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All Journal Nexus Pendidikan Kedokteran dan Kesehatan Open Access Indonesian Journal of Medical Reviews
Ibnu Kharisman
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Education Health Professions Medicine & Pharmacology

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Hubungan Diskusi Tutorial dengan Pencapaian Learning Objectives Blok Hematologi Mahasiswa Pendidikan Dokter Fakultas Kedokteran Universitas Sebelas Maret Surakarta Ibnu Kharisman; Murkati FK UNS; Prihandjojo Andri Putranto
Nexus Pendidikan Kedokteran dan Kesehatan Vol 3, No 1 (2014): Nexus Pendidikan Kedokteran & Kesehatan
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (262.503 KB)

Abstract

Background: Learning system in university has been transformed from Teacher Centered Learning (TCL) to Student Centered Learning (SCL). In medical education, SCL systems applied by the Problem Based Learning (PBL) method. Learning objectives in tutorial group discussion which is the implementation of PBL method in Sebelas Maret University Faculty of Medicine reflect the National Standard of Competence of Indonesian Medical Doctor that must be achieved by every medical student in Indonesia. As a new program at Sebelas Maret University Faculty of Medicine, tutorial group discussions roles in ushering students to achieve learning objectives is still in doubt. Until now, there has been no research on the effectiveness of a tutorial discussion on Sebelas Maret University Faculty of Medicine therefore authors are interested in doing this research. Methods: This research is an observational analysis research by cross sectional study approaching. The sample of this research is medical student of Sebelas Maret University Medical Faculty who are undergoing Hematology Block. Sample is taken by cluster sampling method, 43 persons randomly taken from 5 tutorial group of discussion. The chosen sample asked to undergo a pretest before first meeting of tutorial group discussion of Hematology Block. After the second meeting, sample then asked to undergo a posttest. The samples point results of pretest and posttest then compared and analyzed with McNemar method. Results: The percentage of learning objectives achievement from pretest is 7,00% and the percentage from posttest is 37,20%. McNemar test shown significant difference with p=0,000 (p<0,05). Conclusion: Tutorial group discussion is related with the achievement of learning objectives in Hematology Block. Keywords: tutorial group discussion, learning objectives, problem based learning
Malignant Pericardial Effusion in Lung Adenocarcinoma: When to Escalate from Pericardiocentesis to Open Pericardiostomy Ibnu Kharisman; Prima Kharisma Hayuningrat
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 6 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i6.810

Abstract

Malignant pericardial effusion (MPE) is a grave, life-limiting complication of advanced cancer, where lung adenocarcinoma is a leading cause. Its management is a cornerstone of palliative cardio-oncology, focused on alleviating debilitating dyspnea and enhancing the quality of remaining life. The optimal therapeutic pathway, especially following the failure of initial interventions, remains a critical challenge, demanding a careful balance between efficacy and treatment burden. A 58-year-old female with stage IV lung adenocarcinoma and a good baseline performance status (ECOG 1) presented with progressive, life-limiting dyspnea (NYHA Class IV). A massive pericardial effusion was diagnosed, and an initial pericardiocentesis provided only transient relief, with severe symptoms recurring within 48 hours. Following a multidisciplinary discussion centered on the patient’s goals of care, the decision was made to escalate to a definitive surgical procedure. A subxiphoid open pericardiostomy was performed, yielding hemorrhagic fluid and pericardial tissue that confirmed metastatic adenocarcinoma. The procedure resulted in complete, durable resolution of her symptoms. In conclusion, open pericardiostomy provides durable relief from the life-limiting dyspnea of MPE, a goal often unachievable with pericardiocentesis alone. For appropriately selected patients with advanced cancer, escalating to a definitive surgical procedure is not merely a treatment for effusion but a crucial intervention to restore function and dignity. This case underscores that for patients with recurrent MPE and adequate performance status, timely surgical intervention is a vital component of effective palliative care, maximizing quality of life.
Co-Authors Murkati FK UNS Prihandjojo Andri Putranto Prima Kharisma Hayuningrat