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Journal : Medica Hospitalia

Hubungan Tympanogram dengan Lokasi dan Ukuran Tumor pada Pasien Karsinoma Nasofaring Dewi, Julita Melisa; Marliyawati, Dwi; Muyassaraoh, Muyassaroh
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (257.771 KB) | DOI: 10.36408/mhjcm.v9i1.682

Abstract

Introduction : Hearing loss is the most frequent symptomps of patients with Nasopharyngeal Carcinoma (NPC), because there is a connection between the middle ear and the nasopharynx through the eustachian tube. Tympanometry is a hearing test in terms of evaluating the middle ear. Objective : This study aimed to evaluate the correlation between the tympanogram and the location and size of the nasopharyngeal carcinoma tumor at Dr. Kariadi General Hospital Semarang. Methods : This is a descriptive analytic study with cross-sectional study design of NPC patients at Dr. Kariadi Hospital Semarang, July 2020 to June 2021. Tympanometry was performed at the beginning of the diagnosis of NPC, the location and size of the tumor based on a head and neck physical examination, nasopharyngoscopy and CT scan results. Data analysis with spearmen rho . test. Result : From 52 subjects were diagnosed with NPC, most of them were in the 5th decade. The most common location of the tumor was in Rossenmuler fossa and extended to the wall and roof of the nasopharynx bilaterally (n=29; 55,7%). The most tumor size was T4 (n=26;50%). The results of statistical analysis showed that the tympanogram image had a strong correlation with the location of the tumor in NPC patients (r=0.853; p<0.001), but had no correlation with tumor size (r=0.061; p=0.668). Conclusion : The tympanogram in NPC is related to the location of the tumor, not to the size of the tumor.
DETEKSI DINI KEJADIAN OTOTOKSIK PADA ANAK DENGAN KEGANASAN YANG MENDAPAT KEMOTERAPI PLATINUM BASED: Ototoxicity Incidence in Children with Malignancy Who Received Platinum-Based Chemotherapy Asthika, Ismiar; Marliyawati, Dwi; Muyassaroh, Muyassaroh
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 2 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (264.345 KB) | DOI: 10.36408/mhjcm.v9i2.690

Abstract

Latar belakang : Kejadian ototoksik pada anak dengan keganasan yang mendapatkan kemoterapi cisplatin 60–70%. Ototoksik pada anak menyebabkan gangguan perkembangan bahasa, kemampuan verbal dan komunikasi pada anak sehingga dapat menurunkan kualitas hidup. Tujuan penelitian ini adalah mengetahui kejadian ototoksik pada anak dengan keganasan yang mendapat kemoterapi platinum based. Metode : Penelitian observasional analitik dengan design belah lintang pada anak dengan keganasan yang diberi kemoterapi platinum based periode Agustus – September 2020. Data diambil dari rekam medik pasien Klinik Onkologi Kasuari RSUP dr. Kariadi Semarang, ototoksik bila hasil OAE refer pada frekuensi ≥ 8KHz pada satu atau kedua telinga. Analisis data dengan uji Chi-Square. Hasil : Didapatkan 38 sampel terdiri dari 22 laki-laki (57,89%) dan 16 perempuan (42,11%), dengan jenis kemoterapi cisplatin sebanyak 21 pasien (55,26%) dan jumlah pemberian kemoterapi ≥ 3 kali sebanyak 23 pasien (60,53%). Kejadian ototoksik lebih banyak pada jenis kelamin laki-laki, banyak terjadi pada pemberian kemoterapi cisplatin dan banyak terjadi pada pemberian ≥ 3 siklus. Jenis kelamin (p=0,248) dan Jenis kemoterapi (p=0,344) tidak berhubungan dengan kejadian ototoksik. Frekuensi siklus kemoterapi (p = 0,0005) berhubungan dengan kejadian ototoksik. Simpulan : Kejadian ototoksik banyak pada anak laki laki, dengan keganasan yang mendapat kemoterapi cisplatin, banyak terjadi ototoksik pada pemberian ≥ 3 siklus, frekuensi siklus kemoterapi berhubungan dengan kejadian ototoksik
OSA FAKTOR RISIKO KEJADIAN OBSTRUCTIVE SLEEP APNEA PADA PASIEN STROKE ISKEMIK: - Rosyidah, Nurul Uly; Mailasari Kusuma Dewi, Anna; Marliyawati, Dwi; Yunika, Kanti; Suryawati, Herlina; Budiarti, Rery
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 3 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v9i3.826

