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All Journal Acta Interna : The Journal of Internal Medicine Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Biology, Medicine, & Natural Product Chemistry Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education The Indonesian Biomedical Journal Berita Kedokteran Masyarakat Indonesian Journal of Biomedicine and Clinical Sciences

Mardiah Suci Hardianti

Department Of Internal Medicine, Dr. Sardjito Hospital / Faculty Of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Daerah Istimewa Yogyakarta, Indonesia

Author-ID : 2970654

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Accuracy of fine needle aspiration biopsy to diagnose lymphadenopathy in Dr.Sardjito General Hospital, Yogyakarta, Indonesia Ery Kus Dwianingsih; Claudia Priska Adelin; Andre Stefanus Panggabean; Linda Pratiwi; Naomi Yoshuantari; Mardiah Suci Hardianti; I Indrawati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 1 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Lymphadenopathy is a non-specific enlargement of lymph nodes which may be caused by infection, cancer, or autoimmune disease. To date, only a few studies reported the diagnostic value of fine-needle aspiration biopsy (FNAB) in lymphadenopathy. This study was performed to evaluate diagnostic reliability of FNAB for benign and malignant lymphadenopathy. This was a retrospective cross-sectional study. The obtained data were statistically analyzed for its sensitivity, specificity, and accuracy. Out of 126 collected FNAB cases with histopathological confirmed results in Dr. Sardjito General Hospital, Yogyakarta, 85 (67.4%) were malignant lymphadenopathy, consisting of 42 metastatic tumor cases, 38 non-Hodgkin lymphoma (NHL) cases, and 4 Hodgkin lymphoma (HL) cases.The overall diagnostic sensitivity, specificity, and accuracy of FNAB in lymphadenopathy was 85.88, 70.73, and 80.95%, respectively. In diagnosing metastatic tumors, FNAB had sensitivity of 83.33%; specificity of 89.28%; and accuracy of 87.3%. The sensitivity, specificity, and accuracy of FNAB in diagnosing NHL was 60.52, 94.31, and 84.12%, respectively. FNAB had a sensitivity of 25%, specificity of 95,90%, and accuracy of 93.65% to diagnose HL. Meanwhile, the accuracy of FNAB in diagnosing malignancies in generalized lymphadenopathy, head-neck lymphadenopathy, and inguinal lymphadenopathy was 90.90; 81.39 and 44.44%, respectively. In conclusion,FNAB has moderate diagnostic value in diagnosing overall malignant lymphadenopathy, including metastatic tumors. FNAB also has some limitations in diagnosing NHL and HL, with sensitivity less than 70% for both diseases. However, it has high accuracy to diagnose generalized lymphadenopathy.

Convalescent plasma for COVID-19: A reasonable option for the pandemic based on both scientific and practical point of views Mardiah Suci Hardianti; Syahru Agung Setiawan; David Dwi Putera; Teguh Triyono; Jarir At Thobari; Johan Kurnianda
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 3 (2020): Special Issue: COVID-19
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Convalescent plasma treatment has become a promising adjunctive option to treat COVID-19. Several case reports consistently supported the feasibility of this approach by showing the safety and improvements of clinical and laboratory aspects from the treated patients. However, more clinical trials are still required to establish the definitive statement about its potential effectiveness. We review the scientific basis for the application of convalescent plasma in COVID-19 to understand its potentials better. We also cover the potential risks and benefits for this treatment in order to be more selective and careful when preparing and deciding to apply this approach. Lastly, we summarize any important points to monitor after the administration of this treatment to prioritize safety and measure the effectiveness of the treatment.

