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Kidney Transplantation in Semarang: Outcomes and Prognosis Eriawan Agung Nugroho; Tommy Supit; Ardy Santosa; Nanda Daniswara; Sofyan Rais Addin; Anggun Ari Mukti
Medica Hospitalia : Journal of Clinical Medicine Vol. 6 No. 1 (2019): Med Hosp
Publisher : RSUP Dr. Kariadi

Introduction & objective:Kidney transplantationis increasingly performed acrossIndonesia, including in Semarang. However there are limited publications onrenal transplantationfrom Indonesia, especially from centers outside Jakarta. The objective of this case series is to give a brief overview on the transplantation performed in Semarang, discusscurrent issues and ongoing efforts to address them. Case series:Twenty-seven renal transplants in Dr. Kariadi General Hospital from January2012 until July 2018wereretrospectively analyzed. On average recipients were younger (32.5 years old) compared to the donors (46.8 years old). All kidneys were acquired from living donors with the majority of them to be blood-related(74.1%). The 3 leading etiologies of end-stage renal disease were hypertension (36.0%), diabetes mellitus (26.9%), and autoimmune disease (11.2%). The average total ischemic time was 36.9 minutes andthe average length of stay was 11 days. We report 5 cases of mortality, 3 cases of allograft rejection and no re-transplantation. Discussion: The demographics of kidney transplant patients in Semarang were similar compared to the National data. The limited number of transplant in Semarang contributes to the low number of survival rate and highlights the need of further training and expertise. Better survival rate can be achieved with more transplants number as well as reaching the plateau of learning curve within the coming years. Conclusion: The development of kidney transplant in Semarang follows the National milestones. In order to maximize the potentialthe institution, further improvements should concentrate on the development of integrated organ transplant infrastructure. The main goal of this institution is to establish a solid transplant center capable of covering Central Java, aiding the decentralization of kidney transplant in the Nation Keywords: Kidney transplantation, End-stage Renal Disease, Chronic Kidney Disease, Indonesia, Semarang, Epidemiology, Update

Primary Non-Hodgkin’s Lymphoma of the Female Urethra Presenting as Carunculous of Urethra: A Very Rare Case Report Tan Hengky; Nanda Daniswara; Ardy Santosa; Adi Soedarso; Eriawan Agung Nugroho; Sofyan Rais Addin
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Background: Female urethral carcinoma occurred < 1% of all female malignancies. With a small prevalence of Malignant Urethral Lymphoma, there is lack of data about quality of the therapy. Case Report: A 41-year-old woman came to Division of Urology, Department of Surgery Dr. Kariadi Hospital Semarang with chief complaint a recurrence mass on her urethra. Her general condition was fine, and has a normal vital signs. On the physical examination of urogenital region, there was mass on the orifice of urethra external that can easily bleed. She is already performed excision of urethral caruncle with immunohistochemistry examination and found CD-20 positive which indicated a diffuse B-cell Lymphoma. Then she had 6 cycle chemotherapy procedures in Division of Hematooncology, Internal Medicine Department. Until now, she routinely check-up to urology and internal medicine departments to monitor her disease progression. Conclusion: Female urethral carcinoma is very rare, although surgery alone has been established as effective for treating low-stage urethral cancer, neither surgery nor radiation therapy alone provide good results. Delay in diagnose and treatment can decrease patient survival. Keyword: non-Hodgkin’s lymphoma, immunohistochemistry, Urethral carcinoma, urethral caruncle, chemotherapy

The Correlation between Total Ischemic Time with Length of Hospitalization : a Single Centre Report Eriawan Agung Nugroho; Muhamad Azwin Kamar; Dila Junita
International Journal of Science and Engineering Vol 13, No 1 (2019)
Publisher : Chemical Engineering Diponegoro University

Kidney transplantation is recognized as an advanced modern therapeutic modality for patients with end stage renal failure. Cold Ischemic Time (CIT) has been found as an important independent risk factor for delay graft function (DGF) in kidney transplantation. Recent studies suggested that prolonged Warm Ischemic Time (WIT) may decrease graft’s survival in living kidney transplantation donor.This study aimed to evaluate the total ischemic time during recipient surgery and accessed its contribution for hospitalization time in kidney transplantation patients.This is an observational, cross sectional study. The datawas collected from medical record of patient who underwent kidney transplantation from 2014 until December 2018at Kariadi General Hospital Semarang. There were 28 patients, 18 were maleand 10 were female.Total ischemic time was compared with length of hospitalization. Data was analyzed with Spearman test in SPSS version 23. The study showed that total ischemic time was significantly correlated with hospitalization time (p < 0.001). However, donor’s age did not affect prolonged total ischemic time with p = 0.673, which is not significant (significant if p value < 0.05). In conclusion, total ischemic time has a significant correlation with hospitalization time. In contrary, no significant correlation between donor’s age and prolonged total ischemic time.

