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All Journal journal of internal medicine E-Jurnal Medika Udayana ISM (Intisari Sains Medis) : Jurnal Kedokteran
Tjokorda Gde Dharmayuda
Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology

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GAMBARAN KUALITAS HIDUP PASIEN KANKER LIMFOMA NON HODGKIN YANG DIRAWAT DI RSUP SANGLAH DENPASAR (STUDI PENDAHULUAN) Sutrisno, Heri; Dharmayuda, Tjokorda Gde; Rena, Renny A
journal of internal medicine Vol. 11, No. 2 Mei 2010
Publisher : journal of internal medicine

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Abstract

Quality of life was a target therapy in cancer patients especially on metastatic cancer. Quality of life currently havebecomeone of stadard for therapeutic evaluation. Because quality of life was a subjectif characteristic and can only measure bypatient, so measuring quality of life patients must use multidimensional measure tool that offend aspect from physical, social andemotional, simple, easy to understand and answer by all patients and must to validated.To observe description of quality of life from cancer patient of Non Hodgkin Lymphoma (NHL) which admitted in SanglahHospital Denpasar, we have done analytic descriptive research on NHL patients with used EORTC QLQ-C30 questioner. Fifteenof NHL patients which cared in Internal Department Sanglah Hospital on January ? June 2010, 12 (80%) were male and 3 (20%)were female. Good quality of life was 8 (53.3%), moderate was 5 (33.3%) and poor was 2 (13.2%). From 10 (66.7%) patientsundergone chemotherapy, good quality of life was 5 (50%), moderate was 3 (30%) and poor was 2 (20%). There is correlationbetween quality of life of NHL patients with grading of clinical disease (p = 0.032; r = -0.554), there is no correlation qualityof life with giving chemotherapy in NHL patients (p = 0.560; r = -0.164). Meassuring quality of life NHL patient with EORTCQLQ-C30 was correlated with Karnofsky score (p = 0.031; r = 0.557) and ECOG (p = 0.04; r = -0.699).
KESULITAN DIAGNOSIS DAN TERAPI PADA LIMFOMA PANKREAS DISERTAI SINDROMA KAUDA EQUINA Ridwan, Muhammad; Dharmayuda, Tjokorda Gde
journal of internal medicine Vol. 9, No. 1 Januari 2008
Publisher : journal of internal medicine

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Abstract

Lymphoma, part of non-Hodgkin’s lymphoma, is a rare malignancy in pancreas. Its clinicalpresentations and supporting laboratory and imaging results are similar to those of pancreas adenocarcinoma.Apart from pancreas, extranodal type of non-Hodgkin can involve many other organs including bone marrows,nervous system, and kidneys. Treatment should be focused on emergency priority and the underlying cause. Inthis case report, we have documented a 44 year-old man who initially presented jaundice and abdominal massand then diagnosed with pancreas tumor. However, pathology anatomy and histochemistry examinations ofperipancreas tissue biopsy and indicated a non-hodgkin lymphoma of pancreas, in form of diffuse large B celllymphoma, intermediate grade. The patient was developing cauda equina syndrome a week after laparotomy.Discussion among team suggested that both conditions may have the same root: lymphoma. The patient wasthen put on CHOP regiments of chemotherapy program and later, also underwent a spinal decompressionprocedure. Overall, jaundice, abdominal mass and other related symptoms subsided, and quality of lifeimproved, although some cauda equina symptoms remained.
TINGKAT HARAPAN HIDUP PASIEN LIMFOMA NON-HODGKIN BERDASARKAN SKOR IPI YANG MENDAPATKAN KEMOTERAPI LINI PERTAMA DI RSUP SANGLAH DENPASAR TAHUN 2014 I Putu Dhidhi Pradnya Suryadiarsa; Ni Made Renny Anggraeni Rena; Tjokorda Gde Dharmayuda
E-Jurnal Medika Udayana Vol 8 No 5 (2019): Vol 8 No 5 (2019): Vol 8 No 5 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Abstract

