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All Journal Universa Medicina Jurnal Profesi Medika: Jurnal Kedokteran dan Kesehatan Medica Hospitalia
Bakhtiar, Yuriz
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Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Clinicopathologic Features in a TSH Secreting Pituitary Tumor : a Case Report Bakhtiar, Yuriz; Kesumayadi, Irfan; Fujio, Shingo; Arifin, Muhamad Thohar
Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan Vol 17 No 2 (2023): Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran UPN Veteran Jakarta Kerja Sama KNPT

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33533/jpm.v17i2.6530

Abstract

Thyrotropin-stimulating hormone-producing adenoma (TSHoma) is a rare cause of hyperthyroidism. Patients with this condition are often diagnosed when the tumor has already grown significantly, as the diagnosis of TSHoma is frequently delayed and confused with primary hyperthyroidism. Our case describes a 60-year-old woman with a goiter who was referred to our center from the otolaryngology department. Her thyroid panel in endocrinology showed elevated free hormone levels (fT3: 4.6 mg/ml and fT4: 1.93 mg/ml) and an unsuppressed TSH: 12.85 μ mIU/l, suggesting central hyperthyroidism. A thyroid gland sample obtained by a fine needle aspiration biopsy did not show malignant cells. An MRI scan of the pituitary gland revealed a macroadenoma with KNOSP grade 1. She underwent transsphenoidal surgery for the tumor. Histopathology revealed an acidophilic adenoma with the expression of TSH and prolactin by immunostaining. The proliferation rate, as indicated by MIB-1 staining, was only 0.6%. The decrease in thyroid hormones after the operation confirmed the effectiveness of the surgery. In conclusion, TSHoma, a rare tumor associated with hyperthyroidism, requires a careful diagnosis for effective management. Our article serves as reference material for understanding cases of pituitary-secreting tumors in Indonesia.
The Relationship Between Pre-Operative Clinical Characteristics With Changes In Post-Operative Memory Scores On Temporal Lobe Epilepsy Patient Bintoro, Aris Catur; Arifin, Muhammad Thohar; Harsono, Harsono; Muttaqin, Zainal; Hadisaputro, Soeharyo; Husni, Amin; Bakhtiar, Yuriz; Karlowe, Vega; Pratomo, Joko
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 1 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i1.844

Abstract

Background: Most temporal lobe epilepsy (TLE) will become seizure-free after anterior temporal lobectomy (ATL) surgery but often result in cognitive decline, specifically in verbal or visual memory. Objective: This study examined the relationship between several demographic characteristics and pre-operative clinical conditions with changes in pre-post surgical memory of TLE patients. Methods: This study used a retrospective cohort in which the subjects were TLE patients who had undergone ATL surgery at Kariadi Hospital or Telogorejo Hospital, Semarang. Demographic variables include the age of onset, duration of illness, level of education, and clinical variables include seizure frequency, EEG waveform, number of AED, lesion site, and IQ score. Results: Memory re-examination was conducted on TLE patients who had undergone surgery between 2018 and 2021, with 55 subjects who fulfilled the criteria. Characteristics of the subjects were male 31(56%) males, 38% Senior High School education, the mean age of onset was 13,87±6,899, age at surgery was 27,67±9,802, 21 (39%) normal pres-surgical EEG waveform, 31 (56%) lesion on the left and the most frequent seizures occurred in 36 subjects (65%). Statistical test results showed a significant relationship between age of onset and changes in verbal memory recognition scores (p 0.044), lesion side with changes in verbal memory task scores (p 0.018), recall (p 0.005), recognition (0.008), and IQ scores with changes in visual memory construction recall (p 0.041) Conclusion: Age of onset, lesion side, and IQ score characteristics were related to the changes in memory scores between pre- and post-operative anterior temporal lobectomy in TLE patients.
Gait Analysis of Ankle Joints of Indonesians at Low, Medium and High Speeds Novriansyah, Robin; Hadi, Jason Reynald; Bakhtiar, Yuriz; Husni, Amin; Ismail, Rifky
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 3 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i3.1175

