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Systematic review: better or (otherwise) misleading for clinical decision? Hardyanto Soebono, Muhammad Bayu Sasongko
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 42, No 01 (2010)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (191.744 KB)

Systematic review is a method to combine multiple sources of evidence through an explicit and reproducible way ofliterature search and critical appraisal of the quality of included studies, with or without mathematical methods tosynthesis these information. Since this method was first introduced more than centuries ago, systematic review hasbeen increasingly popular and widely used particularly in the area of medicine. Systematic review is often veryuseful to physicians to help supporting the clinical decision making and significantly reducing their time to seek forappropriate evidence. However, despite its reproducible and systematic steps to substantially minimize the presenceof biases, physicians should still be aware that systematic review is not completely biases resistant. Inclusion ofpoor quality studies, heterogeneity, and publication or other reporting biases are commonly evident in systematicreview that may hinder the quality of the conclusion. This review summarizes the core principals of systematicreview and its potential biases, and discusses when the systematic review is useful or needing careful attention.Key words: treatment-scientific evidence- meta-analysis- critical appraisal-outcomes

Systematic review: better or (otherwise) misleading for clinical decision? Muhammad Bayu Sasongko Hardyanto Soebono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 42, No 01 (2010)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (191.744 KB)

Systematic review is a method to combine multiple sources of evidence through an explicit and reproducible way ofliterature search and critical appraisal of the quality of included studies, with or without mathematical methods tosynthesis these information. Since this method was first introduced more than centuries ago, systematic review hasbeen increasingly popular and widely used particularly in the area of medicine. Systematic review is often veryuseful to physicians to help supporting the clinical decision making and significantly reducing their time to seek forappropriate evidence. However, despite its reproducible and systematic steps to substantially minimize the presenceof biases, physicians should still be aware that systematic review is not completely biases resistant. Inclusion ofpoor quality studies, heterogeneity, and publication or other reporting biases are commonly evident in systematicreview that may hinder the quality of the conclusion. This review summarizes the core principals of systematicreview and its potential biases, and discusses when the systematic review is useful or needing careful attention.Key words: treatment-scientific evidence- meta-analysis- critical appraisal-outcomes

The eyelid tumor in Yogyakarta, Indonesia Agus Supartoto; Annisa Nurina Ayuningtyas; Banu Aji Dibyasakti; Purjanto Tepo Utomo; Datu Respatika; Muhammad Bayu Sasongko
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 51, No 3 (2019)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Many types of eyelid tumors may easily be diagnosed from a clinical point of view. However only a small number of large studies exist exploring the frequency of eyelid lesions from different regions. According to the epidemiology of various eyelid lesions happened in Yogyakarta Special Region, this study was aimed to investigate the prevalence of eyelid tumors in Yogyakarta Special Region. A total of 94 patients were enrolled in a descriptive study. The data were taken retrospectively from the medical record. All patients were diagnosed with eyelid tumors from January 2014 until December 2017 by histopathological examination. Among the subjects, 56 (59.6%) were male and 38 (40.4%) were female. There was no difference found in laterality (OD 46% vs OS 50%). Sebaceous carcinoma was found in 15 (16%) patients, followed by squamous cell carcinoma (SCC) 13 (13.8%), basal cell carcinoma (BCC) 11 (11.7%), epidermoid cyst 7 (7.4%), non-Hodgkin lymphoma 7 (7.4%), and others. We also found that 11 (11.7%) of patients showed an inflammation appearance only. The therapy was varied from extirpation and biopsy (39.4%), wide excision (27.7%), excision and biopsy (18.1%), exenteration (10.6%), and also anterior and lateral orbitotomy (2.1%) for each procedure. The eyelid tumor was found equally in the right and the left eye. Sebaceous carcinoma followed by SCC and BCC were the most common eyelid tumor found in this study. A further study is needed to determine the risk factor of each tumor.