Limfoma Non-Hodgkin (LNH) merupakan penyakit hematologi dengan keganasan yangterjadi pada limfosit, disebabkan oleh abnormalitas dari perkembangan limfosit yang akanmembentuk suatu tumor, apabila dibiarkan maka dapat berkembang menjadi kanker. SkorInternational Prognostic Index (IPI) merupakan alat ukur yang digunakan untuk memperkirakantingkat harapan hidup pasien LNH secara multidimensional dengan beberapa komponen, yaituumur, stadium penyakit, kadar serum Lactate Dehydrogenase (LDH), keterlibatan ekstranodul,dan status kinerja. Penelitian ini dilakukan untuk mengetahui tingkat harapan hidup pasien LNHberdasarkan skor IPI yang mendapatkan kemoterapi lini pertama di RSUP Sanglah Denpasartahun 2014. Studi ini menggunakan metode penelitian deskriptif retrospektif terhadap pasienLNH di RSUP Sanglah Denpasar selama tahun 2014. Dari 25 pasien yang menjadi responden,memiliki rentang umur antara 61-76 tahun dengan rerata umur 65,68 + 4,7 tahun dan medianumur 65 tahun. Pasien lelaki berjumlah 19 orang dengan persentase 76%. Gejala klinis penyakitLNH ditandai dengan adanya benjolan (100%), demam (80%), penurunan berat badan (80%),lemas (80%), anemia (72%), dan keluhan organ (52%). Diffuse Large B-Cell Lymphoma(DLBCL) merupakan gambaran histopatologi tersering di RSUP Sanglah Denpasar denganpersentase 68%. Hasil skor IPI diantaranya empat pasien (16%) kategori low risk, dua pasien (8%)kategori low-intermediate risk, dua pasien (8%) kategori high-intermediate risk, dan 17 pasien(68%) kategori high risk. Sebagian besar kasus LNH di RSUP Sanglah Denpasar memilikiprognosis yang buruk, sehingga memiliki tingkat harapan hidup sebesar 34% dalam dua tahundan 26% dalam lima tahun.Kata kunci: Tingkat harapan hidup, Limfoma Non-Hodgkin, Skor IPI
Karakteristik anemia pada lansia di RSUP Sanglah Denpasar pada bulan Januari-Juni 2017 Alvi Laili Zahra; Ida Bagus Putu Putrawan; Tjokorda Gde Dharmayuda
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (212.399 KB) | DOI: 10.15562/ism.v10i2.241

Abstract

Background: Anemia is a symptom depending on the decrease of hemoglobin levels, the number of erythrocytes, and the volume of erythrocytes. The symptoms of anemia commonly occur in the elderly. In general, the common causes that often complained in the elderly are less efficient in absorbing some of the nutrients, decreased appetite due to illness, difficulty swallowing due to reducing of saliva, slow feeding, reduced teeth, and nausea. Anemia in the elderly should not be considered as an unavoidable consequence of aging. Treatment of this problem should start as early as possible.Aim: This study aims to determine the characteristics of anemia in the elderly in RSUP Sanglah from January to June 2017.Method: This research is a descriptive cross sectional study conducted at RSUP Sanglah Denpasar. Data obtained in the form of secondary data patient record period January  - June 2017. Data were analyzed using Microsoft Excel 2010.Result: Of the 102 patients, the average age was 69.3 ± 7.1 years with the highest proportion of patients aged 60-70 years old is 56 people (54.9%). The proportion of male is 71 people (69,6%). Of the total samples, there were 75 patients anemia patients  (73.5%) and 27 patients without anemia (26.5%). The highest proportion of anemia depend on their stages are 51 patients of mild anemia (68%). 47 patients (62.7%) were normochromic and normocitary anemia. The highest proportion is anemia with kidney disease (38,7%).
Faktor prognostik pasien Chronic Myeloid Leukemia (CML) yang menggunakan terapi Tyrosine Kinase Inhibitor (TKI) berdasarkan skoring Sokal dan Hasford: sebuah tinjauan sistematik Roderick Wilson Tendean; Ni Made Renny Anggreni Rena; Tjokorda Gde Dharmayuda
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (965.635 KB) | DOI: 10.15562/ism.v12i1.926

