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HUBUNGAN ANTARA WAIST HIP RATIO DENGAN PLANTAR ARCH INDEX PADA MAHASISWI FAKULTAS KEDOKTERAN UNIVERSITAS DIPONEGORO Rizka Aulia Tsani; Agung Aji Prasetyo
Jurnal Kedokteran Diponegoro (Diponegoro Medical Journal) Vol 8, No 1 (2019): JURNAL KEDOKTERAN DIPONEGORO
Publisher : Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (380.789 KB) | DOI: 10.14710/dmj.v8i1.23375

Abstract

Latar Belakang: Mahasiswa Fakultas Kedokteran mempunyai faktor risiko overweight dan obesitas. Pengukuran lemak tubuh dapat dilakukan dengan beberapa cara, salah satunya dengan Waist Hip Ratio (WHR). WHR dapat mencerminkan banyaknya timbunan lemak terutama yang ada di perut dan panggul. Kelebihan berat badan dapat menyebabkan musculus, tendon, dan ligamen yang menyangga arcus pedis khususnya arcus longitudinalis medialis meregang dan melemah, tulang dan sendi kaki dapat bergeser, kolaps sehingga menimbulkan nyeri dan flat foot deformity. Arcus longitudinalis medialis dapat diukur menggunakan Staheli’s plantar arch index. Tujuan: Mengetahui hubungan antara waist hip ratio dengan plantar arch index pada mahasiswi Fakultas Kedokteran Universitas Diponegoro. Metode: Penelitian ini merupakan penelitian observasional analitik dengan pendekatan cross sectional. Sampel adalah 30 mahasiswi tahun ketiga Fakultas Kedokteran Universitas Diponegoro yang memenuhi kriteria penelitian. Pengambilan sampel dengan metode simple random sampling. Dilakukan pengukuran lingkar pinggang, lingkar panggul, dan plantar arch index dari foot print responden. Uji statistik menggunakan uji Saphiro-Wilk dan uji korelasi Spearman. Hasil: Dari 30 subjek penelitian, terdapat 12 subjek penelitian (40%) yang tergolong obesitas sentral dan 18 subjek (60%) yang tergolong non obese. Pengukuran PAI menunjukkan terdapat 2 subjek (6,67%) yang mempunyai PAI tinggi dan 28 subjek (93,33%) dengan PAI normal. Korelasi WHR dengan PAI berdasarkan uji korelasi Spearman didapatkan nilai p=0,535 dan r=0,118. Kesimpulan: Tidak terdapat korelasi signifikan antara Waist Hip Ratio (WHR) dengan Plantar Arch Index (PAI) pada mahasiswi Fakultas Kedokteran Universitas Diponegoro.Kata Kunci: Waist Hip Ratio, Plantar Arch Index
PERBEDAAN DERAJAT FIBROSIS HEPAR TIKUS WISTAR YANG DILAKUKAN LIGASI DUKTUS KOLEDOKUS ANTARA KELOMPOK PEMBERIAN KOMBINASI UDCA-GLUTATHIONE DENGAN PEMBERIAN TUNGGAL UDCA Novita Ikbar Khairunnisa; Agung Aji Prasetyo; Ika Pawitra Miranti
Jurnal Kedokteran Diponegoro (Diponegoro Medical Journal) Vol 5, No 4 (2016): JURNAL KEDOKTERAN DIPONEGORO
Publisher : Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (805.603 KB) | DOI: 10.14710/dmj.v5i4.15594

