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Correlation between Obesity and Seroma Following Modified Radical Mastectomy Kurnia, Ahmad; Suhandi, Andri; Budiningsih, Setyawati
The New Ropanasuri Journal of Surgery Vol. 1, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. Obesity becomes one of concern for surgeon asit provides additional morbidity in breast cancer. It influencesthe healing process negatively, and increase the complications following mastectomy. The most often found complication is seroma. Its incidence in obese is found higher than non–obese patient. Studies evaluating the correlation between obesity and seroma showed controversy. Hence, we run a study aimed to find out such a correlation in our characteristics. Method.We conducted cross sectional study. All patients treated with modified radical mastectomy (MRM) during period of 2013 to 2014 were included. Subject characteristics were recorded, including age, body mass index (BMI). Bilateral breast malignancy, diabetes mellitus and hypertension were excluded.Drain production and infection, and length of staywas recorded. Kolmogorov Smirnov test is used to find out normal distribution. In normal distribution, Pearson test or Spearman’s is used to find out correlation. Results. Out of 72 samples underwent MRM and drainage, there were 67 enrolled. The mean age was found of 48.5±8.5 years, and mean BMI of 25.43 kg/m2 ± 4.08.Length of stay ranged of 3–8 days andmean total seroma production was found of 502.3mL ± 207.8. We foundmoderate positive linear correlation between obesity and seroma (r = 0.581; p <0.01; r2 = 0.338) rolled of 33.8% and strong positive linear correlation between seroma and length of stay (r = 0.581; p <0.01;r2 = 0.542)rolled of 52.4%. Conclusion. We found positive linear correlation between seroma and obesity, and positive linear correlation between seroma and length of stay
Wide Excision of Non–Melanoma Skin Cancer at dr. Cipto Mangunkusumo General Hospital, 2012–2015: Recurrence and Prognostic Factors Pratama, Dennis William; Kurnia, Ahmad
The New Ropanasuri Journal of Surgery Vol. 4, No. 1
Publisher : UI Scholars Hub

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Introduction. Skin cancer is one of many kinds of cancer which incidence increases globally. Basal cell carcinoma (BSC) and squamous cell carcinoma (SCC) are the most common prevalence of non–melanoma skin cancer, and also are the most common cancer among skin cancer. The main therapy for such skin cancer is wide excision within its safety margin added by adjuvant therapy. Despite adequate therapy, people with skin cancer still have a risk of recurrence. This study assesses the prognostic factors of recurrence among people with non–melanoma skin cancer who underwent wide excision surgery. Method. This study was a retrospective cohort with survival analysis. The patient's data who underwent wide excision surgery were from Perhimpunan Ahli Bedah Onkologi Indonesia (PERABOI)registry and medical record from Oncology Surgery Division in RSCM from January 2012–December 2015. Data selection was done based on inclusion and exclusion criteria. Results. There were 187 patients with non–melanoma skin cancer who underwent wide excision surgery; the recurrence was detected on 15% of the case. Most of the patients were ≥45 years old with the most common histopathological feature of the skin cancer was basal cell carcinoma. We did a survival analysis with Cox regression and the result was previous history of skin cancer (RR 6.903; 95% CI 2.925–16.292), perineural invasion (HR 3.818; 95% CI 1.561–9.340), location of the lesion (HR 0.071; 95% CI 0.022–0.228), and size of the tumor (HR 1.842; 95% CI 1.244–2.729) was the factorsthat increased recurrence. Conclusion. History of previous skin cancer, perineural invasion, location of the lesion, and size of the tumor were the prognostic factors for recurrence among patients with non–melanoma skin cancer who underwent wide excision surgery
Purse-String Suture for Skin Closure Following Large Thyroidectomy Kurnia, Ahmad; Siregar, Bintang Abadi; Ramli, Muchlis
The New Ropanasuri Journal of Surgery Vol. 5, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. The total number of patients with thyroid nodules, especially large thyroid nodules (> 6 cm diameter), is increasing. However, the conventional suturing technique for closure of thyroidectomies is still only recommended as the standard for the tumor with a diameter up to 6 cm. Hence, this study aims to prove another surgical technique, purse-string stitching technique, for better esthetic outcomes on large thyroidectomy. Methods. This study was a non-randomized control trial. The subjects included the patients of Cipto Mangunkusumo Hospital in 2013 to 2014 with a thyroid tumor > 6 cm in diameter without any history of anterior cervical surgery and positive lymph nodes. Subjects were divided into the purse-string group and the conventional group. Thyroidectomies were done on all subjects, then were closed by the suturing technique of each group. Outcomes were recorded in the follow-up sessions, including wound scar size, wrinkle existence, and subject’s satisfaction level. Results. Purse-string technique resulted in shorter scar length compared to the conventional technique (median 35 mm vs. 94 mm, p< 0.01). The other outcomes, such as the width of the scar (median 3 mm vs. 2 mm, p=0.265), the presence of wrinkles (0 vs. 2, p=0.480), and satisfaction level of subjects (median 9 vs. 9, p=0.287) were also assessed. Conclusion. The purse-string suturing technique on large thyroidectomy wound closure could be an alternative, besides the conventional suturing technique for a better esthetic result.
Four square method for improving students’ writing ability in EF Teens & Kids Kalimalang Lumenta, Febriany Maria; Surista, Ade; Kurnia, Ahmad
ETUDE: Journal of Educational Research Vol 1, No 1 (2020): ETUDE: Journal of Educational Research Vol 1 No 1 November 2020
Publisher : CV. Mitra Palupi

