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All Journal Medicina Sport and Fitness Journal Jurnal Ergonomi Indonesia (The Indonesian Journal of Ergonomic) E-Jurnal Medika Udayana Majalah Ilmiah Fisioterapi Indonesia Jurnal Kesehatan Vokasional ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Kedokteran: Media Informasi Ilmu Kedokteran dan Kesehatan Jurnal EduHealth Public Health and Preventive Medicine Archive Journal of Global Pharma Technology Eduvest - Journal of Universal Studies Journal Physical Therapy UNISA Research Horizon Physical Therapy Journal of Indonesia Indonesian Journal of Pharmacology and Therapy Jurnal Info Kesehatan

I MADE MULIARTA .

Fakultas Kedokteran Universita Udayana

Author-ID : 211637

Aerospace Engineering Arts Humanities Biochemistry, Genetics & Molecular Biology Chemistry Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Education Engineering Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary

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Hubungan lama duduk terhadap nyeri punggung bawah miogenik dan faktor-faktor yang berhubungan pada pengerajin kain tenun di Desa Sidemen, Kecamatan Sidemen, Kabupaten Karangasem tahun 2017 Ida Ayu Dyah Yusa Dhammayanthi; Susy Purnamawati; Made Muliarta
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Lower back pain (NPB) is a major cause of disability affecting work and general welfare of workersAim: The study aims to determine the long sitting relationship to the lower back pain of miogenik and factors related to the weaving fabric in the village of Sidemen so that the results of the study can be used as a confirmatory study.Method: This study uses cross-sectional analytic design with the research sample are all respondents with low back pain complaints as appropriate with the inclusion criteria. The sample was chosen by purposive sampling technique with minimum number is 76 samples.Result: The results of the study showed that the largest number of samples were based on female gender groups 85.5% (65 people), age 25-50 years 75.0% (57 people), tenure> 10 years 90.8% (69 people), BMI not at risk (â‰¤29.9) of 63.2% (48 people), for sporting habits 1 time a week 94.7% (72 people), based on Pain Disability Index (PDI) disrupted with PDI 0-35 score of 96 , 1% (73 people), based on sitting time> 4 hours of 81.6% (62 people), and for lower back pain complaints no NPB of 64.5% (49 people).Conclusion: Exact Fisher test results obtained p 0.011 which indicates that Ho is rejected which means there is a relationship between the sitting time to lower back pain miogenik on artisans of woven fabrics in the village of Sidemen. PR (prevalence ratio) was found to be 5,871 which means woven craftsman who sat> 4 hours 5,871 times more risky to experience lower back pain than sitting <4 hours.Â Nyeri punggung bawah (NPB) tersebut merupakan penyebab utama kecacatan yang mempengaruhi pekerjaan dan kesejahteraan umum pekerja. Penelitian ini menggunakan rancangan cross-sectional analitik dengan sampel penelitian adalah semua responden dengan keluhan nyeri punggung bawah memenuhi kriteria inklusi. Sampel dipilih dengan teknik purposive sampling dengan jumlah minimal adalah 76 sampel.Tujuan: Tujuan penelitian ini adalah untuk mengetahui hubungan lama duduk terhadap nyeri punggung bawah miogenik dan faktor-faktor yang berhubungan pada pengerajin kain tenun di Desa Sidemen sehingga hasil penelitian dapat digunakan sebagai studi konfirmatif..Metode: Hasil penelitian menunjukkan jumlah sampel terbanyak berdasarkan kelompok jenis kelamin perempuan 85,5% (65 orang), usia 25-50 tahun 75,0% (57 orang), masa kerja >10 tahun 90,8% (69 orang), IMT yang tidak beresiko (â‰¤29,9) sebesar 63,2% (48 orang), untuk kebiasaan olahraga 1 kali dalam seminggu 94,7% (72 orang), berdasarkan Pain Disability Index (PDI) terganggu dengan skor PDI 0-35 sebesar 96,1% (73 orang), berdasarkan lama duduk >4 jam sebesar 81,6% (62 orang), dan untuk keluhan nyeri punggung bawah tidak NPB sebesar 64,5% (49 orang).Simpulan Hasil uji Exact Fisher memperoleh p 0,011 yang menandakan bahwa Ho ditolak yang artinya terdapat hubungan antara lama duduk terhadap nyeri punggung bawah miogenik pada pengerajin kain tenun di Desa Sidemen. PR (prevalensi rasio) didapatkan 5,871 yang artinya pengerajin kain tenun yang duduk >4 jam 5,871 kali lebih berisiko untuk mengalami nyeri punggung bawah dibandingkan yang duduk <4 jam.

Gambaran fungsi paru pengrajin kayu di Desa Petulu Gianyar, Bali-Indonesia Asshiddiqie Chirac Sepakat Purba1, Luh Made Indah Sri Handari Adiputra2, I Made Muliarta2 Asshiddiqie Chirac Sepakat Purba; Luh Made Indah Sri Handari Adiputra; I Made Muliarta
Intisari Sains Medis Vol. 10 No. 3 (2019): (Available online: 1 December 2019)
Publisher : DiscoverSys Inc.

Introduction: The woodworking industry is experiencing very rapid growth. Petulu Village is a village famous for its wood crafts. The working environment in Petulu village has risk factors in the form of physical factors (dust, noise, heat, lighting), chemical factors, and the most important is Dust. The purpose of this study was to describe the description of lung function of wood craftsmen including (Gender, Age, Nutritional Status, Working Period, Smoking History and Use of Personal Protective Equipment) in Petulu Village, Gianyar, Bali.Method: This study is a descriptive study with a Cross-Sectional approach which aims to describe the lung function of woodworkers in Petulu Gianyar Village. The sample in this study was taken using the simple random sampling method. The number of samples in this study consisted of 31 respondents. Primary data collection using a questionnaire and measuring lung function using spirometry.Results: The results of this study indicate that the respondents were 16 men (51.61%) and 15 women (48.39%). Respondents aged over 30 years were 25 people (80.65%) and aged under 30 years as many as 6 people (19.35%). Respondents with underweight nutritional status 1 person (3.23%), normal 15 people (48.39%) and fat 15 people (48.39%). Respondents with a working period of more than 5 years were 25 people (80.65%) and tenure under 5 years was 6 people (19.35%). Respondents who have smoking habits as many as 12 people (38.71%) and do not have smoking habits as many as 19 people (61.29%). Respondents who did not use personal protective equipment were 6 people (19.35%) and respondents who used personal protective equipment were 25 people (80.65%). The results of lung function measurements found that respondents who experienced restrictive pulmonary function disorders were 18 people (58.06%) and respondents with normal pulmonary function were 13 people (41.94%).Conclusion: Based on the results of the study showed that as many as 18 people (58.06%) wood craftsmen in Petulu Gianyar Village experienced restrictive lung function disorders.