Hospital Waste Management in Kidney Transplantation Procedure: Implications and Solutions Eriawan Agung Nugroho; Leonardo Cahyo Nugroho
Waste Technology Vol 7, No 1 (2019)
Publisher : Diponegoro University

The number of patients diagnosed with end-stage renal disease (ESRD) in Indonesia is increasing annualy, showing a similar trend with the global prevalence. Withits superior outcome, kidney transplantation remains to be the traetment of choice for ESRD. The treatment with transplant kidney procedure makes extensive use of presterilized disposable items which, after use, are contaminated by blood. The preferred route of disposal of such items is by incineration. Disposal costs have risen and this increase in costs has not been matched by waste management programs in kidney transplantation procedure. Many of the waste items like container for blood products and intravenous infusion fluid contain erwhichiswidely used in kidney transplantation procedure generated alsoconta in polyvinylchloride (PVC) whose incineration is environmentally sensitive. Furthermore blood tubing sets contain plasticizers such as di(2-ethylhexyl) phthalate (DEHP), which is known to pose health risks to specific groups of patients. The generation of hospital waste in a kidney transplantation procedure is analyzed, issues associated with disposal are discussed, and approaches toward a cost effective environmentally sustainable hospital waste management program are reviewed.

Efficacy of Combination Dutasteride and Lycopene to Reduce Bleeding in Benign Prostate Hyperplasia (BPH) Post- Transurethral Resection of the Prostate (TURP) Overview of Hypoxia inducible factor-1 alpha (HIF-1 α) Expression and Hematocrit Levels Eriawan Agung Nugroho; Siti Amarwati; Nugroho Akhbar
Majalah Obat Tradisional Vol 25, No 1 (2020)
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/mot.45933

Trans Urethral Resection of the Prostate (TURP) is one of the gold operating standards for people with Benign Prostate Hyperplasia (BPH), but the complications, like bleedings, often occur both in durante and post-surgery. The risk of bleeding in TURP is caused by angiogenesis. Hypoxia-Induced Factor-1 Alpha (HIF-1 α) is one of the trigger factors for angiogenesis in BPH. Based on the existing literature, it was found that there was a relationship between lycopene and dutasteride which both had a synergistic effect in inhibiting angiogenesis. However, the mechanism is unknown. This study aims to assess the effectiveness of the combination of dutasteride and lycopene on the expression of HIF-1α and hematocrit levels in BPH patients undergoing TURP surgery. This research was an experimental study with "Double-Blind Randomized Controlled Trial Post Test Only Design". The 22 patients were divided into 2 groups, namely T (dutasteride + lycopene), C (lycopene+plasebo), which were given every 24 hours for a minimum of 30 days until the TURP operation was carried out. The observation of HIF-1α expression used immunohistochemical methods. Different tests were conducted between the groups with Independent T-test. The result shows the combination of dutasteride and lycopene was not significant in reducing the HIF-1α expression, indicated by mean rank in the group (C) (= 21.60), group (T) (= 20.00). The results obtained from the Independent T-test were (p = 0.410), meaning the difference in HIF-1α expression between the 2 groups was not significant: Average Δ Ht group C (= 1.26); group T (= -0,98). The statistical test with the Independent T-test obtained (p = 0.027), where there were significant differences. Giving a combination of dutasteride and lycopene for at least 30 days pre-TURP surgery was not effective in reducing the expression of hypoxia-induced factor - 1 alpha (HIF-1α) but was effective in reducing hematocrit levels compared to a single administration of dutasteride in BPH patients undergoing TURP surgery.

