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Clinico-moleculo-pathological Conference (CMPC): A Clinical Teaching Method to optimise knowledge integration and collaboration in the workplace-based specialist education Bekti, Rachmad Sarwo; Seputra, Kurnia Penta
Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Vol 14, No 2 (2025): June
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jpki.105471

Abstract

Integrating current molecular knowledge and research with real-world clinical and pathological conditions is a critical step in finding the most appropriate approach for modern and personalized patient care. A modified clinicopathological conference, called the Clinico-molecular-pathological conference (CMPC), was introduced in one out of five introductory specialist training courses at our teaching hospital. It is intended to enhance the application of basic biomedical sciences, particularly biomolecular aspects, in integrated clinical care and personalised medicine. We attempted to analyse the CMPC’s implementation and its educational impact from the perspectives of trainees through a program evaluation activity adopting the first two levels of the Kirkpatrick Pyramid. From 4 batches (2022-2024), 433 out of 447 residents (96.87% response rate) responded to our online program evaluation questionnaire. From the reaction and learning level, the CMPC has convincingly been favoured by residents as an engaged learning method for elaborating basic medical sciences, especially biomolecular topics, into a real clinical and patient care context. Despite the poor correlation of the course’s overall satisfaction to the CMPC mark and final course marks (p>0.05), there is a positive and significant correlation between CMPC mark and Course Final mark (r=0.39; p=0.00). Qualitative response to the survey triangulated the acceptance of CMPC as a promising learning method to promote integrated learning as well as multidisciplinary collaboration. The case study provides insight into how CMPC is favoured by the residents to learn difficult subjects, and is related to academic achievement. CMPC is also perceived to be a promising method to promote integration in patient care in medical specialist education. Further research is needed to optimise both the educational and quality service impact of the CMPC in the workplace-based medical specialist education.
THE RELATIONSHIP OF NEUTROPHIL-TO-LYMPHOCYTE RATIO (NLR) WITH LOCALIZED AND NON-LOCALIZED TESTICULAR GERM CELL TUMORS Seputra, Kurnia Penta; Nurhadi, Pradana; Husein, Rahmat
Indonesian Journal of Urology Vol 32 No 3 (2025)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v32i3.1019

Abstract

Objective: This study aim to reveal the relationship preoperative neutrophil-to-lymphocyte ratio (NLR) with testicular germ cell tumors (GCT). Material & Methods: A total of twenty-six patients diagnosed with TGCT from 2017 to 2022 in Saiful Anwar Hospital, Malang were included in this retrospective study. Patients were grouped as localized and non-localized. Hematological and biochemical blood measured the days before radical orchiectomy. Results: Eleven patients (42.3%) had seminomas and fifteen patients (57.7%) had non-seminomatous testicular cancer. Six patients (23.1%) had localized and twenty patients (76.9%) had non-localized testicular cancer. There was a statistically significant difference between mean NLR of the localized patients and non-localized patients (localized NLR: 1.7±0.84, non-localized: 3.65±0.97, p=0.000). The optimal cut-off value for localized and non-localized TGCT was 3.05 with sensitivity 83.33% and specificity 75%. That was statistically significant between cut-off value NLR with localized and non-localized TGCT (correlation coefficient 0.505, p=0.008). Conclusion: NLR appears to be a useful marker for TGCT. It is successful in predicting localized and non-localized disease in early preoperative period. Keywords: Neutrophil-to-lymphocyte ratio, testicular cancer, testicular germ cell tumors.
COMPLICATIONS OF PERCUTANEOUS CYSTOSTOMY AT TERTIARY HOSPITAL Prabowo, Satria Adji Hady; Daryanto, Besut; Seputra, Kurnia Penta
Indonesian Journal of Urology Vol 32 No 3 (2025)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v32i3.1053

Abstract

Objective: This study aims to identify the complications associated with percutaneous cystostomy performed at tertiary hospital. Material & Methods: This study employed a retrospective descriptive design involving patients who underwent percutaneous cystostomy at Saiful Anwar General Hospital from January 2019 to December 2024. Data were collected by reviewing patient medical records, including information on average age, gender, diagnosis, and complications related to the procedure. Complications were classified into intra-procedural and post-procedural categories. This study was approved by the Health Research Ethic Commission of Saiful Anwar General Hospital No: 400/050/K.3/102.7/2025. Results: A total of 72 patients were included in the study (71 males, 1 female), with an average age of 58.58 years. Early complications observed in 7 patients included catheter obstruction in 6 patients (8.3%) and hematuria in 1 patient (1.4%). Late complications limited to surgical site infection, which occurred in 3 patients (4.2%). Conclusion: Percutaneous cystostomy is a safe and effective procedure with a low complication rate, making it a viable routine practice in clinical urology. Keywords: Percutaneous cystostomy, urinary retention, complications
CARCINOMA TESTIS PROFILE IN TERTIARY HOSPITAL Chaerul , Harry Achsan; Seputra, Kurnia Penta; Daryanto, Besut
Indonesian Journal of Urology Vol 30 No 1 (2023)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v30i1.816

