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PENGARUH KEMORADIASI KANKER KEPALA LEHER TERHADAP KADAR UREUM DAN KREATININ SERUM Iqhbal, Rahmadonal Muhammad; Ningrum, Farah Hendara; Prihharsanti, CH Nawangsih
DIPONEGORO MEDICAL JOURNAL (JURNAL KEDOKTERAN DIPONEGORO) Vol 7, No 2 (2018): JURNAL KEDOKTERAN DIPONEGORO
Publisher : Faculty of Medicine, Diponegoro University, Semarang, Indonesia

Latar belakang : Salah satu modalitas kemoterapi pada kanker kepala leher adalah kombinasi kemoterapi dan radioterapi. Pemberian kemoterapi neoadjuvant menjadi pilihan terapi. Penggunaan regimen kemoterapi dan tindakan radioterapi tidak hanya membunuh sel-sel kanker, akan tetapi dapat menimbulkan toksisitas pada tubuh penderita. Cisplatin merupakan golongan obat kemoterapi berbasis platinum yang memiliki efek samping penurunan fungsi ginjal.Tujuan : Mengetahui pengaruh kemoradiasi kanker kepala leher terhadap fungsi ginjal pada kadar ureum dan kreatinin dalam darah.Metode : Penelitian observasional cross sectional (non-komparatif) yang dikaji menggunakan data rekam medik di RSUP Dr Kariadi Semarang tahun 2012-2016. Sampel merupakan pasien dengan kanker kepala leher yang mendapat kemoterapi neoadjuvant yang dipilih berdasarkan consecutive sampling. Penilaian fungsi ginjal diambil dari hasil laboratorium kadar ureum dan kreatinin sebelum dan sesudah kemoradiasi. Uji statistik dilakukan menggunakan Uji Wilcoxon.Hasil: Didapatkan 21 sampel yang merupakan pasien karsinoma nasofaring yang telah menjalani kemoterapi neoadjuvant yang terbagi dalam pemberian sebanyak IV siklus, V siklus, VI siklus dengan 33x radioterapi.Data yang diperoleh dalam persentase yaitu kadar ureum meningkat 90,5% dan kadar kreatinin meningkat 90,5%. Hasil analisis data menunjukkan terdapat pengaruh yang bermakna pada kadar ureum dan kreatinin sebelum dan sesudah pemberian kemoterapi neoadjuvant p<0,05 (p=0,01).Kesimpulan : Ditemukan peningkatan antara kadar ureum dan kreatinin sebelum dan sesudah kemoradiasi kanker kepala leher

HUBUNGAN DERAJAT XEROSTOMIA DENGAN PH SALIVA PASCA RADIOTERAPI KANKER KEPALA LEHER Novia Khoerunnisa; Farah Hendara Ningrum; Ch. Nawangsih Ch. Nawangsih
DIPONEGORO MEDICAL JOURNAL (JURNAL KEDOKTERAN DIPONEGORO) Vol 6, No 2 (2017): JURNAL KEDOKTERAN DIPONEGORO
Publisher : Faculty of Medicine, Diponegoro University, Semarang, Indonesia

Latar belakang Radioterapi memberi efek destruktif pada kelenjar saliva yang menyebabkan xerostomia dan juga menurunnya kapasitas buffer saliva sehingga terjadi penurunan pH. Penilaian derajat xerostomia dapat dilakukan secara objektif dengan pengukuran curah saliva dan subjektif menggunakan kuesioner xerostomia, salah satunya Groningen Radiotherapy Induced Xerostomia (GRIX).Tujuan Mengetahui hubungan derajat xerostomia dengan pH saliva pasca radioterapi kanker kepala leher.Metode Penelitian ini merupakan penelitian cross sectional observasional dengan sampel pasien yang menjalani radioterapi kanker kepala leher di Unit Radioterapi RSUP Dr. Kariadi Semarang. Data yang dikumpulkan dari data primer berupa skala rasio hasil pengukuran pH saliva dan data ordinal hasil penilaian kuesioner xerostomia. Uji statistik menggunakan uji normalitas data Saphiro Wilk dan dilanjutkan uji non parametrik Spearman Rank Correlation Test.Hasil Rerata pH saliva 6,37±0,19 dan rerata skor penilaian kuesioner 21.97±9.58. Terdapat hubungan negatif yang signifikan antara derajat xerostomia dan pH saliva dengan koefisien korelasi sebesar -0,529 (p < 0,05).Kesimpulan Terdapat hubungan negatif signifikan antara derajat xerostomia yang diukur dengan kuesioner GRIX dan pH saliva pada pasien pasca radioterapi kanker kepala leher di RSUP Dr. Kariadi Semarang. Semakin berat derajat xerostomia yang ditunjukkan dengan semakin tinggi skor pada kuesioner GRIX, maka akan semakin rendah pH saliva.