Efficacy and safety of convalescent plasma therapy in patients with COVID-19: arapid review of case series David Dwi Putera; Mardiah Suci Hardianti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 3 (2020): Special Issue: COVID-19
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Coronavirus disease 2019 (COVID-19) has become a world pandemic since early 2020.Currently, there is no established treatment to combat this potentially fatal disease. Convalescent plasma (CP) therapy has a strong scientific basis and historical perspective to treat previous viral infections such as Ebola, Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS). The aim of this review was to evaluate the efficacy and safety of convalescent plasma CP therapy in patients with COVID-19.We searched for every available study from major databases (CENTRAL, MEDLINE via Ovid, EMBASE) through 20th April 2020. We independently screened, extracted, assessed the risk of bias, analyzed the data using SPSS version 26, and narratively summarized the data. For the outcomes, we wanted to evaluate the changes of clinical parameters, radiological appearance, pulmonary function, the titer of neutralizing antibody, viral load, the disappearance of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA, and adverse events.We found five case series from our literature searching. The overall methodological quality of the case series was moderate. We included 27 patients, and all patients received CP transfusion. All patients experienced improvement of clinical symptoms and pulmonary lesions after receiving 200 to 2400 mL (median 200 mL) of CP transfusion. All patients in reported studies had negative results of reverse transcriptase-polymerase chain reaction(RT-PCR) after 1 to 26 days of transfusion (median 3 days). There was one non-life threatening adverse event reported after CP transfusion (facial red spot). In conclusion, CP therapy in COVID-19 patients showed promising results as it improved clinical symptoms and parameters, and it is well-tolerated based on our included studies. However, further expanded clinical trials with better designs are still required to evaluate the efficacy of this treatment although suchidea will be quite challenging to be conducted in the era of an epidemic.

Association of AID and MUM1 by Immunohistochemistry in Diffuse Large B-Cell Lymphoma Mardiah Suci Hardianti; Syahru Agung Setiawan; Nungki Anggorowati; Wiwiek Probowati
The Indonesian Biomedical Journal Vol 13, No 1 (2021)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v13i1.1421

BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease with dysregulation of somatic hypermutation (SHM) and class switch recombination (CSR) have been known to contribute for its lymphomagenesis. Activation-induced cytidine deaminase (AID) enzyme plays a vital role for both processes. Multiple myeloma oncogene 1 (MUM1) is known to upregulate the AID expression in normal and pathological conditions. However, both AID and MUM1 expression association in DLBCL is still unexplored using immunohistochemistry method. We examined DLBCL samples and then retrospectively tested its correlation with clinical findings.METHODS: A retrospective cohort study with 20 cases of DLBCL biopsy tissue with AID and MUM1 antibody was conducted. The samples were then classified into concordant (AID+/MUM1+ or AID-/MUM1-) and discordant group (AID-/MUM1+). The clinicopathological comparison was performed to observe any association between immunohistochemistry expression and clinical findings.RESULTS: Among 20 samples of DLBCL, concordant expression rate of AID and MUM1 was 80% with kappa Cohen’s of 0.578 (p=0.004). A significant association was observed between AID and MUM1 expression with a prevalence ratio of 2.25 (95% CI: 1.08-4.67; p=0.008). Clinical characteristics were not significantly different between each group. Restricted mean survival time was shorter in the concordant group compared with the discordant group but statistically insignificant (21.16 vs. 22.5 months; p=0.531).CONCLUSION: The result of this study showed the association between AID and MUM1 expression in DLBCL. However, whether the association may add further molecular heterogeneity of DLBCL is still to be confirmed by expanding the study.KEYWORDS: AID, CSR, DLBCL, MUM1, SHM

[PHS5] Dampak Volume Berita Figur Publik dan Peringatan Hari Kanker terhadap Volume Pencarian Kanker di Indonesia: Studi Analisis Google Trend Syahru Agung Setiawan; Mardiah Suci Hardianti
Berita Kedokteran Masyarakat (BKM) Vol 35, No 4 (2019): Proceedings the 5th UGM Public Health Symposium
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (293.725 KB)

