4 No. 1 (2025): Volume 4 No 1 (April) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i1.183

Introduction: Thrombocytopenia in pregnancy could result in a wide range of prognosis, with the worst-case being life-threatening. Thrombocytopenia in pregnancy is a rare condition which could result in bleeding, endangering both maternal and foetal components. During pregnancy, thrombocytopenia could be caused by various factors, including idiopathic thrombocytopenic purpura and preeclampsia. Case Presentation: A 28-year-old pregnant woman, primigravid, gestational age 37-38 weeks old, single pregnancy, presents with fever ongoing for 12 days. A routine blood test returned a thrombocyte count of 11000/mm3. Patient received 8 units of thrombocyte concentrate with no improvement and progressive decline of thrombocyte count. Patient was assessed with severe thrombocytopenia caused by suspected dengue fever, with differential diagnoses being HELLP syndrome and idiopathic thrombocytopenic purpura. Patient was also assessed with severe preeclampsia and severe oligohydramnios. Patient’s condition improved after termination of pregnancy by caesarean section, accompanied with gradual return to normal thrombocyte count value. Conclusion: Thrombocytopenia in pregnancy could be caused by various factors, necessitating the need for a thorough medical evaluation to determine the underlying cause. A multidisciplinary and collaborative approach is highly recommended in managing pregnant women with thrombocytopenia.

Successful Modified Chemotherapy Regiment in Patient with Hairy Cell Leukemia Variant Hermanto, Djoko Heri; Hatinah, Amalia Nurul; Arifah, Nina Nur
Clinical and Research Journal in Internal Medicine Vol. 6 No. 1 (2025): Volume 6 No 1, May 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.01.14

Hairy Cell Leukemia variant (HCLv) is distinct from Hairy Cell Leukemia classic (HCLc) and categorized as an unclassified splenic B-cell lymphoma/leukemia. HCLv is a rare disease with a 15% survival rate after 15 years, and accounts for only 0.4% of chronic lymphoid malignancies and the etiology remains unclear. In this context, it responds poorly to standard Hairy Cell Leukemia (HCL) therapy. The primary complaints of a 64-year-old patient on admission were weight loss, early satiety, fatigue, and abdominal enlargement. Physical examination showed massive splenomegaly, and laboratory results showed thrombocytopenia and leukocytosis with a predominance of lymphocytes. Meanwhile, bone marrow puncture (BMP) and flow cytometry results showed hairy cells with morphology and immunophenotyping consistent with HCLv. Due to the unavailable purine analogs, and considering potential outcomes, the patient was treated with a combination of Cytarabine, Daunorubicin, and Rituximab for 5 days. After 3 months, clinical improvement was observed, and BMP evaluation showed no evidence of hairy cells projection, leading to the patient being declared in complete remission. This case presents a new therapy regimen that has not been previously applied to HCLv cases and it may serve as an option for similar cases, subject to clinician judgment and patient preferences. Keywords: HCL variant, modified chemotherapy regimen, total remission

An Epidemiological Study Incidence Rates of Risk Factors for Colorectal Cancer's Early Symptoms in the Community in Gondanglegi District, Malang, East Java, Indonesia: An Epidemiological Study Hermanto, Djoko Heri; Nurarifah, Nina; Brahmantyo, Herwindo Pudjo; Alfiani, Nadia; Dharmesta, Naya Adi; Ardiyanti, Putri; Qhadafy, Arif; Wardhani, Shinta Oktya
Journal of Epidemiology and Public Health Vol. 9 No. 2 (2024)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2024.09.02.12

Background: Colorectal cancer (CRC) is one of the most common types of cancer worldwide. CRC is most typical symptom is hematochezia while the risk factors encompass sex, age, genetic predispositions, history of colorectal polyps or cancer, chronic inflammatory bowel diseases, physical exercise, and specific dietary choices, including high red meat intake, fried food, and low fiber consumption. This study aims to screen the risk factors of colorectal cancer.Subjects and Method: This research was conducted on residents in the Sepanjang village, Malang Regency, involved in community service by the Internist Association of Malang. Community service was carried out in July 2023 and 148 residents were involved in collecting data on risk factors for colorectal carcinoma. Data collection was carried out using a questionnaire with a cross-sectional approach. The questionnaire assesses the presence of symptoms of bloody stools and several habits related to colorectal carcinoma risk factors, including age, gender, exercise routine, and dietary history. Data presentation and analysis were carried out as in the table.Results: Among the risk factors listed assessed using the questionnaire, Men (p=0.021), lack of exercise (p= 0.008), consumption of fried food (p= 0.021), and consumption of instant noodles (p= 0.013) significantly affect the prevalence of hematochezia.Conclusion: Men, lack of exercise, consumption of fried food, and consumption of instant noodles significantly affect the hematochezia indicating CRC.

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