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All Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Indonesian Journal of Cancer Neurona Acta Neurologica Indonesia
Aninditha, Tiara
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Factors Influencing Distress and Coping Strategies Among Patients with Metastatic Spinal Tumor at Cipto Mangunkusumo General Hospital Agiananda, Feranindhya; Nugraeni, Tiara; Diatri, Hervita; Aninditha, Tiara; Kusumaningrum, Profitasari
Indonesian Journal of Cancer Vol 17, No 4 (2023): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i4.994

Abstract

Background: Patients with metastatic spinal tumor are experiencing various symptoms, including neurological deficits that cause distress and affects their quality of life. The vulnerability to distress is influenced by coping strategies. Therefore, this study aimed to investigate factors associated with distress and coping strategies in patients with metastatic spinal tumors at Cipto Mangunkusumo General Hospital. Methods: In a cross-sectional study conducted at Cipto Mangunkusumo General Hospital from September 2021 to May 2022, factors associated with distress and coping strategies in patients with metastatic spinal tumors were investigated. The analysis included a total of 104 subjects from both outpatient and inpatient settings. Distress levels and areas of concern were assessed using the Distress Thermometer (DT) questionnaire while coping strategies were evaluated through the Coping Orientation to the Problem Experienced (COPE) instrument. Bivariate and multivariable analyses were carried out to assess the relationship between sociodemographic factors, spinal tumor characteristics, specific areas of concern, coping strategies, and distress.Results: The results showed that 57.7% of metastatic spinal tumor patients experienced distress. In the 18-59 age group, motor disorders, sensory disturbances, autonomic disorders, treatment status, problem-focused coping (PFC), emotion-focused coping (EFC), and avoidance coping had significant associations with distress. However, the multivariable analysis showed that EFC (OR = 1.156, 95% CI: 1.024–1.304, p=0.019), avoidance coping (OR = 1.154, 95% CI: 1.005–1.326, p=0.042), and sensory disturbance (OR = 16.001, 95% CI: 1.472–173.960, p=0.023) were identified as risk factors for distress.Conclusions: Patients with metastatic spinal tumors who used emotion-focused coping, avoidance coping, and sensory disturbance faced significant risk factors for distress
An Overview of The Spinal Metastasis Pain with Opioid Therapy and The Affecting Factor Djohansjah, Joice Rosewitasari Aryanti; Andriani, Rini; Aninditha, Tiara; Sofyan, Henry Riyanto
Indonesian Journal of Cancer Vol 18, No 2 (2024): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i2.1065

Abstract

Background: Spinal metastasis is the most frequent type of spinal tumor. Opioid is the first line of treatment for cancer pain despite a multitude of side effects. This study aimed to evaluate the effectiveness of opioids as the latest ladder in the treatment of spinal cancer pain. Methods: A retrospective cross-sectional study was performed comprising 89 spinal metastasis patients at the National Cancer Centre, Dharmais Hospital from November 2021 to March 2022. The demographic and clinical data were retrieved from medical records. This study used the Numerical Rating Scale (NRS) to evaluate the improvement of pain. The change of NRS ≥ 2 was considered significant. The data was analyzed using bivariate (Wilcoxon, Mann-Whitney, and Fisher Exact test) and multivariate (linear regression) analysis. Results: A total of 89 subjects were included in the study (median age = 51 years, 57,3% females). There was a significant decrease in the severity of cancer pain (p0.005) between admission (initial NRS 7) and treatment completion (final NRS 2) in the first hospitalization of all groups. There was no correlation between the clinical characteristics of the participants and the NRS score determined upon admission and at the end of the course of treatment. Conclusions: There was a significant improvement in the cancer pain intensity in the subjects with spinal metastasis cancer pain who received opioid naive therapy.
Educating General Practitioners about Medication-overuse Headache: Importance and Call to Action Sofyan, Henry Riyanto; Madjid, Irma Savitri; Faiq, Ahmad Rafi; Indrapriambada, Ery Riady; Humaira, Sarah; Aninditha, Tiara
Acta Neurologica Indonesia Vol. 3 No. 01 (2025): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v3i01.49

Abstract

Medication overuse headache (MOH) is a secondary headache that frequently accompanied chronic primary headaches which poses a great burden in an individual and systemic level. Globally, it is recognized as one of the relevant headaches for primary care. However, in Indonesia, it has not been included in the standard competence for doctors, and therefore has been underrecognized by general practitioners who encountered headache patients in primary care. In this policy brief, we mapped the problems regarding MOH and proposed several action plans, including educating GPs, as the recommendations.
Cerebrospinal Fluid Profile in Suspected Leptomeningeal Metastases in Dr. Cipto Mangunkusumo National Referral Hospital and Dharmais National Cancer Center Hospital Aninditha, Tiara; Maulina, Lisa; Andriani, Rini; Susanto, Eka; Ranakusuma, Teguh; Sofyan, Henry Riyanto
Indonesian Journal of Cancer Vol 19, No 1 (2025): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i1.1286