Hubungan antara Tumor Infiltrating Lymphocytes (TIL), ekspresi Programmed Death-Ligan 1 (PD-L1) pada sel tumor dan TIL dengan kedalaman invasi pada karsinoma urotelial kandung kemih tipe tidak spesifik di RSUP Sanglah, Bali, Indonesia Luh Ayu Widayanti; I Gusti Ayu Sri Mahendra Dewi; Herman Saputra; Anak Agung Ayu Ngurah Susraini; Ni Putu Sriwidyani; I Made Muliarta
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Urotelial carcinoma is one of carcinoma with increasing morbidity and mortality. The depth of invasion is one of risk factors that influence recurrence and survival rate in urotelial carcinoma. Patient with deeper invasion has poorer prognosis in recurrence and survival rate. Generally, carcinoma have microenvironment such as tumor infiltrating lymphocytes (TIL) to eliminate the tumor cells, in proliferative area. Cancer cells can avoid host immunity through PD-1/PD-L1 pathway. This study aimed to determine the association between TIL and PD-L1 expression with the depth of invasion of urotelial carcinoma.Methods: This study was a cross sectional analytic study with 37 samples size. The samples were taken from paraffin block of patients with urotelial bladder carcinoma non-specific type, that has performed resection and histopathological examination at Anatomical Pathology Laboratory Sanglah Hospital Denpasar, from January 1st, 2015 to December 31th, 2019. Rediagnosis was carried out to assess the histopathological diagnosis, TIL and depth of invasion. Then PD-L1 immunohistochemistry was performed. Data were analyzed by Chi-Square test with p<0.05. Data were analyzed using SPSS version 20 for Windows.Results: In this study on bladder urothelial carcinoma non-specific type at Sanglah Hospital Denpasar, we found there is no association between TIL and the depth of invasion (p=0.471). There is association between PD-L1 expression in tumor cells with the depth of invasion (p=0.006), OR 7.04 (CI 95% =1.64-30.20). There is association between PD-L1 expression in TIL with the depth of invasion (p=0.001), OR 13.2 (CI 95% = 2.62-66.43).Conclusion: There is association between PD-L1 expression in tumor cells an PD-L1 expresion in TIL with the depth of invasion. Positive expression of PD-L1 in tumor cells and TIL are more likely to become advance invasion. Tumor Infiltrating Lymphocytes (TIL) and PD-L1 expression on TIL can be used as predictive factors for the depth of invasion in urotelial carcinoma. Latar Belakang: Karsinoma urotelial merupakan salah satu karsinoma dengan morbiditas dan mortalitas yang terus meningkat. Salah satu faktor risiko yang mempengaruhi rekurensi dan survival rate pada karsinoma urotelial adalah kedalaman invasi. Invasi yang lebih dalam memiliki prognosis yang lebih buruk. Karsinoma umumnya disertai lingkungan mikro antara lain tumor infiltrating lymphocytes (TIL) yang berfungsi untuk mengeliminasi tumor. Sel kanker memiliki kemampuan untuk menghindari imun host antara lain melalui ikatan PD-1 dengan PD-L1. Tujuan dari penelitian ini untuk mengetahui hubungan antara TIL dan ekspresi PD-L1 dengan kedalaman invasi pada karsinoma urotelial.Metode: Penelitian ini merupakan studi analitik potong lintang dengan besar sampel adalah 37, yang berasal dari blok parafin penderita karsinoma urotelial kandung kemih tipe tidak spesifik yang diperiksa histopatologi di Laboratorium Patologi Anatomi RSUP Sanglah Denpasar dari 1 Januari 2015 sampai 31 Desember 2019. Rediagnosis preparat dilakukan untuk menilai diagnosis histopatologi, TIL serta kedalaman invasi. Kemudian dilakukan pulasan imunohistokimia PD-L1. Data dianalisis dengan uji Chi-Square dengan nilai p<0,05. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Hasil penelitian ini menunjukkan bahwa pada karsinoma urotelial kandung kemih tipe tidak spesifik di RSUP Sanglah Denpasar, tidak terdapat hubungan yang signifikan antara TIL dengan kedalaman invasi (p=0,471). Terdapat hubungan yang signifikan antara ekspresi PD-L1 pada sel tumor dengan kedalaman invasi (p=0,006) dengan OR 7,04 (IK 95% =1,64-30,20), antara ekspresi PD-L1 pada TIL dengan kedalaman invasi (p=0,001) dengan OR 13,20 (IK 95% = 2,62-66,43).Kesimpulan: Terdapat hubungan antara ekspresi PD-L1 pada sel tumor dan pada TIL dengan kedalaman invasi pada karsinoma urotelial kandung kemih tipe tidak spesifik di RSUP Sanglah Denpasar. Ekspresi positif PD-L1 pada sel tumor dan pada TIL memiliki kemungkinan lebih besar untuk menjadi invasi lanjut.