Purpose: Indonesia has grown huge number of internet users thus becomes novel health promotion target in digital era. As Google Trends allows observing public health seeking information rapidly along with our concern towards public cancer interest which is affected by public figure news and cancer campaign, we studied cancer search oscillations in Indonesia in relation to both factors.Methods: Search queries comprised of cancer topics (Kanker; Kanker Darah; Leukemia; Kanker Paru; Kanker Getah Bening; Kanker Nasofaring), public figures news (Ani Yudhoyono; Arifin Ilham; Adira Taista; Anak Denada; Istri Indro; Sutopo; Valentino Nahak), and cancer awareness days (Hari Kanker Sedunia; Hari Kanker Anak; Hari Kanker Payudara) were generated to get their search volumes from 2018 to first trimester of 2019 subsequently grouped them into 3 main topics (cancer, public figure news, and cancer awareness day). Trend-to-trend analysis among main topics is evaluated using Pearson’s correlation, multiple linear regression, and cross-correlation.Result: Strong correlation is evidenced between cancer and public figure search (r = 0,752; p= <0,001) but lower in cancer awareness day (r=0,296; p = 0,017). Multivariate analysis shows significant impact of public figure, secular trend, and cancer awareness day on cancer search volume in Indonesia (R2 = 0,646; p < 0,001).Discussion: This study demonstrates strong influence of public figures on cancer-seeking despite temporary for about 4 weeks with public figure search leads 1 week before evidenced cancer search. Positive yet lower effect of cancer campaign requires some improvement towards this intervention.Conclusion: Compared with cancer campaign, public figure news would ‘blow-up’ most Indonesian internet users towards cancer searching significantly but temporarily, which demands health promoter to maximize this ‘golden period’ to give informative and reliable cancer content in conjunction to fight cancer hoax, or possibly cooperate with cancer survivor public figures for promoting public awareness towards cancer.

The Effect of Weight Gain on Recurrence During Hormonal Therapy in Breast Cancer with Positive Estrogen Receptor and Negative Her2 Subtype Nugraha, Doddy Rizqi; Taroeno-Hariadi, Kartika Widayati; Hardianti, Mardiah Suci
Acta Interna The Journal of Internal Medicine Vol 11, No 1 (2021): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.94634

Background. Weight gain is found in patients with positive estrogen subtype breast cancer. The effect of weight gain on breast cancer recurrence is still being debated and associated with a poor prognosis. Being overweight is associated with an increase in estrogen production by adipose tissue.Methods. A retrospective and prospective cohort study with data collection was conducted from July 2018 - June 2019 at the outpatient unit of Dr. Sardjito Hospital. We reviewed medical records of patients who came from January 2013 - July 2018. Three categories of weight gain: weight loss, increase 0 - 5%, and increase > 5% from baseline will be evaluated.Statistical Analysis. The relationship between weight gain and some risk factors of recurrence was analyzed with cox regression and multivariate logistic regression tests. The Kaplan Meier method is used to show lifetime data.Result. Weight gain in breast cancer patients with positive Her2-negative estrogen receptor subtypes was not associated with recurrence (p = 0.264; HR 0.637; 95% CI 0.289 - 1.405). Patients with body mass index ≥ 25 kg / m2 at diagnosis had a lower risk of relapse than patients with body mass index < 25 kg / m2 (p = 0.026; HR 0.461; 95% CI, 0.234 - 0.912).Conclusions Weight gain after diagnosis in breast cancer patients with positive estrogen receptor-negative Her2 subtypes receiving hormonal therapy is not associated with recurrence.