Abstract

LATAR BELAKANG: Sleep Disordered Breathing (SDB)  memiliki hubungan dua arah dengan stroke iskemik. SDB yang tidak diobati dapat menyebabkan stroke berulang. Penanganan SDB adalah kunci untuk preventif pada pasien stroke. TUJUAN: Menganalisis IMT, lingkar leher besar, deviasi septum, hipertrofi konka, hipertrofi tonsila palatina, makroglosia, dan obstruksi saluran nafas atas sebagai faktor risiko SDB pasien stroke iskemik. METODE: Penelitian observasional dengan desain cross sectional, pada 86 pasien stroke iskemik di Poli Neurologi dan THT-KL RSUP Kariadi Semarang bulan Desember 2021-Juli 2022. Data diperoleh melalui kuesioner, pemeriksaan fisik dan pemeriksaan nasolaringoskopi fleksibel. Analisis menggunakan uji chi-square dan uji regresi multivariat. HASIL: Didapatkan 86 subjek terdiri dari 42 laki-laki(48,8%) dan perempuan 44 (51,2%), usia rerata 54 th, dan 61 subjek (70,9%) stroke iskemik pertama. Septum deviasi (p= 0,020), hipertrofi konka inferior (p= 0,021), makroglosia (p= 0,012), hipertrofi tonsila palatina (p= 0,013), dan obstruksi saluran nafas atas (p= 0,035) merupakan faktor risiko SDB pada pasien stroke iskemik. Septum deviasi berisiko 6,1x, konka inferior hipertrofi berisiko 4,1x, dan hipertrofi tonsila palatina  berisiko 8,8x terhadap SDB pada pasien stroke iskemik. SIMPULAN: Septum deviasi, konka inferior hipertrofi, makroglossia, hipertrofi tonsila palatina, makroglosia, dan obstruksi saluran nafas atas merupakan faktor resiko terhadap SDB pasien stroke iskemik. Hipertrofi tonsila palatina merupakan faktor risiko yang paling dominan terhadap SDB pasien stroke iskemik. KATA KUNCI: SDB, faktor risiko, stroke iskemik, hipertrofi tonsila palatina, septum deviasi
Comparison Of Clinical Response Between Combine Chemotherapy 5 Fluorourasil - Platinum Based And Ifosfamid - Taxane - Platinum Based In Recurrent Nasopharyngeal Carcinoma Sanjaya, Rio; Yusmawan, Willy; Antono, Dwi; Marliyawati, Dwi; Yunika, Kanti
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 3 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i3.926