Phlebotrophic Effect of Graptophyllum Pictum (L.) Griff on Experimental Wistar Hemorrhoids Mario Sadar Bernitho Hutagalung; Bernadus Parish Budiono; Sigit Adi Prasetyo; Ignatius Riwanto; Eriawan Agung Nugroho; Yan Wisnu Prajoko; Neni Susilaningsih
Journal of Biomedicine and Translational Research Vol 5, No 1 (2019): July 2019
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v5i1.3704

Background : The 1st and 2nd degree hemorrhoids is managed non-operatively with the anti-inflammatory and plebothropic drugs. Graptophyllum pictum extract (GPE) has already been used widely in Indonesia to treat hemorrhoid with good result, however, the mechanism is not supported by the molecular research.Objective : This study is intended to study the phlebothropic effects of GPE by measuring the degree of edema and extravassal leucocytes of experimental wistar hemorrhoid.Methods : Experimental study with Randomized Controlled Trial Post-test only design in male wistar rats, weight around 200 gr, induced for the development of a disease-like condition of hemorrhoids by 6% croton oil on the anus for 3 days. Random allocation was performed to divide the 14 wistar rats in 2 groups. Group I as control got normal saline solution, while group II was treated with GPE 100mg/kgbw, started on day 4th for 5 consecutive days. On 9th day blood was extracted from retroorbital fossa and anus was resected up to 2 cm from anal verge and weighted. The degree of anal edema was measured by rectoanal coefficient, that is rasio between anal weight (miligrams) and body weight (grams).Results : Until the end of study, all wistar rat were still alive. The mean (±SD) of body weight of control group was 173.84 (±13.37) and the treatment group was 171.70 (±13.10), and there was no significant differences (p = 0.833). The mean (±SD) of rectoanal coefficient in the treatment group was 2.46 (±0.41) and it was significantly lower than control group (3.13 ± 0.85) (p = 0.029). The mean (±SD) of extravassal leukocytes in the treatment group was 900.14(±48.09) and it was significantly lower than the control (1003.28 ± 99.30) (p = 0.042).Conclusions : Graptophyllum pictum extract at doses of 100 mg/Kgbw have phlebotonic effect in decreased edema and extravassal leukocytes.

Association between Hyperglycemia and Prostate Volume in Patients with Benign Prostate Enlargement : A Hospital Case-Control Study Eriawan Agung Nugroho; Rickky Kurniawan
Journal of Biomedicine and Translational Research Vol 3, No 2 (2017): December 2017
Publisher : Faculty of Medicine, Diponegoro University

Introduction: Prostate is a male organ which might enlarge mostly, either benign or malignant. Hyperglycemia is one of the factor that increase the risk of benign prostate hyperplasia. There is lack of studies which assessed the relationship between benign prostate hyperplasia and isolated hyperglycemia. The aim of this study was to evaluate the association between hyperglycemia and prostate volume in patients with benign prostate enlargement in dr. Kariadi Hospital Semarang. Method: We conducted a retrospective analysis of clinical data which obtained from 640 men between 2010 and 2012 who admitted to the hospital with diagnosis of benign prostate enlargement. By their medical records, these patients were evaluated of their plasma glucose level and prostate volume by trans rectal ultrasound. The presence of hyperglycemia was determined based on the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Patients have already been diagnosed with controlled diabetes mellitus by an internist. We allocated the subjects into two groups: patients with hyperglycemia and non-hyperglycemia. Logistic regression analysis was used to assess whether hyperglycemia was associated with the increased risk of benign prostate enlargement.Results: Significant difference of prostate volume found between groups. Prostate volume was significantly greater in hyperglycemia group compared with non-hyperglycemia ones in all sub-groups based on age (in decades). Odds Ratio (OR) in patients with hyperglycemia was 2.25 (95% CI: 1.23-4.11). By non-parametric Spearman test it obtained Group 1 (P1) p = 0.000 and r = 0.669, group 2 (P2) it obtained p = 0.000 and r = 0.672, group 3 (P3) it obtained p = 0.000 and r = 0.415 which implied strong positive associationConclusion: Hyperglycemia and prostate volume were significantly associated in patients with benign prostate enlargement. Hyperglycemia became a significant risk factor for prostate enlargement in patients with benign prostate enlargement in dr. Kariadi Hospital Semarang.