Abstract

Background : Amputation is a loss of body part, and most amputations are lower extremity amputations. The most common is transtibial amputation. After an amputation a person will need a prosthesis. However, up to now there has been no functional prosthesis specifically made for Indonesians who undergo transtibial amputation because the ankle joint gait data that are currently used are European gait data. So it is necessary to measure the normal gait data of Indonesians' ankle joint. The aims of this study was to measure the normal gait data of the ankle joint of Indonesian population Methods : The Research sample is Indonesians aged 18–26 years with normal gait measured by the 2DMA (two-dimensional motion analyzers) at low, medium and high speeds. The resulting data is searched for the mean and standard deviations and then an independent t-test is performed between normal gait data of Indonesians and Europeans Results : Indonesians have a range of maximum dorsiflexion values for low, medium, and high speeds of : 7.9°, 8.3°, 8.9° and maximum plantar flexion for low, medium, and high speeds of 13.4°, 20.6°, 26°. In the comparison test there was a significant difference between the maximum plantar flexion angle of Indonesians and Europeans. Conclusion : Indonesians have a range of maximum dorsiflexion values for low, medium, and high speeds of 7.9°, 8.3°, 8.9° and maximum plantar flexion for low, medium, and high speeds of: 13.4°, 20.6°, 26°. There is a difference between the normal gait of the ankle joint of Indonesians and Europeans.
The survival benefits of adjuvant radiotherapy for malignant meningioma: a retrospective cohort study Bakhtiar, Yuriz; Eka Setiawan, Fariz; Ilmansyah, Rafi; Prihastomo, Krisna Tsaniadi; Priambada, Dody; Rizky Aryani Septarina, Faiza; Arifin, Muhamad Thohar; Muttaqin, Zainal
Universa Medicina Vol. 44 No. 3 (2025): Ahead Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.318-327

Abstract

BackgroundMalignant meningiomas (MM) are rare aggressive tumors associated with poor survival outcomes. Due to their rarity, there is limited data on the outcomes and prognostic factors of MM patients, particularly on adjuvant radiotherapy roles in this tumor population. This study aims to investigate the clinical characteristics, prognostic factors, and survival outcomes of MM with focus on survival benefits of adjuvant radiotherapy. MethodsThis retrospective cohort study analyzed 19 MM patients, who were initially subjected to postoperative radiotherapy, at Dr. Kariadi General Hospital, Semarang, from 2013 to 2023. Kaplan-Meier analysis was used to estimate survival rates at 1, 2, and 5 years. Univariate and multivariate Cox regression analyses were performed to identify factors associated with overall survival (OS). Variables with a p-value ≤ 0.25 in univariate analysis were included in the multivariate models. ResultsThe median OS was 16 months (95% CI 0.0–40.2), with estimated 1-year, 2-year, and 5-year survival rates of 52.6%, 42.1%, and 15.8%, respectively. Adjuvant radiotherapy (RDT) was associated with a significantly improved OS (p<0.001). However, sex, age, tumor location, and extent of resection did not show a significant association with OS. Cox regression showed that RDT had no statistically significant effect on OS in the multivariate model (HR = 0, 95% CI 0–1.8, p=0.923). ConclusionAdjuvant radiotherapy is critical for improving OS in MM patients, and gross-total resection (GTR) alone does not guarantee better long-term outcomes. Further studies with larger cohorts and molecular analysis are necessary to refine treatment strategies for MM.
Co-Authors Amin Husni Aris Catur Bintoro Eka Setiawan, Fariz Fujio, Shingo Hadi, Jason Reynald Harsono Harsono Ilmansyah, Rafi Joko Pratomo, Joko Karlowe, Vega Kesumayadi, Irfan Muhamad Thohar Arifin Muhammad Thohar Arifin Novriansyah, Robin Priambada, Dody Prihastomo, Krisna Tsaniadi Rifky Ismail Rizky Aryani Septarina, Faiza Soeharyo Hadisaputro Zainal Muttaqin