Abstract

Background: Tyrosine Kinase Inhibitor (TKI) therapy is known to improve overall survival in Chronic Myeloid Leukemia (CML) patients. This research aims to assess the overall survival rate in CML patients using TKI therapy.Methods: This systematic review is done due to PRISMA statement guidelines. The search was conducted in Pubmed, PubMed Center, and Taylod and Francis database from 2015 to 2018 with inclusion criteria age>18 years, intervention TKI therapy, Sokal and Hasford score, overall survival outcome. The title and abstract of these articles were reviewed for relevance, based on inclusion criteria. This systematic review uses STROBE to evaluate the individual study's quality, which consists of 22 domains.Results: In the final stage, this systematic review identifies two articles. Overall, the quality of these two articles based on the STROBE checklist is not good. Both articles said that CML patients given TKI therapy with smaller Sokal and Hasford scores would have a higher overall survival rate.Conclusion: Overall, this systematic review obtained evidence of the high rate of overall survival in CML patients given TKI therapy. One study said that patients with lower Sokal and Hasford scores would have a higher overall survival rate. However, a study related to this is still limited and further research is needed, including larger populations, the evaluation of the mortality rate, and the comparison prognostic factor among TKI therapy. Latar Belakang: Terapi Tyrosine Kinase Inhibitor (TKI) diketahui dapat meningkatkan overall survival pada pasien Chronic Myeloid Leukemia (CML). Tujuan dari penelitian ini adalah untuk menilai tingkat overall survival pada pasien CML yang menggunakan terapi TKI.Metode: Penulisan tinjauan sistematik ini dilakukan berdasarkan pedoman PRISMA. Pencarian artikel dilakukan pada database Pubmed, PubMed Centre, Taylor and Francis dari tahun 2015 sampai 2018 dengan kriteria inklusi umur >18 tahun, intervensi terapi TKI, skoring Sokal dan Hasford, outcome overall survival. Judul dan abstrak ditinjau berdasarkan relevansi penelitian. Penilaian kualitas studi dilakukan berdasarkan checklist STROBE yang terdiri dari 22 domain.Hasil: Pada tahap akhir didapatkan studi sebanyak 2 artikel. Secara umum kualitas studi kedua artikel berdasarkan checklist STROBE kurang baik. Kedua studi mendukung bahwa pasien CML yang diberikan terapi TKI dengan skor Sokal maupun Hasford yang semakin kecil akan memiliki tingkat overall survival yang semakin tinggi.Kesimpulan: Secara umum tinjauan sistematik ini memperoleh bukti mengenai tingginya overall survival pasien CML yang diberikan terapi TKI. Sebagian studi mendukung bahwa pasien dengan skor Sokal dan Hasford yang semakin rendah akan menyebabkan tingginya overall survival. Namun, studi mengenai hal terkait masih terbatas dan dibutuhkan penelitian lebih lanjut yang menyertakan populasi dalam jumlah yang lebih besar, mengevaluasi tingkat mortalitas, dan perbandingan faktor prognostik antar terapi TKI. 
Priapism as an initial presentation in Chronic Myeloid Leukemia (CML): a case report Ni Luh Putu Herawati; Tjokorda Gde Dharmayuda
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (487.601 KB) | DOI: 10.15562/ism.v12i1.986

Abstract

Background: Priapism is a persistent, usually painful erection that lasts for more than four hours and occurs without sexual stimulation. Priapism is a rare clinical sign of Chronic Myeloid Leukemia (CML), with an incidence of 1-5 cases per 100,000 people per year. In men who suffer from CML, ischemic priapism occurs secondary to hyperleukocytosis and venous obstruction by thrombus and microthrombus. Case Presentation: In this case, a 24-year-old male, a Balinese ethnicity, present with prolonged erectile complaints accompanied by increased pain. From the examination performed, it was concluded that the patients had the ischemic type of priapism. From CBC, the patient was obtained hyperleukocytosis and continued with peripheral blood smear and bone marrow puncture. The patients concluded with CML, and initial intervention includes therapeutic aspiration, irrigation, hydroxyurea and other supportive therapies. It is a urological emergency requiring urgent treatment to prevent long-term complications, in particular erectile dysfunction.Conclusion: Priapism is an unusual clinical manifestation of CML, whereas priapism is a urological emergency requiring immediate therapy. Treatment delay can cause complications of erectile dysfunction in men.  
Co-Authors Alvi Laili Zahra Heri Sutrisno I Made Bakta I Putu Dhidhi Pradnya Suryadiarsa Ida Bagus Putu Putrawan Ketut Suega Muhammad Ridwan Ni Luh Putu Herawati Ni Made Renny Anggraeni Rena Renny A Rena Roderick Wilson Tendean Sumohadi, I Made Duwi