Abstract

Objective: This study was undertaken to estimate the epidemiological characteristics, histological types, and subtypes of testicular neoplasm according to the WHO classification in our patient group. Material & Methods: This was a retrospective study done over a period of ten years from January 2010 - December 2020 in our institution. Histopathological slides were retrieved and reviewed for tumour. Testicular Neoplasm patients who underwent orchidectomy and chemotherapy clinical data including the patient’s age, tumor location, tumor side, pathological finding, tumor marker, chemotherapy regiment, prognosis, chemotherapy response, and side effect were observed. All the data were analyzed descriptively and using SPSS 17.0. Results: A total of 31 cases of testicular and paratesticular neoplasm were encountered in our study with a mean age of 32.516.2 years. The highest incidence was 15-35 years old (48.3). Scrotum mass was the most frequent clinical presentation (70.96%) and left side became the predominant area (52%). Most of the patients come in late stage T3 (51.61%) and N3 (67.74%) with no metastatic process (70.96). The major pathological finding was Seminoma (64.51%), Teratoma (16.12), Yolk Sac (12.9%), Embryonal, and Mixed (3.22%). AFP, B-HCG, and LDH were elevated in some Seminoma, Teratoma, and Yolk Sac groups. The most wide chemotherapy used was 4 series BEP (87.09%). Patient prognosis highest incidence were Intermediate (70.96%). Most of the patients showed complete response (67.74) of chemotherapy. Nausea, vomiting, alopecia, and mucositis were observed as chemotherapy side effect in all patients. Conclusion: Testicular neoplasm peak incidence appears in young male. Most patients come to health care service in late stage. Seminoma become the highest testicular neoplasm incidence in our study. Elevated tumor markers were found in some patients. Four cycle BEP chemotherapy regiment showed great outcome for these patients. Keywords: Epidemiological, histological, testicular neoplasm.
CHARACTERISTIC CHEMOTHERAPY RESPONSE OF TESTICULAR CANCER PATIENTS IN TERTIARY HOSPITAL Fabrianta, Dio Mafazi; Seputra, Kurnia Penta; Daryanto, Besut
Indonesian Journal of Urology Vol 29 No 3 (2022)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v29i3.823

Abstract

Objective: The purpose of this study was to determine the correlation of testicular tumor markers on the success of chemotherapy in my institution. Material & Methods: This research is a retrospective study single center using the medical record database at the span of the research period. The patient with testicular carcinoma who underwent complete chemotherapy between 2017 until 2022 was included. The data collected and analyzed by descriptive data and analytical correlation using SPSS Ver. 25. The comparation test using T-test and Anova. Results: A total of 31 testicular cancer patients were enrolled in the study. Fifteen patients were seminoma and 16 patients were non-seminoma. The mean age of patient at presentation of seminoma and non seminoma were 38.3 ± 17.03 and 30.74 ± 13.01. Most patients presented a karnofsky score about 79 ± 15. There was a negative correlation (r=-0.492) with a significant correlation between the types of testicular carcinoma cases and the response to chemotherapy (p=0.027). There was a significant difference in cases of seminoma and non-seminoma to the success of the chemotherapy response (p=0.024). There was a positive correlation between serum β-HCG, AFP, LDH with serial chemotherapy result with a no significant correlation (p=0.879; p=0.242; and p=0.277). Conclusion: Most types of the testicular carcinoma responses to chemotherapy. Patients with seminoma pathology have better response to chemotherapy compared to non-seminoma.
EARLY-STAGE TESTICULAR CANCER MANAGEMENT REFERRING TO EUROPEAN ASSOCIATION OF UROLOGY (EAU) GUIDELINES: A SURVEY IN INDONESIA Zen Ary Prasetyo; Seputra, Kurnia Penta; Rainy Umbas; Besut Daryanto
Indonesian Journal of Urology Vol 30 No 2 (2023)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v30i2.842