THE EFFECT OF PARACETAMOL AND CODEINE ANALGESIC COMBINATION ON SERUM GLUTAMIC OXALOACETATE TRANSAMINASE LEVELS IN MALE WISTAR RATS Rona Ayu Hanifah; Farah Hendara Ningrum; Erwin Kresnoadi; Satrio Adi Wicaksono
DIPONEGORO MEDICAL JOURNAL (JURNAL KEDOKTERAN DIPONEGORO) Vol 9, No 2 (2020): DIPONEGORO MEDICAL JOURNAL ( Jurnal Kedokteran Diponegoro )
Publisher : Faculty of Medicine, Diponegoro University, Semarang, Indonesia

Introduction : Paracetamol is an effective analgesic to relieve mild to moderate pain when it is used in therapeutic doses. Codeine is an opioid analgesic to relieve moderate to severe pain. Both are metabolized in the liver and have different mechanisms in the treatment of pain. The use of paracetamol and codeine as monotherapy has been extensive, but research on the effectiveness of these drugs in combination is still limited, especially about its effect in liver damage. This study was to investigate the effect of paracetamol and codeine analgesic combination Serum Glutamic Oxaloacetate Transaminase levels in male Wistar rats. Method : This was an experimental study using Post-Test Only Control Group Design. The samples were 24 male wistar rats randomized into 4 groups; group I (control group, without treatment), group II receiving paracetamol 32 mg/kgBB, group III receiving codeine 1,9 mg/kgBB, and group IV receiving combination of paracetamol 32 mg/kgBB and codeine 1,9 mg/kgBB. Drugs were administered through oral gastric instillation 4 times a day for 28 days. Blood samples were collected at the 29th day through retroorbital vessel to measure the SGOT levels. The data was analysed using One-Way ANOVA test and Post-Hoc test. Results : The results of this research were obtained from statistical tests where there was no significant increase of the levels of Serum Glutamic Oxaloacetate Transaminase of Wistar rats which received a combination of paracetamol and codeine in the control group (p = 0.005). While in the other group there was not significant differences of the levels of Serum Glutamic Oxaloacetate Transaminase. Conclusion : There is no significant difference of Serum Glutamic Oxaloacetate Transaminase levels between the administration of paracetamol and codeine combination compared to the control group.Keywords : Paracetamol, codeine, paracetamol and codeine combination, SGOT levels, pain

PENGARUH DEEP BREATHING AKUT TERHADAP SATURASI OKSIGEN DAN FREKUENSI PERNAPASAN ANAK OBESITAS USIA 7-12 TAHUN Syela Nirmada Herdiyanti; Tanti Ajoe Kesoema; Farah Hendara Ningrum
DIPONEGORO MEDICAL JOURNAL (JURNAL KEDOKTERAN DIPONEGORO) Vol 7, No 2 (2018): JURNAL KEDOKTERAN DIPONEGORO
Publisher : Faculty of Medicine, Diponegoro University, Semarang, Indonesia

Latar belakang : Obesitas mengakibatkan gangguan mekanisme ventilasi-perfusi dan gangguan pertukaran gasyang berakibat pada penurunan saturasi oksigen yang diikuti peningkatan frekuensi pernapasan. Deep breathing tidak invasif, mudah dilakukan, dan mampu meningkatkan compliance paru sehingga dapat memperbaiki pertukaran gas, sehingga mampu memperbaiki saturasi oksigen dan frekuensi pernapasan penderita obesitas.Tujuan penelitian : Mengetahui pengaruh deep breathing akut terhadap saturasi oksigen dan frekuensi pernapasan anak obesitas.Metode penelitian : Penelitian ini merupakan penelitian pra-eksperimental dengan rancangan one group pre test and post test. Subjek penelitian adalah sepuluh orang anak obesitas usia 7-12 tahun yang terdaftar sebagai siswa di Sekolah Dasar Negeri Tembalang yang dipilih dengan teknik purposive sampling. Subjek penelitian diberikan intervensi deep breathing selama 15 menit. Saturasi oksigen dan frekuensi pernapasan subjek penelitian diukur sebelum dan setelah melakukan deep breathing.Hasil penelitian : Uji hipotesis untuk perbedaan saturasi oksigen dan frekuensi pernapasan diuji dengan uji Friedman. Hasil uji hipotesis pada saturasi oksigen sebelum dan setelah melakukan deep breathing didapatkan nilai significancy sebesar p=0,019 (p<0,05), artinya terdapat perbedaan pada hasil pengukuran saturasi oksigen. Hasil uji hipotesis pada frekuensi pernapasan sebelum dan setelah melakukan deep breathing didapatkan nilai significancy sebesar p=0,209 (p>0,05), artinya tidak terdapat perbedaan pada hasil pengukuran frekuensi pernapasan.Simpulan dan saran : Deep breathing akut berpengaruh terhadap saturasi oksigen namun tidak berpengaruh terhadap frekuensi pernapasan. Deep breathing dapat dijadikan latihan untuk mempertahankan fungsi sistem pernapasan tetap baik pada anak obesitas.