Abstract

Latar Belakang: Kolestasis dapat memicu kematian sel, fibrosis, sirosis, dan kegagalan fungsi hepar. Walaupun dengan manfaat yang terbatas, Ursodeoxycholic Acid (UDCA) merupakan terapi yang direkomendasikan oleh Food and Drug Administration sebagai tatalaksana kolestasis. Glutathione memiliki peran penting sebagai antioksidan dan regulasi proses seluler seperti diferensiasi, proliferasi dan apopstosis sel. Terganggunya keseimbangan Glutathione memiliki korelasi terhadap penyakit hepar .Tujuan: Mengetahui adanya perbedaan derajat fibrosis hepar pada tikus yang dilakukan ligasi duktus koledokus antara kelompok pemberian kombinasi UDCA-Glutathione dengan pemberian tunggal UDCAMetode: Penelitian True Experimental dengan rancangan “post test only control group design”. Menggunakan 15 ekor tikus wistar yang dibagi menjadi tiga kelompok K , P1 dan P2. Tiap tikus dilakukan ligasi duktus koledokus. Kelompok K sebagai kontrol dan tidak diberi terapi, P1 diberi terapi UDCA 20 mg per oral dan P2 diberi kombinasi UDCA 20 mg per oral dan Glutathione 15 mg IM. Setelah intervensi selama 21 hari, seluruh tikus diterminasi dan dilakukan pembuatan preparat hepar dengan pengecatan Masson-trichrome. Derajat fibrosis ditentukan menggunakan sistem Laennec. Uji statistik menggunakan uji Kruskal Wallis dan dilanjutkan uji Mann Whitney.Hasil: Pemeriksaan derajat fibrosis menunjukkan adanya perbedaan yang bermakna antara kelompok P2 dengan K (p = 0.013) dan antara kelompok P2 dengan P1 (p = 0.006). Tetapi tidak ditemukan perbedaan yang bermakna antara kelompok P1 dan K (p= 0.469)Simpulan: Pemberian terapi kombinasi memberikan gambaran fibrosis yang lebih rendah.
GAMBARAN VASKULARISASI RETINA PASCA PEMBERIAN OKSIGEN KONSENTRASI TINGGI (STUDI EKSPERIMENTAL RETINOPATHY OF PREMATURITY PADA TIKUS WISTAR) Tita Erlanggawati; Agung Aji Prasetyo; Puspita Kusuma Dewi
DIPONEGORO MEDICAL JOURNAL (JURNAL KEDOKTERAN DIPONEGORO) Vol 7, No 4 (2018): JURNAL KEDOKTERAN DIPONEGORO
Publisher : Faculty of Medicine, Diponegoro University, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (747.483 KB) | DOI: 10.14710/dmj.v7i4.22264

Abstract

Latar belakang: Retinopathy of Prematurity (ROP) didefinisikan sebagai proliferasi abnormal pembuluh darah retina pada bayi baru lahir akibat terpapar oksigen konsentrasi tinggi. Patogenesis ROP ditandai dengan terbentuknya neovaskularisasi pada retina yang dipengaruhi oleh kadar Vascular Endhotelial Growth Vactor (VEGF) dan kerusakan jaringan akibat stress oksidatif. Glutation adalah antioksidan utama dalam tubuh yang mudah berikatan dengan senyawa radikal bebas, pada penelitian ini digunakan untuk mengurangi terbentuknya pembuluh darah abnormal pada retina.Tujuan: Mengetahui adanya pengaruh pemberian glutation terhadap gambaran vaskularisasi retina pada tikus Wistar yang diberi oksigen konsentrasi tinggi.Metode: Penelitian true experimental dengan posttest only control group design. Penelitian dilakukan selama 14 hari menggunakan tikus Wistar usia 1-7 hari (n=18) yang secara random dibagi menjadi 3 kelompok (kelompok kontrol negatif, kelompok kontrol positif, dan kelompok perlakuan). Kelompok kontrol negatif tidak diberikan perlakuan. Kelompok kontrol positif diberikan paparan oksigen 95% selama 4 jam. Kelompok perlakuan diberikan paparan oksigen 95% selama 4 jam dan injeksi glutation. Tikus di terminasi dan dilakukan enukleasi pada hari ke 15. Bulbus oculi tikus diambil untuk dilakukan pengecatan HE dan diperiksa gambaran histopatologi dengan cara menghitung fokus proliferasi sel endotel yang terbentuk. Uji statistik menggunakan uji Saphiro Wilk dilanjutkan uji Kruskal Wallis dan uji Mann-Whitney untuk melihat pebedaan antar kelompok.Hasil: Jumlah neovaskularisasi paling tinggi ditemukan pada kelompok kontrol positif. Penurunan jumlah neovaskularisasi terjadi pada kelompok perlakuan. Terdapat perbedaan bermakna jumlah neovaskularisasi retina kelompok kontrol positif dibandingkan dengan kontrol negatif (p=0,003) dan kelompok perlakuan (p=0,006). Tidak terdapat perbedaan bermakna jumlah neovaskularisasi retina antara kelompok kontrol negatif dan kelompok perlakuan (p=0,212).Simpulan: Pembentukan pembuluh darah abnormal pada retina yang diberikan glutation lebih sedikit dibandingan dengan yang tidak diberi glutation.Kata Kunci: Retinopathy of Prematurity (ROP), glutation, radikal bebas, oksigen, neovaskularisasi
Laparoscopic Primary Crural Repair for Acute-on-Chronic Organoaxial Gastric Volvulus Secondary to a Type II Paraesophageal Hernia: A Case Report and Review of Surgical Strategy Danu Adi Prakosa Darmawan; Agung Aji Prasetyo; Ahmad Fathi Fuadi; Dimas Erlangga Nugrahadi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1393