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Background:  Children are easily to speak up their idea directly but do not know how to shift it into proper writing. The children, English learners, need the writing aspect due to fulfill every English aspect especially in their school academicPurpose: This research is going to increase the students’ writing ability through eclectic method.Design and methods: This research has another concept with drawing the eclectic method in different ways. The writer tries to put four square writing methods in order to apply the eclectic method in developing students’ writing ability in EF Kids and Teens Kalimalang. This research is a descriptive quantitative research which will be done by field work. In this research, the writer uses the descriptive and quantitative design to analyze the data. The instrument and variable of this research consist of several parts. They are the directive of teaching method, the directive of the test form, and the result test.Results: The combining of Four Square Writing Method and classroom writing performance as Eclectic Method significantly improves the students’ score. It is clearly showed by the increasing of the mean score. The mean score of the pretest is 68.46% while the mean score of the posttest is 79.13% which increased 10.46%.
Consequential Surgeries Limit Recurrence of Skin Malignancies in Xeroderma Pigmentosum: A Case Report Kurnia, Ahmad; Kartini, Diani; Herwirastri, Novinda; Adyasa, Zoya M
The New Ropanasuri Journal of Surgery Vol. 6, No. 2
Publisher : UI Scholars Hub

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Abstract

Xeroderma Pigmentosum (XP) is a rare inherited skin malignancy with no causative treatment options. Reporting a 23-year-old woman with xeroderma pigmentosum who underwent several surgical tumor removals followed by further five procedures to apply tissue expander, facial resurfacing using full-thickness skin grafts with a donor from abdominal. The next series was tumor resection in the chin, forehead, nasal reconstruction, tumor removal on bilateral third digits, and defect closure. No recurrence after nine years of postoperative monitoring with an aesthetically acceptable result.
Breast reconstruction Ahmad Kurnia
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.833 KB) | DOI: 10.19106/JMedScieSup004804201601

Abstract

Breast reconstruction is such a unique procedure that might potentially be adjustedin line with time and all advances in technology and instruments (endoscopy,silicone implants, alloderm grafting). In addition, it adapts in accordance to better,more sophisticated knowledge of breast anatomy (vascularization, perforator, andinnervation), breast subunits, and systemic changes. Surgical techniques and thecurrently available list of materials might be utilized to reconstruct the breast insuch a way to yield cosmetic satisfaction. Combination and modification of thosetechniques might be adjusted to the patients’ requests without crossing over thepaths of the disease being corrected (cancer, benign tumor, infection, or otherbreast anomalies).Breast reconstruction’s prerequisite is the absence of cancer approximately 1cm from the edge of incision, adjusted by shape and size of breasts, and sizeof cancer. Several techniques might be applied to conserve and reconstruct thebreasts when the disease has been diagnosed. Oncoplasty applies all techniquesavailable to reaffirm the principles of oncology, by increasing the distance fromthe edges of cancer and proceeding with reconstruction by reduction/mastopexy(volume displacement), or adjacent/distant flaps (volume replacement). Thedisadvantage of BCS/BCT is the short distance from the edge of incision to thetumor due to the risk of post-operative breast deformity, especially when surgeryis followed by adjuvant radiation.
Total and Intratumoral CD8+ T Cell Expressions are Correlated with Miller Payne Grading and WHO Clinical Response of Neoadjuvant Chemotherapy Sonar Soni Panigoro; Sinta Chaira Maulanisa; Ahmad Kurnia; Denni Joko Purwanto; Primariadewi Rustamadji; Herqutanto Herqutanto; Ferry Sandra
The Indonesian Biomedical Journal Vol 15, No 2 (2023)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v15i2.2110