Seorang Anak Perempuan 1 Bulan Dengan Apert Syndrom (Acrocephalosyndactyly Syndrome Type 1) Nareswari, Tara; Ningrum, Farah Hendara
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Latar Belakang Sindrom apert merupakan salah satu jenis acrocephalosyndactyly yang paling dikenal dan disebabkan oleh mutasi gen fibroblast growth factor receptors2 (FGFR2) Acrocephalosyndactyly didefinisikan sebagai sindrom kongenital ditandai dengan penutupan yang terlalu dini dari sutura sutura tengkorak (craniosynostosis) Hal ini menghasilkan kepala dan wajah yang berbentuk tidak normal, serta fusi jari tangan dan kaki (sindactyly) 1. Tujuan studi kasus ini adalah untuk mengetahui penegakhan diagnosis sindrom apert Laporan kasus Pasien datang ke poli anak RS Kariadi Semarang tanggal 15 Oktober 2018 yang merupakan rujukan dari RS Keluarga Sehat Pati, dengan assesment suspek sindrom tertentu DD/ Craniosinostosis syndrom, Baller gerold syndrom. Orangtua pasien mengeluhkan bahwa saat bernafas anak berbunyi grok grok. Kesan dari pemeriksaan radiologi skeletal survey adalah Craniosynostosis yang membentuk gambaran Harlequin Eye, Syndactyly manus kiri, Polyndactyly pedis kiri, yang mana dari keseluruhan tanda klinis tersebut mendukung gambaran Apert Syndrome. Sedangkan kesan dari pemeriksaan MSCT kepala tanpa kontras adalah Sutura coronaria kanan kiri tampak sudah menutup, microcephali, brachicephalic, tak tampak gambaran hidrocephalus, tak tampak kalsifikasi patologis yang mencurigakan suatu infeksi kongenital, tak tampak tanda tanda peningkatan tekanan intracranial Pembahasan Apert syndrome (acrocephalosyndactyly) adalah kelainan perkembangan yang jarang terjadi, ditandai oleh craniosynostosis, hipoplasia midface, syndactili simetris tangan dan kaki. Karakteristik prodromal untuk penampilan wajah-cranio yang khas adalah craniosynostosis awal jahitan koronal, dasar kranial dan agenesis dari jahitan sagital. Apert Syndrome adalah sindrom craniosynostosis yang paling dikenal luas Apert syndrome merupakan acrocephalosyndactyly tipe I adalah malformasi kongenital yang langka dengan dikarakteristikan oleh kraniosinostosis, hipoplasia mid-face, syndactyly pada tangan dan kaki. Pada pasien ini tampak synostosis sutura coronaria kanan kiri yang membentuk gambaran harlequin eye. Syndactyly tangan dan kaki, dengan syndactyly pada tangan yaitu tipe 2 atau biasa disebut mitten hand yaitu tampak fusi jari ke 2- 4 tanpa keikutsertaan ibu jari. Dengan penampilan klinis pada mid face pasien menunjukan wajah dismorfik, flat facies, mata proptosis, hidung low nasal bridge, dan mulut palatum letak tinggi Kesimpulan Apert Syndrom merupakan salah satu tipe Acrocephalosyndactyly yaitu kelainan kongenital akibat mutasi heterozigot pada gen FGFR2 dengan sifat dominant autosomal, yang ditandai dengan craniosinostosis, hipoplasia midface, dan syndactyly pada tangan dan kaki. Pemeriksaan radiologi memiliki peranan penting dalam mendiagnosa kelainan ini

Correlation between Preoperative Osteitis Degree with Postoperative Endoscopic Score in Chronic Rhinosinusitis Apriansyah, Apriansyah; Dewi, Anna Mailasari Kusuma; Ningrum, Farah Hendara
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 1 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i1.784