Correlation of Prolonged Total Ischemic Time with Body Mass Index in Kidney Transplant: A Single Center Report Eriawan Agung Nugroho; Erwin Wibowo; Prathita Amanda Aryani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 11 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i11.367

Background: Chronic kidney disease (CKD) is a rising health concern worldwide, especially in Indonesia. The treatment of choice for end-stage renal disease is Kidney Transplantation.1 Numerous studies showed that prolonged total ischemic ischemic time may cause hypoxia of the graft tissue and increased risk of ischemia and reperfusion injury (IRI) and delayed graft function (DGF).2 Body mass index of kidney transplant recipients may cause prolonged duration of the procedure, as well as prolonged total ischemic time. This study aimed to determine the correlation between prolonged total ischemic time with body mass index. Method: This was an observational and cross-sectional analysis at Kariadi General Hospital Semarang involving patients who underwent kidney transplantation from January 2016 to December 2019. The total ischemic time was recorded intraoperatively. The Body Mass Index data were provided by medical records. The program used to statistically analyze the data was SPSS 23.0, and Spearman was used for hypothesis testing. Result: This study included 25 kidney transplant recipients. The mean total ischemic time was 43,27 ± 6,63 minutes. There was a significant positive correlation between prolonged ischemic time and body mass index (r= 0,506 ; p= 0,010). Conclusion: Prolonged total ischemic time was positively correlated with increased body mass index and these results are statistically significant.

Correlation of Prolonged Total Ischemic Time with Body Mass Index in Kidney Transplant: A Single Center Report Eriawan Agung Nugroho; Erwin Wibowo; Prathita Amanda Aryani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 11 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i11.367

Background: Chronic kidney disease (CKD) is a rising health concern worldwide, especially in Indonesia. The treatment of choice for end-stage renal disease is Kidney Transplantation.1 Numerous studies showed that prolonged total ischemic ischemic time may cause hypoxia of the graft tissue and increased risk of ischemia and reperfusion injury (IRI) and delayed graft function (DGF).2 Body mass index of kidney transplant recipients may cause prolonged duration of the procedure, as well as prolonged total ischemic time. This study aimed to determine the correlation between prolonged total ischemic time with body mass index. Method: This was an observational and cross-sectional analysis at Kariadi General Hospital Semarang involving patients who underwent kidney transplantation from January 2016 to December 2019. The total ischemic time was recorded intraoperatively. The Body Mass Index data were provided by medical records. The program used to statistically analyze the data was SPSS 23.0, and Spearman was used for hypothesis testing. Result: This study included 25 kidney transplant recipients. The mean total ischemic time was 43,27 ± 6,63 minutes. There was a significant positive correlation between prolonged ischemic time and body mass index (r= 0,506 ; p= 0,010). Conclusion: Prolonged total ischemic time was positively correlated with increased body mass index and these results are statistically significant.

The Effect of Combination of Green Tea and Roselle Extract on Morphology and Motility of Spermatozoa in Rats Induced by Monosodium Glutamate Nurjaya Adinugroho; Awal Prasetyo; Eriawan Agung Nugroho
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 9 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i9.576

Background: Infertility is a reproductive system problem and has been increasing recently. One of the reasons is the poor quality of spermatozoa, which can be assessed through its morphology and motility. Excessive consumption of MSG can affect the quality of spermatozoa. The provision of a combination of green tea and roselle extract, which is an antioxidant and is expected to be able to counteract the effects of MSG’s free radicals on spermatozoa. The objective of the study is to determine the morphology and motility of Wistar Rats’ spermatozoa in the control group given MSG and in the experimental group given MSG and a combination of green tea and roselle extract at a dose of 200 mg/kg/day and 400 mg/kg/day for 14 days. Methods: Fifteen Wistar rats were randomly divided into three groups, a control group with MSG, group 1 with MSG and a combination of green tea and roselle extract at a dose of 200 mg/kg BW/day (P1), and group 2 with MSG and combination green tea and roselle extract at a dose of 400 mg/kg BW/day (P2). After 14 days of treatment, the morphology and motility of the spermatozoa of each mouse were studied and assessed microscopically. Results: In the morphological study, the control group had the lowest normal value and the highest abnormal value among all groups. Meanwhile, the P1 group had the highest normal and lowest abnormal values compared to the other two groups. Conclusion: The administration of a combination of green tea and roselle extract improved the morphology and motility of Wistar rats’ spermatozoa. However, an increased dose of a combination of green tea and roselle extract was not proven to affect the morphology and motility of Wistar rats' spermatozoa.

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