Hubungan antara Stromal Tumor Infiltrating Lymphocytes (TIL) dengan ekspresi Programmed Death-Ligand 1 (PD-L1) pada karsinoma payudara invasif tipe tidak spesifik subtipe Human Epidermal Growth Factor Receptor-2 (HER-2) enriched di RSUP Sanglah, Bali, Ind Popi Imelda Margareth Sitompul; Herman Saputra; Luh Putu Iin Indrayani Maker; I Gusti Ayu Sri Mahendra Dewi; Ni Putu Sriwidyani; I Made Muliarta
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Breast cancer is the most common malignancy cancer in women. This malignancy is molecularly heterogeneous, where overexpression of the HER-2 growth factor receptor generally has a more aggressive nature. The role of immune system interaction, namely Tumor Infiltrating Lymphocytes (TIL) and Programmed Death-Ligand 1 (PD-L1) expression, is associated with prognostic and predictive factors. Therefore, this study aims to investigate the association between stromal TIL with PD-L1 expression in invasive breast carcinoma non-specific type HER-2 enriched subtype.Methods: This study was an observational analytical study with cross-sectional design from January 1st 2015 to December 31st 2019. The samples were taken from a paraffin block of patients with invasive breast carcinoma non-specific type, that has performed histopathological examination, ER, PR, HER-2 and FISH/CISH immunohistochemistry examination at the Anatomical Pathology Laboratory of Sanglah Hospital Denpasar. The samples obtained were stained with PD-L1 immunohistochemistry. The preparation was evaluated to assess TIL. Data were analyzed using SPSS version 20 for Windows.Results: The study found a statistically significant association between stromal TIL with PD-L1 expression in tumor cells (p = 0.018). There is statistically significant association between stromal TIL with PD-L1 expression in TIL (p = 0.001). There is statistically significant association between stromal TIL with PD-L1 expression in total tumor cells and TIL (p = 0.007) in invasive breast carcinoma non-specific type HER-2 enriched subtype at Sanglah Hospital, Denpasar.Conclusion: In conclusion, there is an association between stromal TIL with the expression of PD-L1 in tumor cells and TIL in invasive breast carcinoma non-specific type HER-2 enriched subtype. Latar Belakang: Kanker payudara merupakan keganasan tersering pada wanita. Keganasan ini bersifat heterogen ditinjau dari aspek molekuler, dimana overekspresi HER-2 umumnya memiliki sifat yang lebih agresif. Peranan sistem imun, yakni ekspresi Tumor Infiltrating Lymphocytes (TIL) dan Programmed Death-Ligand 1 (PDL-1) dihubungkan dengan faktor prognostik. Oleh karena itu, penelitian ini bertujuan untuk mengevaluasi hubungan antara stromal TIL dengan ekspresi PD-L1 pada karsinoma payudara invasif tipe tidak spesifik subtipe HER-2 enriched.Metode: Penelitian ini merupakan penelitian observasional analitik dengan rancangan studi potong lintang mulai dari 1 Januari 2015 sampai 31 Desember 2019. Sampel adalah blok parafin penderita karsinoma payudara invasif tipe tidak spesifik yang telah dilakukan pemeriksaan histopatologi, imunohistokimia ER, PR, HER-2 dan FISH/CISH di Laboratorium Patologi Anatomi RSUP Sanglah Denpasar. Sampel yang diperoleh dilakukan pulasan imunohistokimia PD-L1 Preparat sampel digunakan untuk menilai TIL. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Pada penelitian ditemukan hubungan yang signifikan secara statistik antara stromal TIL dengan ekspresi PD-L1 pada sel tumor (p=0,018). Terdapat hubungan yang signifikan secara statistik antara stromal TIL dengan ekspresi PD-L1 pada TIL (p=0,001). Terdapat hubungan yang signifikan secara statistik antara stromal TIL dengan ekspresi PD-L1 pada total sel tumor dan TIL (p=0,007) pada karsinoma payudara invasif tipe tidak spesifik subtipe HER-2 enriched di RSUP Sanglah Denpasar.Kesimpulan: Hasil penelitian ini menunjukkan terdapat hubungan bermakna antara stromal TIL dengan ekspresi PD-L1 sel tumor dan TIL pada karsinoma payudara invasif tipe tidak spesifik subtipe HER-2 enriched.

Hubungan antara ekspresi Vascular Cell Adhesion Molecule-1 (VCAM-1) dengan tipe dan stadium T karsinoma epitel permukaan ovarium di RSUP Sanglah, Bali, Indonesia I Made Wirya Sastra; Luh Putu Iin Indrayani Maker; Anak Agung Ayu Ngurah Susraini; I Wayan Juli Sumadi; I Gusti Ayu Sri Mahendra Dewi; Herman Saputra; I Made Muliarta
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Vascular Cell Adhesion Molecule-1 (VCAM-1) is an important protein in oncogenesis, angiogenesis, tumor development, and metastasis. Studies regarding the expression of VCAM-1 in ovarian carcinoma have found both supportive and contradictory results. Therefore, this study evaluates the relationship between VCAM-1 expression and the type and stage of ovarian surface epithelial carcinoma at Sanglah General Hospital, Bali, Indonesia.Methods: This study was a cross-sectional analytical study with a sample size of 36, which came from paraffin block of patients with ovarian surface epithelial carcinoma who were examined histopathologically at the Anatomical Pathology Laboratory of Sanglah Hospital Denpasar from 1 January 2017 to 31 December 2019. Samples are grouped into type I and type II, then the stage I or II and III groups. After that, the VCAM-1 immunohistochemical streak was performed to assess high or low expression in these groups and analyzed its relationship with the type and stage T of ovarian surface epithelial carcinoma. Data were analyzed using SPSS version 25 for Windows.Results: The analysis results using the Chi-Square test showed a statistically significant relationship (p=0.001) between the VCAM-1 expression with type and stage surface epithelial ovarian carcinoma (p=0.007). The results of the mean difference test are 0.48 (95% CI=0.33-0.70) and showed a statistically significant difference (p=0.001) between VCAM-1 expression with a type of ovarian carcinoma.Conclusion: In conclusion, there is an association between expression VCAM-1 with the type of surface epithelial ovarian carcinoma and at a stage, with a 2.3 times higher probability of VCAM-1 expression in the stage III group than in stage I or II group. Latar Belakang: Vascular Cell Adhesion Molecule-1 (VCAM-1) merupakan salah satu protein yang penting dalam onkogenesis, angiogenesis, perkembangan tumor dan metastasis. Penelitian-penelitian mengenai ekspresi VCAM-1 pada karsinoma ovarium mendapatkan hasil yang pro dan kontra. Oleh karena itu, penelitian ini bertujuan untuk mengetahui hubungan antara ekspresi VCAM-1 dengan tipe dan stadium T karsinoma epitel permukaan ovarium di RSUP Sanglah, Bali, Indonesia.Metode: Penelitian ini merupakan studi analitik potong lintang dengan besar sampel adalah 36, yang berasal dari dari blok parafin penderita karsinoma epitel permukaan ovarium yang diperiksa secara histopatologi di Laboratorium Patologi Anatomi RSUP Sanglah Denpasar dari 1 Januari 2017 sampai 31 Desember 2019. Sampel dikelompokkan menjadi tipe I dan tipe II, kemudian kelompok stadium I atau II dan III. Setelah itu dilakukan pulasan imunohistokimia VCAM-1 untuk menilai ekspresi tinggi ataupun rendah pada kelompok-kelompok tersebut dan dianalisis hubungannya dengan tipe dan stadium T karsinoma epitel permukaan ovarium. Data dianalisis dengan uji Chi-Square dengan nilai p <0,05.Hasil: Hasil penelitian menunjukkan terdapat hubungan yang bermakna secara statistik (p=0,001) antara ekpresi VCAM-1 dengan tipe karsinoma dan stadium T (p=0,007). Hasil uji beda rerata adalah 0,48 (IK 95%=0,33-0,70) dan menunjukkan perbedaan bermakna secara statistik (p=0,001) antara ekspresi VCAM-1 dengan tipe karsinoma ovarium.Kesimpulan: Sebagai simpulan, terdapat hubungan antara ekspresi VCAM-1 dengan tipe karsinoma epitel permukaan ovarium dan pada stadium, dengan kemungkinan 2,3 kali terjadi ekspresi VCAM-1 yang tinggi pada kelompok stadium III dibandingkan stadium I atau II.