BACKGROUND: In chronic rhinosinusitis patients, there is a subgroup of patients with persistent symptoms after treatment, who often shows bone thickening and remodeling in their paranasal sinuses and described as osteitis. Osteitis can be evaluated by several methods, one of which is the Global Osteitis Score (GOS) AIM: To analyse the correlation between preoperative osteitis degree with the postoperative endoscopic scores in chronic rhinosinusitis METHOD: It was an observational study with cross-sectional design. We use GOS from CT scan before surgery and Lund Mackay’s endoscopic score 4 weeks after Functional Endoscopy Sinus Surgery (FESS). The analysis performed with Spearman correlation test. RESULT: There were 30 patients as subjects. There statistical analysis test between preoperative osteitis degree with post operative endoscopic score showed p = 0.296 with r = 0.197. The analysis result between risk factors for wound healing with the postoperative endoscopic score were allergic rhinitis (p = 1.000), polyps (p = 0.624), and smoking (p = 0.309) CONCLUSION: There is no significant correlation between preoperative osteitis degree with the postoperative endoscopic score, but there is a tendency for a positive correlation between preoperative osteitis degree with the postoperative endoscopic score. There was no significant correlation between allergic rhinitis, polyps, and smoking habits with postoperative endoscopic score

Significant Relationship Between Brixia Score And The Degree Of Acute Respiratory Distress Syndrome In Covid 19 Patients Ibrahim, Irni Dwi Aprianty; Satoto, Bambang; Handoyono, Thomas; Santoso, Antonius Gunawan; Sukmaningtyas, Hermina; NINGRUM, FARAH HENDARA
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 2 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i2.993

BACKGROUND: Chest X-ray has an important role in detecting early features of COVID-19. To improve risk stratification, a scoring system in chest x-ray called Brixia Score was developed. The Brixia score is designed to measure the severity of lung abnormalities in COVID-19, with an 18-point severity scale. Deaths in COVID-19 occur mainly due to Acute Respiratory Distress Syndrome (ARDS). ARDS is classified into mild, moderate, and severe degrees. If the degree can be predicted earlier, patients can receive earlier therapy and death rate can be reduced. AIMS: to analyze relationship between Brixia Score and degree of ARDS in COVID-19 patients. METHOD: the research used an observational analytic method with a cross-sectional approach to 95 subjects who are positive for COVID-19 and diagnosed with ARDS, in January to December 2021. Brixia Score data was collected based on chest X-ray expertise, ARDS degree was based on medical records and blood gas analysis. Analysis of relationship between Brixia score and degree of ARDS was carried out using the Kruskal-Wallis test. RESULT: There was a significant difference in Brixia score based on degree of ARDS (p value <0.05). The highest Brixia score was obtained in severe ARDS, while the low Brixia score was obtained in mild ARDS. This proves that there is a relationship between Brixia score and degree of ARDS. CONCLUSION: Brixia score has a significant relationship to the degree of ARDS in COVID-19 patients.

Correlation Between the Severity Of Chronic Rhinosinusitis and The Degree of Osteitis Based On Computerized Tomography Evaluation Israchmadi, Ardiga; Ningrum, Farah Hendara; Baskoro, Nurdopo; Dewi, Anna Mailasari Kusuma
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 2 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i2.1070

BACKGROUND: The incidence of chronic rhinosinusitis (CRS) is increasing every year, characterized by inflammation of the nasal and paranasal sinuses mucoperiosteum for more than 12 weeks. The inflammatory process of CRS sometimes spreads to the surrounding bone tissue resulting in osteitis. Computerized tomography scan (CT scan) can assess the degree of mucosal inflammation using the Lund-Mackay score (LMS) while the degree of bone thickening and remodelling are assessed with Global osteitis score (GOS) and Kennedy osteitis score (KOS). AIMS: To evaluate the correlation between CRS severity assessment using LMS and osteitis severity assessment using GOS and KOS METHODS: A retrospective analysis using a cross-sectional design was conducted that included 63 CT scans of the paranasal sinus of CRS patients. The spearman rank test was used to analyze data. RESULTS: Assessment using LMS showed 44% patients were classified as severe, while 29% and 27% patients were classified as moderate and mild respectively. Global osteitis score showed 2% patients were categorized as severe, while 22% and 46% patients were categorized as moderate and mild respectively, and 30% patients were not significant. Based on KOS assessment, it was found that 3% patients were classified as severe, while 38% and 59% patients were classified as moderate mild respectively. There was a significant correlation between CRS severity using LMS and GOS (p 0.000) with rho= 0.951. There was a significant correlation between CRS severity using LMS and KOS (p 0.000) with rho value= 0.452. CONCLUSION: This study shows a significant correlation between CRS severity assessment using LMS and bone thickening and remodelling assessment using GOS and KOS. In comparison with KOS, GOS has stronger relationship with LMS.

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