Prognostic Values of Hemoglobin and Red Blood Cell Distribution Width to Overall Survival in Non-Hodgkin Lymphoma Trisnawati, Lidwina Tika; Hardianti, Mardiah Suci; Purwanto, Ibnu
Acta Interna The Journal of Internal Medicine Vol 12, No 2 (2023): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.98483

Background. After the Rituximab era, baseline International Prognostic Index (IPI) is not sufficient for the initial risk stratification of patients with Non-Hodgkin lymphoma (NHL). Low hemoglobin (Hb) levels and high red blood cell distribution width (RDW) baseline are known to be associated with poor outcomes and overall survival in malignancy. This study aimed to evaluate the prognostic value of Hb and RDW to overall survival in NHL patients who undergoing chemotherapy at Dr. Sardjito Hospital.Method. A retrospective cohort study in NHL from patients’ medical records diagnosed from 2014 to 2018 and undergoing chemotherapy at Dr. Sardjito Hospital. The prognostic influence of clinical factors including Hb and RDW on 3 years of overall survival were studied by using Kaplan-Meier curves and univariate Cox regression tests. To evaluate the independent prognostic relevance of basic characteristics data (age, gender, BMI, performance status, Ann Arbor stage, extranodal involvement), Hb, and RDW, multivariate Cox proportional hazards regression was applied. Results. From 292 NHL patients included, the median Hb was 12.7 g/dL and the median RDW was 14.2%. The mean survival time was 31.13 months, 38 patients (13%) died during the 3 years of follow-up. The most common causes of death were sepsis (68.4%) and 12 patients (4.1%) died within <30 days of chemotherapy. Based on Cox regression univariate analysis, patients with lower Hb levels (<10 gr/dL) had a 3-year overall survival lower than Hb>10 gr/dL (71% vs. 87%, CI 95%, p=0.014), with Hazard Ratio 2.49 (p=0.02). Patients with higher RDW>15.5 levels had lower overall survival than patients with RDW<15.5 levels (77.5% vs. 91.1%, CI 95%, p=0.002), and Hazard Ratio 2.78 (p=0.02). Based on multivariate analysis, performance status (OR=2.589, CI 95%, 1.225-5.471, p=0.013) and RDW (OR=2.292, CI 95%, 1.106-4.48, p=0.026) are independent predictor factors of 3-year overall survival.Conclusion. NHL patients with lower Hb and higher RDW levels have lower 3-year overall survival.

Association between chemotherapy-related cardiac dysfunction (CTRCD) and 6-minute walking distance (6MWD) in breast cancer patient receiving anthracycline-based chemotherapy Putri Ayudhia Trisnasari; Irsad Andi Arso; Hasanah Mumpuni; Vita Yanti Anggraeni; Susanna Hilda Hutajulu; Mardiah Suci Hardianti; Hartopo, Anggoro Budi
Indonesian Journal of Biomedicine and Clinical Sciences Vol 56 No 4 (2024)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v56i4.12240

Anthracycline chemotherapy is one of the most commonly given therapies to breast cancer patients. Anthracycline has a cardiotoxicity effect causing cardiac myocyte death. This chemotherapy-related cardiac dysfunction (CTRCD) will decrease oxygen delivery to tissues characterized by reduced cardiorespiratory fitness. The 6-min walking distance (6MWD) could be a predictor of cardiorespiratory fitness. This study aimed to investigate the association between CTRCD and the reduction in 6MWD after receiving anthracycline-based chemotherapy. It was an analytical observational study with a retrospective cohort design that conducted on breast cancer patients underwent anthracycline-based chemotherapy. Subjects were patients from the Cardio-oncocare registry who met the inclusion and exclusion criteria. The CTRCD was assessed using left ventricle ejection fraction (LVEF) and global longitudinal strain (LVGLS) by transthoracic echocardiography examination based on criteria from the European Society of Cardiology guidelines. The 6MWD was assessed by performing 6-min walking tests. The LVEF, LVGLS and 6MWD data were retrieved from the Cardio-oncocare registry database, which were performed before and after chemotherapy. The changes and association of LVEF, LVGLS and 6MWD from before to end of chemotherapy were analyzed. Of 250 Cardio-oncocare registered patients, 58 patients met the criteria. Among them, 17 patients (29%) had CTRCD, and 41 patients (71%) had no CTRCD after chemotherapy. A significant decrease in LVEF and LVGLS in patients with CTRCD was observed. The 6MWD before chemotherapy did not statistically differ between CTRCD and no CTRCD patients. After chemotherapy, the proportion of patients experienced reduction of 6MWD was not significantly different between CTRCD patients and no CTRCD patients [7 patients (41%) vs. 21 patients (51%); p=0.342]. In conclusion, there is no significant association between CTRCD and reduction of 6MWD in breast cancer patients receiving antracycline-based chemotherapy.