Perbedaan ekspresi Vascular Endothelial Growth Factor (VEGF) pada meningioma risiko rendah dan risiko tinggi di RSUP Sanglah, Bali, Indonesia Ivana Juliarty Sitanggang; Ni Putu Sriwidyani; I Wayan Juli Sumadi; I Gusti Ayu Sri Mahendra Dewi; Luh Putu Iin Indrayani Maker; I Made Muliarta
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Vascular Endothelial Growth Factor (VEGF) is an angiogenic factor that plays an important role in tumor angiogenesis. VEGF in meningioma is up-regulated and indicates its role as a proangiogenic factor. It has an association with tumor recurrence and progression. This study aims to determine the differences in VEGF expression in low-risk and high-risk meningiomas at Sanglah General Hospital, Bali, Indonesia.Methods: This study was a cross-sectional analytical study with a sample size of 52, which came from meningioma patients examined histopathologically at the Anatomical Pathology Laboratory of Sanglah General Hospital from January to December 2019. The VEGF immunohistochemical staining was performed and interpreted using Histo score (H-score). VEGF expression was categorized into high and low expression, with the cut-off value determined based on the median value. Data were analyzed using SPSS version 20 for Windows.Methods: The results showed that out of 52 meningioma samples, 37 (71.1%) cases of low-risk meningiomas with low VEGF expression, 6 cases (11.5%) of low-risk meningiomas with high VEGF expression, and 9 cases (17.3%) of high-risk meningiomas with high VEGF expression. There was no high-risk meningioma with low VEGF expression. There was a significant difference in VEGF expression between the low-risk and high-risk meningioma groups (p = 0.00), and high VEGF expression had a prevalence risk for the incidence of high-risk meningioma by 2.5 times (95% CI=1.3-4.6).Conclusion: Based on the results of this study, it was concluded that there was a VEGF expression difference between low-risk and high-risk meningiomas in Sanglah General Hospital Denpasar and high VEGF had a prevalence risk for the occurrence of high-risk meningiomas by 2.5 times. Latar Belakang: Vascular Endothelial Growth Factor (VEGF) merupakan faktor angiogenik yang berperan penting dalam angiogenesis tumor. VEGF pada meningioma mengalami up-regulation yang menunjukkan perannya sebagai faktor proangiogenik yang berkaitan dengan rekurensi dan perkembangan tumor. Penelitian ini bertujuan untuk menentukan perbedaan ekspresi VEGF pada meningioma risiko rendah dan risiko tinggi di RSUP Sanglah, Bali, Indonesia.Metode: Penelitian ini merupakan studi analitik potong lintang dengan besar sampel adalah 52, yang berasal dari blok parafin penderita meningioma yang diperiksa histopatologi di Laboratorium Patologi Anatomi RSUP Sanglah Denpasar dari Januari - Desember 2019. Dilakukan pulasan imunohistokimia VEGF dan penilaiannya menggunakan Histo score (H-score). Ekspresi VEGF dikategorikan menjadi tinggi dan rendah dengan nilai cut-off yang ditentukan berdasarkan nilai median. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Hasil penelitian ini menunjukkan bahwa dari 52 sampel meningioma, terdapat 37 kasus (71,1%) meningioma risiko rendah dengan ekspresi VEGF rendah, 6 kasus (11,5%) meningioma risiko rendah dengan ekspresi VEGF yang tinggi, dan 9 kasus (17,3%) meningioma risiko tinggi dengan ekspresi VEGF tinggi. Tidak didapatkan meningioma risiko rendah dengan ekspresi VEGF rendah. Didapatkan perbedaan ekspresi VEGF yang bermakna antara kelompok meningioma risiko rendah dan risiko tinggi (p=0,00) dan ekspresi VEGF tinggi mempunyai risiko prevalensi untuk terjadinya meningioma risiko tinggi sebesar 2,5 kali (95% IK=1,3-4,6).Kesimpulan: Berdasarkan hasil penelitian ini didapatkan perbedaan ekspresi VEGF antara meningioma risiko rendah dan risiko tinggi di RSUP Sanglah Denpasar dan pada VEGF tinggi mempunyai risiko prevalensi untuk terjadinya meningioma risiko tinggi sebesar 2,5 kali.