Abstract

BACKGROUND: Chemotherapy has reported to stimulate immune system through direct activation of cluster of differentiation (CD)8+ T cells. Neoadjuvant chemotherapy (NAC) is known to improve the clinical response of locally advanced breast cancer (LABC) patients. However, the immune response-related factor evaluation of NAC in LABC patients has not been routinely performed. Therefore, current study was conducted to evaluate the correlation of NAC-induced CD8+ T cell with chemotherapy response based on Miller Payne grading and World Health Organization (WHO) criteria.METHODS: LABC patients were recruited and data regarding age, gender, tumor, nodal stages, histopathological grade, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and Ki67 were obtained. Biopsy and mastectomy tissues were collected and processed for hematoxylin-eosin and CD8 immunohistochemical staining. CD8+ T cell expression in peritumoral and intratumoral areas were documented and measured. Clinical responses based on Miller Payne grading and WHO were analyzed and correlated with CD8+ T cell expression.RESULTS: There were more subjects with high expression of total (80%), intratumoral (82.5%) and peritumoral (65%) CD8+ T cell expressions. The total (p=0.013) and intratumoral (p=0.015) CD8+ T cell expression, but not peritumoral CD8+ T cell expression, were significantly correlated with Miller Payne Grading. The total (p=0.009) and intratumoral (p=0.001) CD8+ T cell expressions were also significantly correlated with WHO clinical response.CONCLUSION: Total and intratumoral CD8+ T cell expressions are correlated with Miller Payne grading and WHO clinical response of NAC. Therefore, total and intratumoral CD8+ T cell expressions could be suggested as a predictive marker for clinical response of NAC.KEYWORDS: breast cancer, neoadjuvant chemotherapy, CD8, clinical response, Miller Payne, intratumoral, peritumoral 
Rancang Bangun Sistem Peringatan Dini Dalam Pencegahan Banjir Akibat Luapan Sungai Berbasis Arduino Menggunakan Metode Fuzzy Logic Kurnia, Ahmad; Mustafa, Rivaldi; Listiana, Reni
Journal of Informatics and Electronics Engineering Vol 2 No 2 (2022): Desember 2022
Publisher : Unit Penelitian dan Pengabdian kepada Masyarakat Politeknik TEDC Bandung Jl. Pesantren Km 2 Cibabat Cimahi Utara – Cimahi 40513 Jawa Barat – Indonesia

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Abstract

Banjir adalah salah satu bencana yang sulit dihindari yang dapat terjadi tanpa peringatan. Penyebab banjir yang utama adalah luapan dari sungai. Umumnya curah hujan yang tinggi dan kemampuan drainase tanah yang rendah menyebabkan air sungai naik sehingga terjadi banjir. Oleh sebab itu dibutuhkan sebuah sistem pemantauan peringatan dini banjir yang terintegrasi dengan masyarakat atau operator secara langsung. Untuk mencegah banjir akibat luapan air sungai, telah dirancang sebuah alat rancang bangun dan proptoptype sistem peringatan dini berbasis Arduino uno dengan menggunakan metode fuzzy logic. Alat ini bekerja dengan dua sensor, yakni sensor Ultrasonik untuk ketinggian aliran air sungai dan water flow sensor untuk kecepatan alirannya. Saat kedua sensor mendeteksi nilai yang melebihi set point yang ditentukan, aktuator motor DC akan berputar untuk mengangkat pintu air. Data nilai sensor juga akan ditampilkan oleh LCD, kemudian buzzer dan lampu indikator sebagai penanda peringatan. Pada saat sistem bekerja maka operator yang menjaga akan mengetahui level dan kecepatan aliran sungai pada saat air sungai naik, sehingga dapat terdeteksi sebelum terjadi luapan yang berakibat banjir. Hasil perancangan dalam penelitian ini telah sesuai yang diharapkan bahwa kecepatan putaran motor yang dihasilkan dipengaruhi oleh data yang terdeteksi dari kedua sensor, kemudian jarak jangkauan sistem, dan perangkat android dapat mendeteksi sampai 15 meter bila tidak ada penghalang, sehingga secara keseluruhan sistem dapat bekerja dengan baik. Dengan demikian, hasil perancangan sistem peringatan dini menggunakan sensor ultrasonik, water flow sensor dengan metode fuzzy logic dalam perancangan dan penelitian ini merupakan solusi yang tepat untuk pencegahan luapan sungai yang berakibat banjir. Kata Kunci— Banjir, Arduino UNO, Sensor ultrasonik, Water Flow Sensor, Fuzzy logic, Sistem peringatan dini
Konsep Pluralisme Abdurrahman Wahid Dan Implikasinya Terhadap Pendidikan Islam Kurnia, Ahmad; Khoiriyah, Affy; Himmawan, Didik
Journal Islamic Pedagogia Vol. 4 No. 1 (2024): Journal Islamic Pedagogia
Publisher : Fakultas Agama Islam Universitas Wiralodra