Abstract

Background: Leptomeningeal metastases (LM) are a condition in which malignant cells spread to the leptomeninges and subarachnoid space, with an increasing incidence and poor prognosis. Cerebrospinal fluid (CSF) analysis is an important examination, with cytology as the gold standard for detecting malignant cells in CSF. We aim to describe the CSF profile (i.e. protein, glucose, cell count, and cytology) in detecting malignant cells among patients with suspected LM in Cipto Mangunkusumo National Referral Hospital and Dharmais National Cancer Center Hospital from January 2018 to December 2021. Method: A multicenter cross-sectional retrospective study was conducted to describe the CSF profile in suspected LM from January 2018 to December 2021. Suspected LM cases were established from clinical and radiological findings. The lumbal puncture was performed in those suspected LM cases. Clinical manifestations, radiological data, tumor type, some aspects from CSF routine analysis (i.e. protein, glucose, cell count), and lumbar puncture frequency were described. Their correlation with CSF cytology was analyzed. Results: There were 153 subjects with abnormalities on CSF routine analysis (75.2%), consisting of CSF cell count 5/uL (47.1%) with a median of 5 (1–3504)/uL, CSF protein 45 mg/dL (52.9%) with a median of 50 (5–820) mg/dL, and CSF glucose 50 mg/dL (15%) with a median of 68 (3–629) mg/dL. The positive CSF cytology result was 20.3%. Positive CSF flow cytometry immunophenotyping in hematological malignancy with suspected LM was 25.6%. There was a significant correlation between the increase in CSF cell count, hematological malignancy, and MRI results with CSF cytology (p 0.001; p = 0.03; p = 0.03). There was no significant correlation between clinical manifestations and lumbar puncture frequency with CSF cytology.Conclusion: Abnormalities in CSF routine analysis were found in the majority of subjects with suspected LM, but the CSF cytology positivity rate was considered low. The presence of varied clinical symptoms and repeated lumbar punctures didn’t increase the likelihood of positive CSF cytology
The Correlation of Inflammatory Markers with Clinical Manifestation, Peritumoral Edema, and Recurrence in Meningioma Patients Aninditha, Tiara; Auliya, Putri; Mulyadi, Rahmad; Aman, Renindra Ananda; Andriani, Rini; Sofyan, Henry Riyanto
Indonesian Journal of Cancer Vol 19, No 2 (2025): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i2.1287

Abstract

Background: Meningiomas can induce inflammation in their tumorigenesis process, thereby linking inflammation with clinical symptoms, peritumoral edema, and recurrence of meningiomas. Easily accessible and cost-effective inflammatory markers include the neutrophillymphocyte ratio (NLR) and monocyte-lymphocyte ratio (MLR). This study aims to investigate the relationship between peripheral inflammation markers, specifically the NLR and MLR, and their association with clinical symptoms, peritumoral edema, and meningioma recurrence.Method: A retrospective cohort study was conducted at Cipto Mangunkusumo National General Hospital from January 2016 to December 2019, utilizing a consecutive non-probability sampling method. Inclusion criteria were patients aged 18 years or older with meningiomas(gradesI-III), first surgery. Peripheral inflammatory markers were derived from differential blood counts, peritumoral edema data from radiological reports, and other data from medical records. The cut-off valuesfor NLR and MLR were determined to be 2.415 and 0.295, respectively. Bivariate analyses using ChiSquare and Mann-Whitney tests were followed by multivariate logistic regression analysis. Results: 173 patients were eligible for analysis. Of these, 27 had preoperative CT scans, 126 had MRIs, and 20 had no preoperative radiology data. Clinical and recurrence analyses were performed on all 173 patients, with radiology and tumor size analyses conducted on subsets of 153 and 126 patients, respectively. The majority of meningiomasin thisstudy were grade I, found in 94.2% of subjects, with the remainder being grade II and III. Higher NLR and MLR values were significantly associated with headaches (p 0.001). Elevated NLR and MLR were also correlated with peritumoral edema (p 0.001). MLR was independently associated with recurrence, with an adjusted odds ratio (aOR) of 12.647 (95% CI 2.355–67.919); p = 0.003.Conclusion: NLR and MLR as peripheral inflammatory markers demonstrated higher median values in meningioma patients with headaches and peritumoral edema. Additionally, inflammation in meningiomas was associated with the occurrence of recurrence.
Gambaran Status Gizi Penderita Tumor Otak Primer dan Metastasis serta Faktor-faktor yang Memengaruhinya Aninditha, Tiara; Tanjung, Gloria; Andayani, Diyah Eka; Aman, Renindra Ananda; Estiasari, Riwanti; Yanuar, Ahmad; Sofyan, Henry Riyanto
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 39 No 3 (2022): Vol 39 No 3 (2022)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v39i3.280