Hubungan Lymph Vessel Density (LVD) dengan invasi limfatik dan metastasis kelenjar getah bening regional pada karsinoma payudara invasif tipe tidak spesifik di RSUP Sanglah, Bali, Indonesia Katrin Rotua Simbolon; I Gusti Ayu Sri Mahendra Dewi; Ni Putu Sriwidyani; Luh Putu Iin Indrayani Maker; Herman Saputra; I Made Muliarta
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Lymph Node Metastasis (LNM) is considered the most important prognostic factor in breast cancer. The progress of lymphatic metastasis is thought to involve the proliferation of lymphatic vessels (lymphangiogenesis), Lymph Vessel Invasion (LVI), and lymph node metastasis step by step. This study aims to evaluate the association between LVD with LVI and regional LNM in invasive breast carcinoma of no special type.Methods: This study used a cross-sectional analytical study, using a sample of 38 paraffin-embedded tissue from the patient with invasive breast carcinoma of no special type in Sanglah General Hospital, Bali, Indonesia, in 2018. The sample will be used to assess LVD and LVI by D2-40 immunohistochemistry. Expression of D2-40 with vigorous-intensity was evaluated on the membrane and cytoplasm of lymphatic endothelial cells to determine the definition of lymphatic vessels. Lymph vessel density was determined by counting the number of lumens of peritumoral lymphatic vessels in five fields of view with the densest lymphatic vessel lumen using a Leica microscope (DM750, 400x, area 0.225mm2). Data were analyzed using SPSS version 24 for Windows.Results: The LVD cut-off value is 16.5 lymphatic vessel lumens/0.225 mm2 (65.4% for sensitivity and area Under the Curve (AUC)=70.2%). Then cases were classified into the category of high LVD (?16,5 lymphatic vessel lumen/0,225 mm2) and low LVD (<16.5 lymphatic vessels lumen/0,225 mm2). The study found a statistically significant association between LVD and lymph vessel invasion (PR=3.6; p=0.043; 95%CI=0.88-14.78) and regional lymph node metastases (PR =1.7; p=0.02; 95%CI=1.03-2.79).Conclusion: This study proved an association between LVD with lymph vessel invasion and regional lymph node metastases. Latar Belakang: Metastasis Kelenjar Getah Bening (KGB) dianggap sebagai faktor prognostik yang paling penting pada kanker payudara. Perkembangan metastasis limfatik diduga melibatkan proliferasi pembuluh limfatik (limfangiogenesis), Lymph Vessel Invasion (LVI) atau invasi limfatik, dan metastasis kelenjar getah bening secara bertahap. Penelitian ini bertujuan untuk mengevaluasi hubungan antara Lymph Vessel Density (LVD) dengan invasi limfatik dan metastasis kelenjar getah bening regional pada karsinoma payudara invasif tipe tidak spesifik.Metode: Penelitian ini menggunakan metode analitik potong lintang dengan sampel 38 blok parafin dari pasien karsinoma payudara invasif tipe tidak spesifik di RSUP Sanglah, Bali, Indonesia tahun 2018. Penilaian LVD dan LVI dengan pulasan imunohistokimia D2-40. Ekspresi D2-40 dengan intensitas yang kuat dievaluasi pada membran dan sitoplasma sel endotel limfatik untuk menetapkan definisi pembuluh limfatik. Lymph vessel density ditentukan dengan menghitung jumlah lumen pembuluh limfatik peritumoral pada lima lapangan pandang yang memiliki lumen pembuluh limfatik terpadat, menggunakan mikroskop Leica (DM750, 400x, luas area 0,225mm2). Data dianalisis dengan SPSS versi 24 untuk Windows.Hasil: Nilai cut-off LVD adalah 16,5 lumen pembuluh limfatik/0,225 mm2 (sensitivitas 65,4% dan Area Under the Curve (AUC)=70,2%). Kemudian kasus dikategorikan menjadi LVD tinggi (?16,5 lumen pembuluh limfatik / 0,225 mm2) dan LVD rendah (<16,5 lumen pembuluh limfatik / 0,225 mm2). Hasil analisis statistik menunjukkan bahwa terdapat hubungan antara LVD dengan invasi limfatik (PR=3,6; p=0,043; IK 95%=0,88-14,78) dan metastasis KGB regional (PR=1,7; p=0,02; IK 95%=1,03-2,79).Kesimpulan: Penelitian ini membuktikan bahwa terdapat hubungan antara LVD dengan invasi limfatik dan metastasis KGB regional.