The predictive factor for conjunctival melanoma recurrence Agus Supartoto; Melita Suwan Djaja; Didik Setyo Heriyanto; Endang Soetristi; Datu Respatika; Muhammad Bayu Sasongko
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 51, No 4 (2019)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Conjunctival melanoma potentially deadly tumor. While many cases of conjunctival melanoma appeared to be a recurrence, there is no valid data about parameters to predict the recurrence of this tumor. This study intended to evaluate whether histopathologic features can be used as a predictor for recurrence in conjunctival melanoma. This was a retrospective study, involving patients with conjunctival melanoma by the year 2013-1017 in Dr. Sardjito General Hospital and Dr. Yap Eye Hospital, Yogyakarta. Patient’s characteristic was determined by age, sex, laterality, tumor size, tumor location, histopathological dominancy, MMC application, recurrence, and metastases. Sixteen cases were found: male (62.5%) and female (37.5%). Age from 5-79 years, mean was 56.19 years. Tumor location was in bulbar in 11 patients (68.7%), palpebral in 5 patients (31.3%).There was significant association between metastasis and the tumor recurrence (OR 13.0; 95% CI 1.9-85.4; p = 0.007). A favorable trend of association was also found between location and the recurrence of melanoma (OR 15.0; 95% CI 0.9-228.8; p = 0.06). In summary, our study showed that the patients that developing distant metastasis were at a greater risk for tumor recurrence.

The risk factor of metastatic status of retinoblastoma patient in Yogyakarta Tertiary Hospital Agus Supartoto; Sri Nawung Hartanti; Banu Aji Dibyasakti; Purjanto Tepo Utomo; Datu Respatika; Muhammad Bayu Sasongko
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 1 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

The metastases of the tumor become a serious problem malignancy including retinoblastoma. This study aimed to observe the correlation between several risk factors with the metastatic status of retinoblastoma patients in Yogyakarta Tertiary Hospital. Records of patients with retinoblastoma treated between 2011 and 2017 were obtained for observational analytic study. The gender, laterality, age, Body Mass Index (BMI) classification, BMI for age, type of retinoblastoma, and metastatic status were analyzed. The association was statistically analyzed by the correlation ratio of Eta test. Thirty-seven cases of retinoblastoma were enrolled in this study, with mean age 29.44 (±14.1) months; 14 females and 23 males. Ten patients (27.0%) have no metastases, while 27 patients (72.9%) exhibit metastases. The multivariate logistic regression analysis demonstrated that male gender (OR 8.3; 95% CI 1.07–64.5; p = 0.04) and age below 24 months (OR 17.6; 95% CI 1.26-248.31; p = 0.03) were a predictive of the metastatic status for retinoblastoma. On the other hand, the laterality, BMI classification, BMI for age, and types of retinoblastoma were not associated with the metastatic status of retinoblastoma. The gender and age were significantly associated with the metastatic status of retinoblastoma. Male patients and age below 24 months were more likely to have metastatic disease of retinoblastoma.

FAKTOR PREDIKTOR GANGGUAN PENGLIHATAN BERAT DAN KEBUTAAN PADA PENDERITA DIABETES DI DAERAH ISTIMEWA YOGYAKARTA Rimawati Aulia Insani Sadarang; Hari Kusnanto; Mohammad Bayu Sasongko
Berita Kedokteran Masyarakat (BKM) Vol 33, No 12 (2017)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Predictors of severe visual impairment and blindness among diabetic patients in Special Territory of YogyakartaPurposeThe purpose of this study was to identify any predictors of severe visual impairment and blindness among diabetic patients in Daerah Istimewa Yogyakarta.MethodsThis research was a cross-sectional study by analyzing registry data from (JOGED.COM). Data included sociodemographic characteristics, diabetic status, health record, and eye diseases. The analysis was done using chi-square and simple logistic regression tests follow with semi-partial correlation, stratification tests and multilevel analysis with Generalized Estimation Equation (GEE).ResultsAs much as 1093 data were included in this study. The prevalence of severe visual impairment was 12% and blindness was 6.5%. Cataract, diabetic retinopathy and diabetes duration >10 years were statistically significant with severe visual impairment and blindness while glaucoma and hypertension only significant with severe visual impairment. The contribution of cataract in severe visual impairment (4.73%) and blindness (3.11%) was highest among eye diseases. There was modification effect of cataract to severe visual impairment and blindness by diabetes duration. Based on GEE, cataract, diabetic retinopathy and diabetes duration > 10 years was the best model to predict the occurrence of severe visual impairment and blindness.ConclusionsPredictors of severe visual impairment and blindness among diabetic patients in Daerah Istimewa Yogyakarta were the cataract, diabetic retinopathy and diabetes duration >10 years. Modification effect of cataract by diabetes duration only was significant in a model to predict blindness.