Abstract

Background: Gastric volvulus, an abnormal rotation of the stomach, is a rare surgical emergency that can lead to life-threatening gastric ischemia and perforation, particularly when associated with a large paraesophageal hernia (PEH). While paraesophageal hernias are the most common predisposing factor in adults, the optimal surgical management, especially regarding the use of fundoplication and gastropexy, remains a subject of debate. Case presentation: We present the case of a 46-year-old male with a six-month history of intermittent epigastric pain and early satiety, who presented with a three-week history of acute-on-chronic gastric outlet obstruction. His symptoms included intractable postprandial vomiting. Laboratory findings were significant for hemoconcentration and a hypochloremic, hypokalemic metabolic state, indicative of severe dehydration. A contrast-enhanced computed tomography scan confirmed a Type II PEH with an organoaxial gastric volvulus, causing complete obstruction. Following aggressive resuscitation, the patient underwent successful laparoscopic surgery. The procedure involved reduction of the herniated and volvulized stomach, complete excision of the hernia sac, and a primary posterior crural repair with pledgeted, non-absorbable sutures. A fundoplication or gastropexy was not performed. Intraoperative endoscopy confirmed successful de-rotation, a patent pylorus, and viable gastric mucosa. The patient had an uneventful recovery and remained asymptomatic with no evidence of reflux at a six-month follow-up. Conclusion: This case highlights the classic "acute-on-chronic" presentation of gastric volvulus secondary to a PEH. It underscores the efficacy and safety of a laparoscopic approach, which facilitates rapid recovery. Furthermore, it suggests that in carefully selected cases with a moderate-sized hiatal defect and preserved anatomy post-reduction, a meticulous primary crural repair without routine fundoplication or gastropexy can be a sufficient and durable treatment, avoiding the potential morbidity of these additional procedures.
Laparoscopic Primary Crural Repair for Acute-on-Chronic Organoaxial Gastric Volvulus Secondary to a Type II Paraesophageal Hernia: A Case Report and Review of Surgical Strategy Danu Adi Prakosa Darmawan; Agung Aji Prasetyo; Ahmad Fathi Fuadi; Dimas Erlangga Nugrahadi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1393

Abstract

Background: Gastric volvulus, an abnormal rotation of the stomach, is a rare surgical emergency that can lead to life-threatening gastric ischemia and perforation, particularly when associated with a large paraesophageal hernia (PEH). While paraesophageal hernias are the most common predisposing factor in adults, the optimal surgical management, especially regarding the use of fundoplication and gastropexy, remains a subject of debate. Case presentation: We present the case of a 46-year-old male with a six-month history of intermittent epigastric pain and early satiety, who presented with a three-week history of acute-on-chronic gastric outlet obstruction. His symptoms included intractable postprandial vomiting. Laboratory findings were significant for hemoconcentration and a hypochloremic, hypokalemic metabolic state, indicative of severe dehydration. A contrast-enhanced computed tomography scan confirmed a Type II PEH with an organoaxial gastric volvulus, causing complete obstruction. Following aggressive resuscitation, the patient underwent successful laparoscopic surgery. The procedure involved reduction of the herniated and volvulized stomach, complete excision of the hernia sac, and a primary posterior crural repair with pledgeted, non-absorbable sutures. A fundoplication or gastropexy was not performed. Intraoperative endoscopy confirmed successful de-rotation, a patent pylorus, and viable gastric mucosa. The patient had an uneventful recovery and remained asymptomatic with no evidence of reflux at a six-month follow-up. Conclusion: This case highlights the classic "acute-on-chronic" presentation of gastric volvulus secondary to a PEH. It underscores the efficacy and safety of a laparoscopic approach, which facilitates rapid recovery. Furthermore, it suggests that in carefully selected cases with a moderate-sized hiatal defect and preserved anatomy post-reduction, a meticulous primary crural repair without routine fundoplication or gastropexy can be a sufficient and durable treatment, avoiding the potential morbidity of these additional procedures.
From Antenatal Clue to Postnatal Cure: Surgical Management of a Symptomatic Jejunal Duplication Cyst in an Infant Agung Hartanto; Agung Aji Prasetyo; Agoes Wibisono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1461