Abstract

Introduction: According to the pathophysiology, weight loss is a specific marker for suspected malignancy. However, this is rarely found in cases of brain tumors. The presence of the blood brain barrier is thought to play a role in differentiating nutritional status in primary and metastatic brain tumors. Therefore, it is necessary to do this research. Aim: Knowing the description, prevalence, differences in nutritional status of patients with primary and secondary brain tumors, and the affecting factors. Methods: Cross-sectional study in patients with primary and secondary brain tumors at Cipto Mangunkusumo General Hospital in 2017-2019. Malnutrition was diagnosed using the GLIM (Global Leadership Initiative on Malnutrition) criteria. Data analysis used Chi-Square/Fisher and multivariate logistic regression. There were 333 subjects: 246 primary and 87 secondary brain tumors. Description of nutritional status of patients with primary brain tumors: 47.6% obese; 6.1% malnutrition; the rest were normal, while in secondary brain tumors: 25.3% were malnourished; 24.1% obese; the rest is normal. Secondary brain tumor at risk of malnutrition with RR 1.257 (95% KI 1.108-1.426), p<0.001. Factors influencing malnutrition were the type of primary/secondary brain tumor, gender, age, decreased consciousness, anorexia, gastrointestinal complaints, intraaxial lesions, multiple lesions, and the location of the lesions involving the frontal lobes. The independently related factor was multiple lesions with an aOR of 3,423 (95% KI 1.124-10.426), p 0.03. Conclusion: The nutritional status of patients with primary and secondary brain tumors was different, with higher levels of malnutrition in secondary brain tumors and higher obesity in primary brain tumors. The number of multiple lesions in the brain affects the occurrence of malnutrition.
PROFIL PEMERIKSAAN EVOKED POTENTIAL PADA KASUS NEUROONKOLOGI DI RSUPN DR. CIPTO MANGUNKUSUMO Tejomukti, Teddy; Aninditha, Tiara
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 1 (2024): Vol 41 No 1 (2024): Volume 41, No 1 - Desember 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i1.476

Abstract

ABSTRACT Introduction: Functional integrity of specified cortical areas and pathways in the central nervous system can be assessed by recording electrical potency such as Evoked Potential (EP) related to sensory or motoric events. Neoplasm can disturb functional integrity in the nervous system. Methods: This was an analytic cross-sectional research with the categorical approach in patients who underwent EP in Neurological Clinic RSUPN dr. Cipto Mangunkusumo Jakarta since 2022. Data were taken from medical records from December 2022 to March 2023. Demographic data, clinical data, neoplasm data, and EP examination data were recorded. The relation between neoplasm (type, location, number of lesions) and symptoms to EP results were analysed with Chi Square test Result: There were 660 evoked potential examinations consisting of 363 SSEP, 242 VEP and 55 BAEP examinations for various neurological clinical indications, however EP examinations indicated for neurooncology cases were 45 subjects or 6.8% of all examinations. A significant relation was found between sensory (p=0.03), motor (p=0.04), and autonomic (p=0.004) symptoms with abnormal SSEP examination results. Pain was not associated with abnormal SSEPs. No significant relationship was found between the number and location of tumors with the SSEP examination. All of the study subjects (100%) had visual disturbances and abnormal features of VEP. The BAEP examination was not analyzed because the sample size was too small. Conclusion: EP may be indicated in neurooncology cases in assessing functional lesions due to tumors, both intracranial and spinal. Keywords: Evoked Potential, nervous system neoplasm
Emotional Impact of In Vitro Fertilization (IVF): Anxiety, Depression, and Their Relationship with Pregnancy Outcomes Agiananda, Feranindhya; Natadisastra, Raden Muharram; Amir, Nurmiati; Irwanto; Aninditha, Tiara; Wibisono, Sasanto; Wahmurti, Tuti; Kekalih, Aria; Karnasih, Artasya; Samjunanto, Achmad; Puspaseruni, Putri Air; Velyani, Dyani Pitra; Prayangga, Regina
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 3 July 2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i3.2626