Abstract

BACKGROUND : Recurrence of Nasopharyngeal Carcinoma (NPC) is the emergence of a tumor remission after administration of chemoradiation based on symptoms and several examinations. The combination of chemotherapy in recurrent NPC still gives good results. The combine of regimens used is still varied and not much study has been done to assess the clinical response. OBJECTIVE : To compare the clinical response between administration of combination 5 Fluorouracil-Platinum based (5-FU) and Ifosfamide-taxan-platinum based (IFO) in recurrent NPC. METHOD :. This observational study used electronic medical record (ERM) data at the ENT oncology clinic at Dr. Kariadi General Hospital for the period January 2020-January 2022. The number of samples that suited to the inclusion and exclusion criteria was 44 subjects divided into two groups of 22 subjects respectively. The chi-square test was used to assess differences in alteration of clinical symptoms, tumor mass size, neck lymph node enlargement, tumours stage reduction, and the effect of confounding factors on response to therapy in both groups. RESULTS : The highest number of patients with recurrent NPC were aged ≥45 Years old and male (75%). WHO type 3 is the most common (95.5%) and ECOG status 1 (95.5%). There was no significant difference administration of the combination of 5-FU with IFO in alteration of clinical symptoms (p=0.500), shrink tumor size (p=0.347), reduction of neck lymph node size (p=0.164), and reduction tumor staging (p=0.347). There was no relationship from confounding factors to clinical response between the administration of the two groups. CONCLUSION : Administration of 5 Fluorouracil-platinum based combination chemotherapy did not provide a better clinical response in terms of clinical symptoms, changes in primary tumor size, neck lymph node size, and decreased tumor stage compared to the Ifosfamide-taxane-platinum based combination based on recurrent NPC.
Risk Factors for Peripheral Vertigo Sekarwangi, Yuni Retno; Marliyawati, Dwi; Yunika, Kanti; Naftali, Zulfikar
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 2 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i2.977

Abstract

Background: Several risk factors influence the occurrence of peripheral vertigo, including advanced age, gender, and chronic metabolic diseases. This disease is not widely recorded in primary care due to the need for detection with simple examinations. Research on the association of several risk factors has yet to be reported. Objectives: To examine the relationship between age, gender, type 2 diabetes mellitus (DM2), and hypertension as risk factors for peripheral vertigo. Methods: This study is a case-control study that used consecutive sampling. The study sample consisted of 39 people: 19 in the case group and 20 in the control group. Data were obtained from 2 health centers and Diponegoro National Hospital, Semarang City. The data were obtained from history taking and physical examinations such as the Gans Sensory Organization Performance Test (SOP), past pointing test, and dysdiadokokinesia test. DM2 disease and hypertension were gathered from medical records. Data analysis used univariate analysis, bivariate analysis with chi-square, and logistic regression multivariate analysis. Results:  Statistical test results concluded that hypertension is a risk factor for peripheral vertigo (p = 0.008; OR = 6.964; 95%CI = 1.657 - 29.263). Whereas age, gender, and DM2 were not risk factors, with p-values of 0.187, 0.378, and 0.417, respectively. Conclusion: The significant risk factor associated with the occurrence of peripheral vertigo was hypertension by 6.964 times.
The Relationship Between Cumulative Platinum-Based Chemotherapy Dose And The Occurrence Of Ototoxicity In Head And Neck Malignancies Purnomo, Hendro; Marliyawati, Dwi; Muyassaroh, Muyassaroh; Ruspita, Dian Ayu; Naftali, Zulfikar
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 2 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i2.1085

Abstract

BACKGROUND: Chemotherapy is a treatment for head and neck malignancies. Hearing impairment is a side effect of chemotherapy, especially caused by platinum-based chemotherapy. Hearing impairment generally occurs at high frequencies after the administration of chemotherapy. AIMS: To prove assosciation between cumulative doses of platinum-based chemotherapy and ototoxic events in head and neck malignancies. METHOD: This is a cross-sectional study. The sample is patients with head and neck malignancy receiving platinum-based chemotherapy at Dr. Kariadi Hospital Semarang from March to June 2023. Hearing assessment using pure tone audiometry was performed randomly at all chemotherapy cycles. Data was analyzed with a chi-square test. RESULT:  Eighty-one subjects (52 male, 29 female), consisting of 71 subjects received cisplatin, and 10 subjects received carboplatin. Ototoxicity occurs in 91.7% of subjects receiving cumulative doses of cisplatin >300mg/m2 and carboplatin >1500mg/m2 compared to cumulative doses of cisplatin <300mg/m2 and carboplatin <1500mg/m2, which was 46.7% (p = 0.001, CI 1.416-2.725). CONCLUSION: There was a significant association between cumulative doses of platinum-based chemotherapy and ototoxicity incidence of head and neck malignancy patients.