Paper-Based versus Mobile Apps for Colorectal Cancer Screening in COVID-19 Pandemic Setting Handaya, Adeodatus Yuda; Hardianti, Mardiah Suci; Rinonce, Hanggoro Tri; Werdana, Victor Agastya Pramudya; Fauzi, Aditya Rifqi; Andrew, Joshua; Hanif, Ahmad Shafa; Tjendra, Kevin Radinal; Aditya, Azriel Farrel Kresna
Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education Vol. 11 No. 1 (2023): Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Educatio
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jpk.V11.I1.2023.19-25

Background: The incidence of colorectal cancer (CRC) in Asia has kept increasing in the last decade. The morbidity and mortality for CRC can be reduced with early detection; however, mass CRC screening with imaging modalities such as colonoscopy, CT scan, or MRI is unfeasible in developing countries such as Indonesia. Asia Pacific Colorectal Screening (APCS) is utilized to stratify individual CRC risk. Online screening via mobile application is an alternative method to ensure the continuity of community screening without risking COVID-19 transmission. Objective: We conducted a descriptive study to evaluate CRC risk using APCS in two different villages. Methods: This is a cross-sectional study involving 925 and 207 subjects in 2019 and 2020, respectively. The APCS survey in 2019 was done before the COVID-19 pandemic with paper-based questionnaires and direct assessment by door-to-door approach. Meanwhile, the APCS survey in 2020 was done during the COVID-19 pandemic using websites and mobile apps available for Android and iOS. We gathered participants' characteristics and the APCS score in both groups and tabulated them. Results: In 2019, out of 925 subjects; 472 (51%) have been classified an average risk of CRC, 370 (40%) have been classified as having a moderate risk of CRC, and 83 (9%) have been classified as in high risk of CRC. In 2020, out of 207 subjects; 106 (51.2%) have been classified as the average risk of CRC, 86 (41.5%) have been classified as the moderate risk of CRC, and 15 (7.3%) have been classified as high risk of CRC. Conclusion: Although there was a decrease in the participation of the screening program with mobile applications in the pandemic era compared with paper-based questionnaires before the pandemic era, online screening using APCS in mobile applications is a preferred alternative for an effective screening method in this pandemic and possibly in the future in Indonesia.

Co-Authors Adeodatus Yuda Handaya Aditya, Azriel Farrel Kresna Ageng Brahmadhi Andre Stefanus Panggabean Andrew, Joshua Anggoro Budi Hartopo Claudia Priska Adelin David Dwi Putera David Dwi Putera Ery Kus Dwianingsih Fajar Adi Kusumo Fauzi, Aditya Rifqi Hanggoro Tri Rinonce Hanif, Ahmad Shafa Hasanah Mumpuni I Indrawati Ibnu Purwanto Irsad Andi Arso Jarir At Thobari Johan Kurnianda Kartika Widayati Taroeno Hariadi Lina Aryati Linda Pratiwi Muhammad Ihsan Qomaruzzaman Naomi Yoshuantari Nina Mulyani Nugraha, Doddy Rizqi Nungki Anggorowati Putri Ayudhia Trisnasari Qomaruzzaman, Muhammad Ihsan Sugiyanto Sugiyanto Sugiyanto Sugiyanto Syahru Agung Setiawan Syahru Agung Setiawan Syahru Agung Setiawan Teguh Triyono Tjendra, Kevin Radinal Trisnawati, Lidwina Tika Vita Yanti Anggraeni Werdana, Victor Agastya Pramudya Wiwiek Probowati

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