Hubungan antara ekspresi BRAF V600E dengan metastasis dan derajat diferensiasi pada adenokarsinoma kolorektal Ni Kadek Ayu Maya Damayanti; Ni Wayan Winarti; Ni Putu Sriwidyani; Luh Putu Iin Indrayani Maker; Herman Saputra; I Made Muliarta
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Colorectal carcinoma is a malignant epithelial tumor of the large bowel that occurs due to extrinsic and intrinsic factors. BRAF V600E gene mutation was found in about 10-15% of colorectal carcinoma. This mutation was associated with aggressive biologic behaviors, metastasis and lesser responsiveness to EGFR inhibitors therapy. This study aims to determine the association between BRAF V600E expression with metastasis and the degree of differentiation of colorectal adenocarcinoma.Methods: This cross sectional study involved 43 samples of adenocarcinoma colorectal patients who had histopathological examinations in the period 2018-2019. Immunohistochemical were performed to assess the expression of BRAF V600E. This expression was concluded positively if 75% or more tumor cells showed intense cytoplasmic staining. Data were analyzed using SPSS version 20 for Windows.Results: Within 43 colorectal adenocarcinoma cases, it was found 7 cases (16.3%) had a positive expression of BRAF V600E. This expression was found in metastasis cases (7/25), not found in cases without metastasis (0/18). There was an association between BRAF V600E expression and metastasis (p=0.014). The positive expressions of BRAF V600E were only found in low-grade differentiation (7/35 cases), were not found in high-grade differentiation (0/8 cases), and no association between BRAF V600E mutation and the degree of differentiation (p=0.167).Conclusion: There was an association between BRAF V600E expression and metastasis of colorectal adenocarcinoma. There was no significant association between BRAF V600E expression and the degree of differentiation of colorectal adenocarcinoma. Latar Belakang: Karsinoma kolorektal merupakan suatu tumor ganas epitelial usus besar yang terjadi akibat pengaruh dari faktor ekstrinsik dan intrinsik. Mutasi gen BRAF V600E ditemukan pada sekitar 10-15% kasus karsinoma kolorektal. Mutasi ini berkaitan dengan perilaku biologik agresif, metastasis, serta kurangnya respon terhadap terapi dengan inhibitor EGFR. Penelitian ini bertujuan untuk mengetahui adanya hubungan antara ekspresi BRAF V600E dengan metastasis dan derajat diferensiasi adenokarsinoma kolorektal.Metode: Penelitian menggunakan rancangan analitik potong lintang dengan 43 sampel penderita adenokarsinoma kolorektal yang telah dilakukan pemeriksaan histopatologi pada periode tahun 2018-2019. Pulasan imunohistokimia dikerjakan untuk menilai ekspresi BRAF V600E. Ekspresi BRAF V600E dinyatakan positif jika 75% atau lebih sel tumor mununjukkan pulasan sitoplasma dengan intensitas kuat. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Dari 43 kasus, ditemukan 7 kasus (16,3%) dengan ekspresi BRAF V600E positif. Ekspresi ini hanya dijumpai pada kasus dengan metastasis (7 dari 25 kasus), tidak dijumpai pada kasus tanpa metastasis (0 dari 18 kasus). Didapatkan hubungan bermakna antara ekspresi BRAF V600E dengan metastasis (p=0,014). Ekspresi BRAF V600E positif hanya ditemukan pada kasus derajat diferensiasi rendah (7 dari 35 kasus), tidak ditemukan pada derajat tinggi (0 dari 8 kasus), dan hubungan tersebut tidak bermakna secara statistik (p=0,167).Kesimpulan: Terdapat hubungan antara ekspresi BRAF V600E dengan metastasis pada adenokarsinoma kolorektal. Tidak terdapat hubungan antara ekspresi BRAF V600E dengan derajat diferensiasi pada adenokarsinoma kolorektal.

Pemberian pasta ekstrak daun pegagan 10% lebih meningkatkan jumlah sel fibroblas dan reepitelisasi pada soket mandibula daripada pasta ekstrak daun mengkudu 10% pasca pencabutan gigi marmut jantan Ni Made Ista Prestiyanti; I Putu Gede Adiatmika; I Made Muliarta
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: The process of wound healing after a tooth extraction is expected to occur more quickly to restore normal functioning of the tissue and reduce the risk of complications. Pegagan leaf (Centella asiatica) and mengkudu leaf (Morinda citrifolia. L) contain active compounds such as flavonoids, tannins, and triterpenoids that accelerate wound healing. This study aims to evaluate the pegagan leaf extract paste increased the number of fibroblast cells and reepitelization more than mengkudu leaf extract paste after tooth extraction.Methods: This study used a post-test-only control group design to the 30 male guinea pigs. The three groups were the placebo paste group, the pegagan leaf extract paste 10% group, and the mengkudu leaf extract paste 10% group, which were treated for 6 days. Examination of the number of fibroblast cells and reepitelization was carried out by taking tissue of the mandibular socket on day 7, histological preparations with HE staining were made. The data obtained were analyzed by SPSS version 20 for WindowsResults: The average difference in the number of fibroblast cells and reepithelization showed a significant difference (p<0.05) between groups. The highest average for the number of fibroblast cells was found in the group that applied topically with pegagan leaf extract paste 10% was 97.98±25.67 cells followed by the group that applied topically with mengkudu leaf extract paste 10% was 64.28±12.22 cells and the group applied topically with placebo paste was 46.36±14.27 cells. The highest average for the reepithelization was found in the group that applied topically with pegagan leaf extract paste 10% was 69.64±24.53 µm.Conclusion: It was concluded that pegagan leaf extract paste 10% increased the number of fibroblast cells and reepitelization than mengkudu leaf extract paste 10%. Latar Belakang: Proses penyembuhan luka setelah pencabutan gigi diharapkan lebih cepat terjadi sehingga dapat mengembalikan fungsi normal dari jaringan dan mengurangi risiko terjadinya komplikasi. Daun pegagan dan daun mengkudu mengandung senyawa aktif seperti flavonoid, tanin dan triterpenoid yang dapat mempercepat penyembuhan luka. Penelitian ini bertujuan untuk mengevaluasi ekstrak daun pegagan dalam meningkatkan jumlah sel fibroblas dan reepitelisasi daripada pasta ekstrak daun mengkudu pasca pencabutan gigi.Metode: Penelitian ini menggunakan rancangan post-test only control group design terhadap 30 ekor marmut jantan. Terdapat 3 kelompok secara acak yaitu kelompok pasta plasebo, kelompok pasta ekstrak daun pegagan 10% dan kelompok pasta ekstrak daun mengkudu 10% yang diberikan perlakuan selama 6 hari. Pemeriksaan jumlah sel fibroblas dan reepitelisasi dilakukan dengan pengambilan jaringan soket mandibula pada hari ke 7, kemudian dibuat preparat histologis dengan pengecatan HE. Data yang diperoleh dianalisis menggunakan uji SPSS versi 20 untuk Windows.Hasil: Perbedaan rerata jumlah sel fibroblas dan reepitelisasi menunjukkan perbedaan yang signifikan (p<0,05) antar kelompok. Rerata jumlah sel fibroblas tertinggi terdapat pada kelompok yang diolesi pasta ekstrak daun pegagan 10% dengan rerata yaitu sebesar 97,98 ± 25,67 sel diikuti oleh kelompok yang diolesi pasta ekstrak daun mengkudu 10% dengan rerata sebesar 64,28 ± 12,22 sel dan kelompok yang diolesi pasta plasebo dengan rerata sebesar 46,36 ± 14,27 sel. Sedangkan rerata reepitelisasi tertinggi terdapat pada kelompok yang diberi pasta ekstrak daun pegagan 10% dengan rerata yaitu sebesar 69,64 ± 24,53 µm.Kesimpulan: Dapat disimpulkan bahwa pasta ekstrak daun pegagan 10% lebih meningkatkan jumlah sel fibroblas dan reepitelisasi daripada pasta ekstrak daun mengkudu 10%.