Kadar Plasma 25-Hydroxyvitamin-D (25-OHD) pada Pasien Age-related Macular Degeneration (AMD) Stadium Akhir di Yogyakarta: Studi Korelasi Supanji Supanji; Dewi Fathin Romdhoniyyah; Ayudha Bahana Ilham Perdamaian; Anindita Dianratri; Muhammad Bayu Sasongko; Angela Nurini Agni; Tri Wahyu Widayanti; Firman Setya Wardhana; Dian Caturini Sulistyaningrum; Mohammad Eko Prayogo; Masashi Kawaichi; Chio Oka
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 13, No 3, (2022)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol13.Iss3.art3

Background: Age-related Macular Degeneration (AMD) is a degenerative disease caused by multiple factors, including inflammation. This condition may lead to irreversible macular damage. Vitamin D has anti-inflammatory and immune-modulating qualities, therefore, is expected to protect against the development of AMD.Objective: This study aimed to evaluate the correlation between plasma 25-hydroxyvitamin D (plasma 25-OHD) levels and neovascular Age-Related Macular Degeneration (nAMD).Methods: This was a case-control study involving AMD and control subjects. All subjects underwent a standardized eye examination to check for eligibility by a retinal specialist. Blood samples were drawn for analysis using a DRG Elisa Kit to determine the plasma 25-OHD (Total). Plasma 25-OHD levels were categorized into deficiency (<12 ng/mL), insufficiency (12 - <20 ng/mL), adequate (20 – 50 ng/mL), and high (>50 ng/mL).Results: Total subjects were 39, which consisted of 20 AMD subjects and 19 controls. There were 17 male subjects (43.6%) and 22 female subjects (56.4%). The mean age for the case and control group was 69.35±7.04 and 68.26±6.83, respectively (p=0.612). Those in their 70s dominated the age distribution with a percentage of 56.41% of all participants. The mean plasma 25-OHD in the case group was 32.30±17.10 ng/mL, while the control group was 50.63±11.95 ng/mL (p=0.066). There was no significant association between AMD and plasma 25-OHD levels in all groups (p>0.05).Conclusion: Plasma 25-OHD levels did not correlate positively with nAMD in our study population.

A new approach for sensitivity improvement of retinal blood vessel segmentation in high-resolution fundus images based on phase stretch transform Kartika Firdausy; Oyas Wahyunggoro; Hanung Adi Nugroho; Muhammad Bayu Sasongko
International Journal of Advances in Intelligent Informatics Vol 8, No 3 (2022): November 2022
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26555/ijain.v8i3.914

The eye-fundus photograph is widely used for eye examinations. Accurate identification of retinal blood vessels could reveal information that is helpful for clinical diagnoses of many health disorders. Although several methods have been proposed to segment images of retinal blood vessels, the sensitivity of these methods is plausible to be improved. The algorithm’s sensitivity refers to the algorithm’s ability to identify retinal vessel pixels correctly. Furthermore, the resolution and quality of retinal images are improving rapidly. Consequently, new segmentation methods are in demand to overcome issues from high-resolution images. This study presented improved performance of retinal vessel segmentation using a novel edge detection scheme based on the phase stretch transform (PST) function as its kernel. Before applying the edge detection stage, the input retinal images were pre-processed. During the pre-processing step, non-local means filtering on the green channel image, followed by contrast limited adaptive histogram equalization (CLAHE) and median filtering, were applied to enhance the retinal image. After applying the edge detection stage, the post-processing steps, including the CLAHE, median filtering, thresholding, morphological opening, and closing, were implemented to obtain the segmented image. The proposed method was evaluated using images from the high-resolution fundus (HRF) public database and yielded promising results for sensitivity improvement of retinal blood vessel detection. The proposed approach contributes to a better segmentation performance with an average sensitivity of 0.813, representing a clear improvement over several benchmark techniques