Abstract

Background: Alimentary tract duplication cysts represent a rare and challenging subset of congenital anomalies. Their non-specific symptomatology often leads to their misidentification as more common pediatric conditions, making a clear diagnostic pathway essential. With jejunal localization being particularly uncommon, these lesions can range from being asymptomatic to causing life-threatening abdominal emergencies. The evolution of high-resolution prenatal imaging, however, has fundamentally altered their management, enabling proactive postnatal intervention. Case presentation: A three-month-old female infant, with a history of a non-specific cystic intra-abdominal mass identified on a second-trimester antenatal ultrasound, was referred for progressive abdominal distension and non-bilious vomiting. Postnatal examination revealed a palpable right upper quadrant mass. A contrast-enhanced computed tomography (CT) scan confirmed a 3.9 x 3.9 x 3.3 cm thick-walled jejunal duplication cyst causing partial obstruction. The patient underwent a successful exploratory laparotomy with segmental jejunal resection and primary end-to-end anastomosis. The postoperative course was uneventful, with complete resolution of symptoms. Histopathology confirmed a benign jejunal duplication cyst without heterotopic mucosa. Conclusion: Jejunal duplication cysts are a critical, albeit rare, consideration in the differential diagnosis of an infant with an abdominal mass or intestinal obstruction. This case serves as a paradigm of modern perinatal care, where an antenatal clue facilitates a planned, definitive postnatal cure. Complete surgical resection remains the gold standard, preventing severe complications and ensuring an excellent long-term prognosis.
From Antenatal Clue to Postnatal Cure: Surgical Management of a Symptomatic Jejunal Duplication Cyst in an Infant Agung Hartanto; Agung Aji Prasetyo; Agoes Wibisono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1461

Abstract

Background: Alimentary tract duplication cysts represent a rare and challenging subset of congenital anomalies. Their non-specific symptomatology often leads to their misidentification as more common pediatric conditions, making a clear diagnostic pathway essential. With jejunal localization being particularly uncommon, these lesions can range from being asymptomatic to causing life-threatening abdominal emergencies. The evolution of high-resolution prenatal imaging, however, has fundamentally altered their management, enabling proactive postnatal intervention. Case presentation: A three-month-old female infant, with a history of a non-specific cystic intra-abdominal mass identified on a second-trimester antenatal ultrasound, was referred for progressive abdominal distension and non-bilious vomiting. Postnatal examination revealed a palpable right upper quadrant mass. A contrast-enhanced computed tomography (CT) scan confirmed a 3.9 x 3.9 x 3.3 cm thick-walled jejunal duplication cyst causing partial obstruction. The patient underwent a successful exploratory laparotomy with segmental jejunal resection and primary end-to-end anastomosis. The postoperative course was uneventful, with complete resolution of symptoms. Histopathology confirmed a benign jejunal duplication cyst without heterotopic mucosa. Conclusion: Jejunal duplication cysts are a critical, albeit rare, consideration in the differential diagnosis of an infant with an abdominal mass or intestinal obstruction. This case serves as a paradigm of modern perinatal care, where an antenatal clue facilitates a planned, definitive postnatal cure. Complete surgical resection remains the gold standard, preventing severe complications and ensuring an excellent long-term prognosis.
Intraoperative Endoscopy as a Navigational Adjunct in Laparoscopic Heller Myotomy for Achalasia: A Consecutive Case Series Jonathan Alvin Nugraha Halim; Ahmad Fathi Fuadi; Dimas Erlangga Nugrahadi; Agung Aji Prasetyo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1479