Hubungan antara ekspresi Epidermal Growth Factor Receptor (EGFR) dengan berbagai parameter klinik dan patologis Triple Negative Breast Cancer (TNBC) di RSUP Sanglah, Bali, Indonesia Volman Tampubolon; Ni Putu Sriwidyani; Luh Putu Iin Indrayani Maker; I Gusti Ayu Sri Mahendra Dewi; Ni Made Mahastuti; I Made Muliarta
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Triple Negative Breast Cancer (TNBC) is a heterogeneous group of breast cancer. Some cases show a good outcome; others show higher recurrence and metastasis. There are several molecular subtypes of TNBC. Basal-like 2 (BL-2) subtype involves Epidermal Growth Factor (EGF) signaling pathway, enriched with many growth factor receptors such as EGFR. This study aims to determine the association between EGFR expression and various clinicopathological parameters in TNBC patients in Sanglah Hospital Denpasar.Methods: This study was an analytical cross-sectional study involving 35 patients TNBC who were examined histopathologically at the Anatomical Pathology Laboratory in Sanglah Hospital Denpasar from January 1st 2016 to December 31st 2020. Re-evaluation of the specimen was conducted to assess histopathological diagnosis, grade, tumor size (T), Lymphovascular Invasion (LVI) and nodal status (N). EGFR expression was evaluated by immunohistochemistry staining and then interpreted based on the intensity and continuity of the stained cell membrane. The association between EGFR expression and clinicopathological parameters was analyzed with a Chi-Square test with a 0.05 significance level.Result: The result of this study showed the age range of TNBC patients was 29-70 years with mean age was 49.7±11.4 years. There were significant association between EGFR expression with T (p=0.008; PR = 2.7; 95%CI 1.4-5.1), LVI (p=0.018; PR = 3.0; CI95% 1.300-7.137) and N (p=0.033; PR=2.7; CI95% 1.121-6.543). There were no significant association between EGFR expression with age (p=1.000), grade (p=0.689) and Ki67 index (0.689).Conclusion: It can be concluded that there are associations between EGFR expression with T, LVI and N. There was no association between EGFR expression with age, grade and Ki67 index. Latar Belakang: Triple negative breast cancer (TNBC) merupakan kelompok kanker payudara yang heterogen. Sebagian kasus menunjukkan survival yang baik, namun sebagian lainnya dengan rekurensi dan metastasis yang lebih tinggi. Terdapat beberapa subtipe molekuler dari TNBC, salah satunya subtipe Basal-like 2 (BL2) yang melibatkan jalur pensignalan Epidermal Growth Factor (EGF), melalui berbagai reseptor factor pertumbuhan, salah satunya EGFR. Penelitian ini bertujuan untuk mengetahui hubungan antara ekspresi EGFR dengan berbagai parameter klinikopatologi pada kasus TNBC di RSUP Sanglah Denpasar.Metode: Penelitian ini merupakan studi analitik potong lintang dengan besar sampel 35 kasus TNBC yang diperiksa histopatologi di Laboratorium Patologi Anatomi RSUP Sanglah Denpasar dari 1 Januari 2016 hingga 31 Desember 2020. Evaluasi ulang preparat dilakukan untuk menilai diagnosis histopatologi, grade, ukuran tumor (T), Lymphvascular Invasion (LVI) dan status nodal (N). Ekspresi EGFR dinilai dengan pewarnaan imunohistokimia selanjutnya di interpretasi berdasarkan intensitas dan kuntinuitas membran sel yang terpulas. Hubungan antara ekspresi EGFR dengan parameter klinikopatologi dianalisis dengan uji Chi-Square dengan nilai kemaknaan p<0,05.Hasil: Hasil penelitian ini menunjukkan rentang usia pasien TNBC 29-70 tahun dan rerata 49,7±11,4 tahun. Terdapat hubungan bermakna antara ekspresi EGFR dengan T (p=0,008; RP=2,7; IK95% 1,4-5,1), LVI (p=0,018; RP = 3,0; IK 95% 1,300-7,137), dan N (p=0,033; RP=2,7; IK95% 1,121-6,543). Tidak terdapat hubungan bermakna antara umur (p=1,000), grade (p=0,689) dan indeks Ki67 (p=0,689).Simpulan: Hasil dari penelitian ini adalah terdapat hubungan antara ekspresi EGFR dengan ukuran tumor, LVI dan status nodal (N). Tidak terdapat hubungan antara ekspresi EGFR dengan umur, grade dan indeks Ki67.