Surgical Technique of Late Spontaneous IOL-Capsular Bag Complex Dislocation with Low Corneal Endothelial Cell Density: A Case Report Firman Setya Wardhana; Dhimas Hari Sakti; Supanji Supanji; Muhammad Bayu Sasongko; Tri Wahyu Widayanti; Angela Nurini Agni
International Journal of Retina Vol 2 No 1 (2019): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2019.vol002.iss001.54

Introduction: IOL-capsular bag complex dislocation is a rare but serious complication of phacoemulsification surgery. Technique to repair this complication should be based on various clinical parameters including quality of corneal endothelial cells and the type of dislocated IOL. Case Presentation: We present a case of a 67-year-old male with left eye spontaneous one-piece foldable IOL-capsular bag complex dislocation to vitreous cavity 4 years after phacoemulsification surgery. Visual acuity of the left eye was 1/60, pupil was round with 3 mm diameter and IOP was 15 mmHg. Noncontact specular microscopy examination showed that the corneal endothelial cell density was 1100 cells/mm2. It was managed with 23-gauge posterior vitrectomy, IOL evacuation to anterior chamber, releasing the capsular bag and repositioning the IOL into posterior chamber by sutured scleral fixation. Result: Follow-up at 6thmonth, best corrected visual acuity of the left eye achieved 6/6, IOL at central position and the last corneal endothelial cell density was 1076 cells/mm2. Conclusions: Late spontaneous IOL-capsular bag complex dislocation with low corneal endothelial cell density can be safely managed with proper surgical technique. Vitrectomy and sutured scleral fixation of the previously dislocated IOL were effective in managing such case. Longer follow-up should be done to assure the stability of IOL position and the quality of corneal endothelial cells.

Shortening Activated Partial Tromboplastin Time (APTT) Between Hypertension and Nonhypertension in Diabetic Mellitus Patients with Bevacizumab Intravitreal Injection Anik Ika Winarni; Ni Luh Putu Widyasti; Natalia Christina Angsana; Rizto Wisuda Senuari; Angela Nurini Agni; Agus Supartoto; Muhammad Bayu Sasongko; Haryo Yudono
International Journal of Retina Vol 2 No 2 (2019): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2019.vol002.iss002.98

Introduction : Bevacizumab intravitreal injection could be detectable in plasma that might interfere the coagulopathy and hemostasis condition. The purpose of this study was to investigate the difference of APTT between hypertensive and nonhypertensive diabetic mellitus patients with bevacizumab intravitreal injection. Methods : This was cohort study conducted at Sardjito General Hospital from March 2019 to June 2019. Thirty-two hypertension patients and 30 nonhypertension patients with diabetes mellitus who underwent bevacizumab intravitreal injection were included. Value of APTT was measured using ACLTOP300 machine prior and 1 week after IVB. The difference in mean APTT value prior and after IVB, range APTT value between two groups were assessed using independent t-test. The percentage of patients who had shortening of APTT in both groups was tested by two populations proportion test. Results : Mean APTT before IVB in hypertensive patients was 36.47 ± 2.92 seconds and in nonhypertensive patients was 36.33 ± 4.39 seconds with p value > 0.05. Mean value of APTT after IVB in hypertension patients was 35.42 ± 3.63 seconds and in nonhypertensive patients was 35.60 ± 3.13 seconds with p value > 0.05. APTT shortening in hypertensive patients was -1.03 ± 3.65 and nonhypertensive patients was -0.73 ± 2.55 with p value > 0.05. The risk of APTT shortening in hypertensive patients was 1.370 (0.831-2.258). The risk of APTT shortening in hypertensive patients who used antihypertensive drugs regularly was 0.538 (0.331- 0.874). Conclusion : There was no difference in shortening of APTT value 1 week after intravitreal bevacizumab injection between hypertensive and nonhypertensive groups in patients with diabetes mellitus. Hence, administration of IVB in hypertensive patients with regular antihypertensive therapy might be safe.

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