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31943/pedagogia.v4i1.115

Abstract

Penelitian ini berjudul konsep pluralisme Abdurrahman Wahid dan implikasinya terhadap pendidikan Islam. Penelitian ini bertujuan untuk mengetahui konsep pluralisme Abdurrahman Wahid dan untuk mengetahui implikasi dari pluralisme terhadap pendidikan Islam. Metode penelitian yang digunakan yaitu library research atau penelitian perpustakaan, dimana untuk mencari data-data yang diperlukan dengan cara mencari dari berbagai sumber seperti buku, jurnal, skripsi terdahulu atau pustaka-pustaka lainnya. Dari hasil penelitian ini dapat disimpulkan bahwa konsep pluralisme yang ditekankan Abdurrahman Wahid adalah pluralisme dalam bertindak dan berpikir. Pluralisme dalam bertindak mensyaratkan seseorang untuk tidak membatasi pergaulan dengan orang lain (eksklusif) meskipun berbeda keyakinan. Pluralisme dalam berpikir adalah kesediaan untuk menerima atau mengambil gagasan atau pemikiran dari kalangan lain. Implikasi dari adanya pluralisme terhadap pendidikan Islam yaitu pertama, pendidikan Islam yang Humanis dan egalitarian, kedua, menghargai perbedaan, ketiga, menghargai nilai-nilai demokrasidan hak asasi manusia.
IMPLIKASI TEORI FISIKA RELATIVITAS DAN KOSMOLOGI TERHADAP PEMAHAMAN TEOLOGI KONTEMPORER Kurnia, Ahmad
Jurnal TEDC Vol 18 No 1 (2024): JURNAL TEDC
Publisher : UPPM Politeknik TEDC Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70428/tedc.v18i1.791

Abstract

Teori Fisika tentang Relativitas membuka pemahaman baru fisika dan kosmologi. Sejak dimulai peradaban manusia, bahasan tentang kosmologi selalu terkait dengan aspek teologi atau ketuhanan. Teori awal kosmoslogi adalah Geosentris, bahwa bumi sebagai pusat kosmos dan alam semesta diciptakan seketika oleh Tuhan. Pemahaman dan Tafsir klasik Kitab Suci agama Abrahamik dinilai sejalan dengan teori Geosentris. Teori Heliosentris – Matahari sebagai pusat kosmos muncul abad ke 16 menggeser faham Geosentris. Faham Heliosentris membuat bahasan kosmoslogi lepas dari konsep-konsep teologis. Terjadilah dikotomi agama dan sains. Konsep Penciptaan kembali muncul di awal abad ke-20 setelah teori Relativitas Einstein menjadi fondasi dalam memahami kosmologi kontemporer. Tulisan ini membahas implikasi teori Relativitas dan perkembangan kosmologi terhadap pemahaman tentang Ketuhanan atau Teologi Kontemporer. Penelitian tulisan memenggunakan metode penelitian kualitatif dengan pendekatan Studi Kepustakaan (Liberary Research) dan analisis yang dikembangkan menggunakan metode analisis deskriptif, dengan konsep keterpaduan sains dan teologi. Hasil penelitian tentang relativitas bahwa ruang dan waktu besaran relatif, menjadi dasar pemahaman teori perkembangan kosmos. Sesuai Hukum Hubble, alam semesta terus berkembang dan bila dirunut mundur, alam semesta berasal dari “Dentuman Besar” sekitar 13,8 milyar tahun lalu. Sebelum dentuman besar, Volume Alam Semesta = nol , artinya belum tercipta ruang dan juga waktu, yang ada adalah “Ketiadaan”. Implikasi teori Relativitas terhadap Teologi adalah konsep ilmiah alam semesta dari “Ketiadaan” menjadi “Ada” yang bukan dari teks kitab suci, meneguhkan keyakinan akan adanya Sang Pencipta, yakni Tuhan. Kata Kunci : Relativitas, Teologi, Kosmos, Geosentris, Heliosentris, Big Bang