Co-Authors A.A.Istri Firasti Widyaratni A.A.Ngurah Wisnu Nayaka Putra AA Lanang Dananjaya Putra Dewa WA adiartha g Agha Bhargah Agus Suarjaya Putra Alex Pangkahilla Ali Imron Anak Agung Ayu Ngurah Susraini Anak Agung Fridami Dewi Andreany Kusumowardani Andy Sirada annie minerva datui Arfian Hamzah Ari Wibawa Ari Wibawa Asshiddiqie Chirac Sepakat Purba Ayunindya, Dewa Ayu Agung Megaretha Bagus Komang Satriyasa Bella Noviantika Bertha Melyana Boki Jaleha Catherina . D A inten Dahlan Abdullah Damayanti, Ni Kadek Ayu Maya Daryono . . Deny Sutrisna Wiatma Desak Made Wihandani Dewa Ayu Eka Wahyuni Dewa Gede Putra Angga Pradnyana Dewa Putu Gde Samatra Dewi, Anak Ayu Nyoman Trisna Narta Diahningrum, Sylvi Dio Septiyan Helmi Dionisius Wora Dw P. Sutjana Dwi Halim Kevin Gautama Dyno Aryo Christanto Enny Wulandari Felicia Holil Gabriela Queensanya Lienardy Ganesa Puput Dinda Kurniawan Gde Ngurah Idraguna Pinatih Gusti Agung Gede Rama Wintara Gusti Made Agung Mega Utama Hairudin - Hendrata, Winona May Herman Saputra Herman Saputra I Dewa Ayu Agung Diah Sutarini I Dewa Ayu Inten Dwi Primayanti I Dewa Ayu Inten Dwi Primayanti I Dewa Putu Sutjana I Gede Bagus Bhaskara Wijaksana I Gede Bayu Utama Putra I Gede Donny Hendrawan I Gede Koko Gustrawan I Gede Widyatmika Pratama I Gusti Agung Ayu Narita Savitri I Gusti Ayu Putu Armayanthi I Gusti Ayu Sri Mahendra Dewi I Ketut Suada I Komang Suciptha Gago I Made Adi Widiantara I Made Ady Wirawan I Made Ari Samudera I Made Astika Yasa I Made Dhita Prianthara I Made Dwi Ariyuda I Made Gotra I Made Jawi I Made Krisna Dinata I Made Niko Winaya I Made Wahyu Palguna I Made Winarsa Ruma I Made Wirya Sastra I Made Wisnu Saputra I Nengah Sandi I Nyoman Adi Putra I Nyoman Mangku Karmaya I Putu Adiartha Griadhi I Putu Gde Surya Adhitya I Putu Gede Adiatmika I Putu Gede Andyka Yasa I Putu Gede Windhu Saputra I Putu Prisa Jaya . I Putu Putra Suarsana I Putu Sutha Nurmawan I Wayan Bandem Adnyana I Wayan Juli Sumadi I Wayan Sugiritama I Wayan Surata I Wayan Weta I.A. Pascha Paramurthi Ida Ayu Dyah Yusa Dhammayanthi Ida Ayu Intan Kartika Dewi Ida Ayu Made Pradnyanini Ida Bagus A. Swamardika Ida Bagus Adnyana Manuaba Ida Bagus Ngurah Ida Bagus Ngurah Ihsan, Muammar Ika Fitri Wulan Dhari Iman Santoso indah adiputra Indira Vidiari J Indra Lesmana Indrasuari, A.A Istri Diah Ivana Juliarty Sitanggang J. A. Pangkahila Jasmine Kartiko Pertiwi Jhon Roby Purba K Tirtayasa K tirtayasa K Tirtayasa K. Tirtayasa Kadek Kristina Harum Lasmi Katrin Rotua Simbolon Ketut Laksmi Puspa Dewi Ketut Tirtayasa Ketut Trisandy Khaerul Anam Komang Tri Adi Suparwati Kunjung Ashadi Kusumaningrum, Cornelia Ayu Laily Mita Andriana Liza Ariani Luh Ayu Widayanti Luh Made Indah S.H. Adiputra Luh Made Indah Sri H.A Luh Made Indah Sri Handari Adiputra Luh Made Indah Sri Handari Adiputra Luh Made Indah Sri Handari Adiputra Luh Made Indah Sri Handari Adiputra Luh Made Indah Sri Handari Adiputra Luh Putu Iin Indrayani Maker Luh Putu Ratna Sundari Luh Putu Ratna Sundari M Widnyana M. Ali Imron M.Ali Imron Made Adhi Dharma Setiawan Made Aditya Yogi Guntara Made Hendra Satria Nugraha Made Rania Deviyanti Made Sudarma Maghfirotul Iffah Makbullah - Maker, Luh Putu Iin Indrayani Manuela Serrano, Christina Zita Maria Imaculata Date Masrum Syam Meiza Anniza Meryl Pulcheria Moh Ali Imron Mohammad Syahroni Muh. Irfan Muh. Irfan Muhammad Ali Imron Muhammad Irfan Muhammad Irfan Muhammad Irfan Muthia Munawaroh Muthiah Munawaroh N. Adiputra N. Adiputra N. Adiputra Ni Eka Dewi Ambarawati Ni Kadek Ayu Maya Damayanti Ni Kadek Citra Patmala Ni Kadek Vindy Aprilyanti Ni Ketut Dewi Irwanti Ni Komang Ari Sepriyanti Ni Komang Dewi Semariasih Ni Luh Gede Puji Andini Ni Luh Made Reny Wahyu Sari Ni Luh Nopi Andayani Ni Luh Tu Pertiwi Ni Made Ida Kristina Dewi Ni Made Indah Pratiwi Ni Made Ista Prestiyanti Ni Made Linawati Ni Made Mahastuti Ni Made Rininta Adi Putri Ni Nengah Nita Sulistyawati Ni Nyoman Ayu Dewi Ni Nyoman Ayu Dewi Ni Nyoman Ayu Dewi Ni Nyoman Suratmiti Ni Putu Dita Kristinayanti Ni Putu Dwi Larashati Ni Putu Haryska Wulan Ni Putu Purnamawati Ni Putu Ruspata Bhyantari Ni Putu Sriwidyani Ni Wayan Rusni Ni Wayan Sintyabudi Kumalapatni Ni Wayan Tianing Ni Wayan Winarti Nila Wahyuni Nurdianto, Arif Rahman Nyoman Kabella Cinthya Devi Oktovianus Fufu Popi Imelda Margareth Sitompul Purnawati, Susy Purnawati Putu Astawa Putu Ayu Sita Saraswati Putu Dede Asta Wiguna R. A.T. Kuswardhani Rina Mayangsari S Indra Lesmana S. Indra Lesmana S. Indra Lesmana S. Indra Lesmana S. P. Dedy Darma Yasa Santi Bery Hastuti Santoso Santoso Sawitri, Anak Agung Sagung Soeyanto, Milka Ivenna Sri Mahendra Dewi, I Gusti Ayu Suadnyana, Ida Ayu Astiti Sugijanto - Sugijanto - Sugijanto - Sulfandi Sulfandi Susy Purnamawati Susy Purnawati Sutha Nurmawan Swarmadika, Ida Bagus Alit Syahmirza Indra Lesmana Tjokorda Gde Bagus Mahadewa Trisna Damayanti Tyas, Ni Luh Putu Larasati Prabawaning Utomo Wicaksono Volman Tampubolon Wahyuddin, Wahyuddin Wahyudin - Wahyuni Novianti, I Gusti Ayu Sri Yohanes Seran Yuliana Yuliana

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Journal : ISM (Intisari Sains Medis) : Jurnal Kedokteran