Abstract

Objective: This study aimed to determine the management of early-stage testicular cancer among urologists in Indonesia by using a survey. Material & Methods: This research was a descriptive-analytic study using a survey method through a Google-forms questionnaire distributed to urologists throughout Indonesia who were willing to participate. Data were collected from September 1 to 30, 2021. Results: Of the total respondents, 15 (14.2%) respondents were consultant urologic oncologists, and 90 (85.71%) respondents were non-consultant urologists or consultant urologists non-oncology. There was no difference in the treatment given by consultant uro-oncologists and non-consultant urologists/consultant urologists non-oncology in the management of surveillance of stage IA-IB seminoma (66.7% vs. 55.6%, p-value = 0.207), chemotherapy of stage IIA-IIB seminoma (100.0% vs. 90.0%, p-value = 0.080), surveillance of stage I non-seminoma cancers (46.7% vs. 41.1%, p-value = 0.304), and chemotherapy of stage IIA and IIB non-seminoma cancers (80% vs. 91.1%, p-value = 0.193). Conclusion: In general, as many as 84.4% of oncology consultant urologists and 83.7% of non-consultant urologists/consultant urologists non-oncology have performed initial diagnostic examinations, treatment, and follow-up following testicular cancer management guidelines according to the European Association of Urology 2021.
HIGH FLOW PRIAPISM IN 7 YEARS-OLD BOY AFTER ACCIDENTALLY CONSUMING APHRODISIAC CHOCOLATE: A CASE REPORT Samudra, Fathan Satria; Seputra, Kurnia Penta; Daryanto, Besut; Nurhadi, Pradana
Indonesian Journal of Urology Vol 30 No 3 (2023)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v30i3.904

Abstract

ABSTRACT Objective: This case report aimed to present our experience of conservative treatments for High Flow Priapism in children. Case(s) Report: A 7 years old boy presented with persistent and painless erections without sexual stimulation for 24 hours, the erection was first noticed when he woke up in the morning after accidentally consuming aphrodisiac chocolate 2 days before admitted to the hospital. There was no previous history of priapism and trauma or other risk factors. Discussion: Laboratory studies were within normal limits. Physical examination revealed a fully erect, nontender penile with rigid corpora cavernosa, soft glans, and erection hardness scale (EHS) 3. A cavernosal blood gas analysis was collected with the following values PH 7.41, pO2 117,7 mmHg, and pCO2 24, 8 mmHg. With diagnosis of High Flow Priapism, he was observed and got conservative treatments; ice and site-specific compression and after that EHS become 1. On follow-up after 2 months reported that patient had normal erections with no further episodes of priapism. Conclusion: High flow priapism in old boy after accidentally consuming aphrodisiac chocolate can managed by conservative therapy with favourable outcome. Keywords: Aphrodisiac chocolate, penile erection, priapism.
PSA LEVEL AND ADVERSE EVENTS IN SIXTH AND TENTH SERIES DOCETAXEL CHEMOTHERAPY IN CASTRATE-RESISTANT PROSTATE CANCER (CRPC) PATIENTS Seputra, Kurnia Penta; Kustono, Andri; Hakim, Muhammad Baihaqy Ibnu
Indonesian Journal of Urology Vol 32 No 1 (2025)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v32i1.917

Abstract

Objective: This study aims to compare the efficacy of docetaxel on PSA levels and to analyze the adverse events caused by docetaxel. Material & Methods: The study design was retrospective cohort. Participants were prostate cancer patients at Saiful Anwar Hospital who received androgen deprivation therapy with increased PSA level 3 times the nadir or 2 bone lesions or soft tissue lesions > 2cm. PSA levels were assessed monthly. Participants were grouped into 6 and 10 series regimens. Adverse events of nausea, diarrhea, alopecia, SGOT SGPT abnormailties, creatinine abnormalities, anemia, and neutropenia were observed. Statistical analysis was performed using a differential T-test. Results: A total of 32 participants were involved. The PSA levels between 6 and 10 series groups were as follows: 1st month (142.2 vs 28.24 ng/mL,p=0.000), 2nd month (101.78 vs 16.98 ng/mL,p=0.001), 3rd month (472.35 vs 13.95 ng/mL,p=0.439), 4th month (120.64 vs 4.0 ng/mL,p=0.180), 5th month (64.325 vs 24.6 ng/mL, p=0.015), 6th month (41.915 vs 20.7 ng/mL,p=0.497). Adverse events in the 6 and 10 series regimens were nausea (25% vs 81.25%), diarrhea (37.5% vs 50%), alopecia (6.25% vs 43.75%), SGOT SGPT abnormalities (25% vs 56.25%), creatinine abnormalities (6.25% vs 37.5%), anemia (18.75% vs 31.25%), leukocytosis (6.25% vs 0%), and neutropenia (25% vs 12.5%). Adverse events in 6 series regimen began to occur in 3rd series with 1 participant experiencing nausea, and the most were 3 participants experiencing diarrhea in 6th series. Adverse events in 10 series regimen began to occur in 4th series with 1 participant experiencing nausea, 1 participant experiencing SGOT SGPT abnormalities, 1 participant experiencing diarrhea, and the most were 4 participants experiencing nausea in the 9th series. Conclusion: The 10 series of docetaxel chemotherapy is not superior to 6 series. Adverse events are more prominent in the 10 series. Keywords: Docetaxel, PSA, adverse events.