Abstract

Objectives: Infertility can significantly impact women's physical and psychological health. Numerous treatment options are commonly pursued, with IVF often considered the last resort for infertile couples. However, IVF is associated with increased stress at every stage, potentially influencing women's perceptions and experiences throughout the procedure. This research examines anxiety and depression faced by women at different stages of IVF and analyzes their association with pregnancy outcomes. Methods: This cohort study was conducted at Dr. Cipto Mangunkusumo General Hospital and Dr. Sander B. Daya Medika Clinic from May 2018 to March 2023. Data were collected using questionnaires and assessments during IVF, focusing on the evaluation of anxiety, depression, and pregnancy outcomes. Chi-square and Fisher’s exact test was used to assess associations between variables, while Friedman ANOVA was used for longitudinal analysis of anxiety and depression scores during IVF. Results: The final analysis comprised 61 participants. The study revealed significant changes in anxiety and depression throughout IVF. Both anxiety (p < 0.001, Kendall’s w = 0.19) and depression levels (p = 0.001, Kendall’s w = 0.121) showed a significant rise across the IVF timeline. There is no statistically significant association between anxiety and depression scores and pregnancy outcomes across three measurement points during IVF (p > 0.05). Conclusion: Anxiety and depression significantly increase during IVF but do not affect clinical pregnancy rates. These findings highlight the importance of mental health screening and psychiatric support during IVF to ensure women’s comfort and enable them to navigate IVF more effectively. Keywords: Anxiety, Depression, Pregnancy Outcomes, Women, In Vitro Fertilization (IVF)
Headache Characteristic in Brain Tumor Patients Sembiring, Saulina; Sofyan, Henry Riyanto; Madjid, Irma Savitri; Alvonsius Silalahi, Raymond Aris Nimrod; Albertin, Elizabeth; Aninditha, Tiara
Indonesian Journal of Cancer Vol 19, No 1 (2025): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i1.1197

Abstract

Background: Headache is an alarm for structural abnormalities, and it frequently manifests as an initial symptom of brain tumors, with an occurrence rate ranging between 36-80%, depending on the type and location of the tumorMethods: We conducted a retrospective cross-sectional study to observe hospitalized brain tumor patients at Dr. Cipto Mangunkusumo Hospital from January 2022 to March 2023. This study described the prevalence and the percentages of baseline characteristics.Results: Our study revealed that out of 101 brain tumor patients, predominated by females (60.4%) with a mean age of 46.2 years. Secondary brain tumors originating from breast cancer were more prevalent (13.9%). Frontal lobe location was frequent (32.3%), displaying rapid growth (66.3%), focal deficits (82.2%), and headaches (79.2%). Atypical headache was the most common phenotype (40%), often occurring either before the onset of neurological deficits (prechronous) or concurrently with them (synchronous). Discussion: The study revealed that high-grade, rapidly growing brain tumors tend to induce focal neurological deficits and headaches due to the tumor’s progressivity and mass effect. Brain tumor lesions were primarily found in the frontal lobe of the supratentorial region, displaying a mainly atypical headache phenotype. The absence of pain receptors in the parenchyma suggested that pain resulted from mechanical stimulation of other pain-sensitive structures.Conclusion: Atypical headaches occurring within 30 days before neurological deficits could indicate potential malignancy.
Co-Authors Agiananda, Feranindhya Ahmad Yanuar Albertin, Elizabeth Alvonsius Silalahi, Raymond Aris Nimrod Aman, Renindra Ananda Andayani, Diyah Eka Andhika Rachman Aria Kekalih Ariarini, Ni Nengah Rida Diafiri, Dinda Djohansjah, Joice Rosewitasari Aryanti Faiq, Ahmad Rafi Hervita Diatri Humaira, Sarah Imran, Darma Indrapriambada, Ery Riady IRWANTO Karnasih, Artasya Kusumaningrum, Profitasari Madjid, Irma Savitri Maulina, Lisa Natadisastra, Raden Muharram Nugraeni, Tiara Nurmiati Amir Prayangga, Regina Pukovisa Prawiroharjo, Pukovisa Puspaseruni, Putri Air Putri Auliya, Putri Rahmad Mulyadi, Rahmad Ranakusuma, Teguh Ranakusuma, Teguh A. S Rini Andriani Riwanti Estiasari Samjunanto, Achmad Sari, Riska Nanda Sembiring, Saulina Sinthia, Novita Ayu Sitorus, Freddy Sofyan, Henry Riyanto Susanto, Eka Tanjung, Gloria Tejomukti, Teddy Velyani, Dyani Pitra Wahmurti, Tuti Wibisono, Sasanto Wiratman, Winnugroho Yesnuar Safri, Ahmad Zairinal , Ramdinal Aviesena