Abstract

Background: Laparoscopic Heller myotomy (LHM) is a primary surgical treatment for esophageal achalasia. Achieving a complete myotomy while avoiding mucosal perforation is paramount for success, yet intraoperative challenges persist. Intraoperative endoscopy (IOE) is recommended by guidelines but remains underutilized. This study aims to illustrate the methodological application and clinical utility of a standardized IOE protocol in LHM. Methods: This study was a retrospective analysis of a prospectively maintained database of a consecutive series of patients who underwent LHM with routine IOE for achalasia at our institution in 2023. We present three consecutive cases. Preoperative evaluation included esophagography, upper endoscopy, and high-resolution manometry (HRM). The primary outcomes were the adequacy of myotomy, incidence of mucosal perforation, and postoperative symptomatic relief measured by the Eckardt score at three months. Results: Three female patients (aged 19, 30, and 65) with achalasia (Type I and II) underwent LHM with IOE. The mean preoperative Eckardt score was 9.3 ± 1.5. IOE was successfully used in all cases to: (1) precisely identify the gastroesophageal junction (GEJ) via transillumination, (2) facilitate submucosal dissection through controlled insufflation, (3) confirm mucosal integrity with an air leak test, and (4) verify a patulous GEJ post-myotomy. No mucosal perforations occurred. At three-month follow-up, the mean Eckardt score significantly improved to 0.3 ± 0.6 (p < 0.05). All patients reported resolution of dysphagia and significant improvement in nutritional status. Conclusion: Our experience with this consecutive series supports the utility of systematic IOE during LHM. It appears to be a valuable tool for enhancing procedural safety, ensuring myotomy adequacy, and achieving optimal short-term functional outcomes. These findings reinforce existing guidelines and should encourage wider adoption of this critical surgical adjunct.
Intraoperative Endoscopy as a Navigational Adjunct in Laparoscopic Heller Myotomy for Achalasia: A Consecutive Case Series Jonathan Alvin Nugraha Halim; Ahmad Fathi Fuadi; Dimas Erlangga Nugrahadi; Agung Aji Prasetyo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1479

Abstract

Background: Laparoscopic Heller myotomy (LHM) is a primary surgical treatment for esophageal achalasia. Achieving a complete myotomy while avoiding mucosal perforation is paramount for success, yet intraoperative challenges persist. Intraoperative endoscopy (IOE) is recommended by guidelines but remains underutilized. This study aims to illustrate the methodological application and clinical utility of a standardized IOE protocol in LHM. Methods: This study was a retrospective analysis of a prospectively maintained database of a consecutive series of patients who underwent LHM with routine IOE for achalasia at our institution in 2023. We present three consecutive cases. Preoperative evaluation included esophagography, upper endoscopy, and high-resolution manometry (HRM). The primary outcomes were the adequacy of myotomy, incidence of mucosal perforation, and postoperative symptomatic relief measured by the Eckardt score at three months. Results: Three female patients (aged 19, 30, and 65) with achalasia (Type I and II) underwent LHM with IOE. The mean preoperative Eckardt score was 9.3 ± 1.5. IOE was successfully used in all cases to: (1) precisely identify the gastroesophageal junction (GEJ) via transillumination, (2) facilitate submucosal dissection through controlled insufflation, (3) confirm mucosal integrity with an air leak test, and (4) verify a patulous GEJ post-myotomy. No mucosal perforations occurred. At three-month follow-up, the mean Eckardt score significantly improved to 0.3 ± 0.6 (p < 0.05). All patients reported resolution of dysphagia and significant improvement in nutritional status. Conclusion: Our experience with this consecutive series supports the utility of systematic IOE during LHM. It appears to be a valuable tool for enhancing procedural safety, ensuring myotomy adequacy, and achieving optimal short-term functional outcomes. These findings reinforce existing guidelines and should encourage wider adoption of this critical surgical adjunct.