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Burden of Pediatric Cancer Treatment: Results of Online Pediatric Cancer Registry Prototype 1 at A Third Referral Hospital in Indonesia Sari, Nur Melani; Reniarti, Lelani; Suryawan, Nur; Susanah, Susi; Wahyudi, Kurnia
Althea Medical Journal Vol 4, No 3 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (606.214 KB) | DOI: 10.15850/amj.v4n3.1204

Abstract

Background: Despite the impressive progress of high-income countries, childhood cancer survival remains low in low and middle-income countries. Cancer is yet to be considered as a significant public health issue which has implicate only few pediatric cancer registry has been well established. The study aimed to describe the burden of pediatric cancer treatment in a third referral hospital in Indonesia through pediatric cancer registry.Methods: A-three-year retrospective analysis of 15 pediatric cancer diagnosed in children aged under 14 years was conducted at Dr Hasan Sadikin General Hospital, Bandung.  Data were extracted from Online Bandung Pediatric Cancer Registry Prototype 1 and analyzed for age, gender, type of cancer. The outcomes were classified as treatment abandonment, treatment refusal, interrupted treatment, death during treatment, and completed treatment.Results: Seven-hundred and seventy-three children, 452 males and 321 females, were diagnosed with 15 types of malignancies.  Peak incidence for each malignancy was different: at a young age was found in retinoblastoma and hepatoblastoma (mean; 3yo) while at adolescence in bone tumor and chronic myelocytic leukemia (9.1; 10 yo respectively). Distribution of the foremost malignancies recorded was: acute lymphoblastic leukemia (44.5%), retinoblastoma (15.2%), and non-Hodgkin lymphoma (8.9%). The cancer cure rate was very low (9.5%), treatment abandonment was still high (41.7%) and most patients died (27.8%) in the course of therapy either from advanced disease, infection, or late presentation. Meanwhile, 167 patients still continued the interrupted treatment.Conclusions: Cancer management is the burden for hospital, however the general outcome is very poor. 
MEMBRAN GUIDED TISSUE REGENERATION UNTUK REGENERASI PERIODONTAL: GUIDED TISSUE REGENERATION MEMBRANE FOR PERIODONTAL REGENERATION Agus Susanto; Susi Susanah; Bambang Pontjo; Mieke Hemiawati Satari
Dentika: Dental Journal Vol. 18 No. 3 (2015): Dentika Dental Journal
Publisher : TALENTA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (650.997 KB) | DOI: 10.32734/dentika.v18i3.1980

Abstract

Berbagai teknik bedah dan bahan terus dikembangkan untuk meningkatkan regenerasi periodontal. Salah satu metode bedahyang sering digunakan pada defek periodontal adalah menggunakan barriermembranguided tissue regeneration (GTR) atauguided bone regeneration (GBR). Prinsip GTR/GBR adalah menggunakan barriermembran untuk menutupi tulang danligamen periodontal, kemudian memisahkannya sementara dari epitel gusi. Fungsi membran ini meningkatkan dan menjagabekuan darah dan bertindak sebagai scaffold untuk perlekatan dan proliferasi sel. Terdapat dua jenis membran yaitumembran non resorbable dan resorbable. Membran non resorbable pada umumnya terbuat dari polytetrafluoroethylene,membran ini sifatnya stabil, nondegradable dan biokompatibel, tetapi penggunaannya memerlukan bedah kedua untukmengambil membran. Membran resorbable berasal dari bahan sintetis seperti polyglycolic, polylactic acid dan bahan alamiseperti kolagen dan laminar bone. Pembuatan membran yang ideal masih terus dikembangkan, membran kolagen saat inilebih sering digunakan karena mempunyai biocompatibility yang optimal walaupun tingkat resorpsi membran sulit untukdiprediksi.
HUBUNGAN TIPE THALASSEMIA β SERTA POLIMORFISME C.-582 A>G PROMOTOR GEN HAMP DAN STATUS BESI THALASSEMIA β BERAT BARU Susanah, Susi; Idjradinata, Ponpon
Majalah Kedokteran Bandung Vol 47, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (704.04 KB)

Abstract

Kelebihan besi merupakan penyebab morbiditas dan mortalitas penderita thalassemia ? berat. Terdapat berbagai faktor yang memengaruhi status besi thalassemia ? berat. Penelitian ini bertujuan menganalisis  hubungan  tipe thalassemia ? serta polimorfisme c.-582 A>G promotor gen hepcidine antimicrobacterial peptide (HAMP) dengan status besi thalassemia ? berat baru. Penelitian dengan metode potong lintang dilakukan di Rumah Sakit Dr. Hasan Sadikin/Fakultas Kedokteran Universitas Padjadjaran Bandung selama November?Desember 2012. Subjek penelitian adalah penderita thalassemia ? berat yang baru didiagnosis berdasarkan pemeriksaan klinis dan laboratorium. Subjek belum pernah mendapatkan transfusi darah dan memiliki kadar C-reactive protein normal. Status besi dinilai dengan mengukur kadar feritin serum (FS) dan saturasi transferin (ST). Analisis statistik yang digunakan adalah uji-t, Uji Mann-Whitney, dan uji chi-kuadrat. Didapatkan 29 subjek thalassemia ? berat baru, 24 thalassemia ? mayor dan 5 thalassemia ?/HbE berat. Tidak ada perbedaan status besi antara kedua tipe thalassemia ? berat baru maupun antara yang mengalami polimorfisme dan yang tidak mengalami polimorfisme c.-582 A>G promotor gen HAMP (p>0,05). Simpulan, tipe thalassemia ? berat dan polimorfisme c.-582  A>G promotor gen HAMP tidak berhubungan dengan status besi penderita thalassemia ? berat yang baru didiagnosis. [MKB. 2015;47(3):192-98]Kata kunci: Feritin, polimorfisme c.-582 A>G promotor gen HAMP, saturasi transferin, thalassemia ? berat Association of ?-thalassemia Type and Polymorphisms of c.-582 A>G Promoter HAMP Gene and Iron Status in Newly Diagnosed Severe ?-thalassemiaAbstractIron overload is the common  cause of morbidity and mortality in severe ?-thalassemia patients. Many factors influence the  iron status in severe ?-thalassemia. This study aimed to analyze the association of ?-thalassemia type, polymorphism c.-582 A>G promotor hepcidine antimicrobacterial peptide (HAMP) gene,  and  iron  status in newly diagnosed severe ?-thalassemia. A cross-sectional study was performed at Dr. Hasan Sadikin General Hospital/Faculty of Medicine, Universitas Padjadjaran Bandung from November to December 2012. Subjects were newly diagnosed severe ?-thalassemia patients who were diagnosed based on clinical manifestation and laboratory examination. Subjects had not received any blood transfusion before and had normal CRP level. Transferrin saturation (TS) and serum ferritin (SF) levels indicate iron status. The statistical analysis was performed using t test, Mann-Whitney, and Chi square test. Twenty nine subjects were diagnosed as newly severe ?-thalassemia, 24 ?-thalassemia mayor and 5 with severe ?-thalassemia/HbE. There was no difference in the iron status between the two types of severe ?-thalassemia  and  between those with and without polymorphism of c.-582 A>G promotor HAMP gene in  newly  diagnosed severe  ?-thalassemia (p>0.05). In conclusiosn, the  ?-thalassemia type and polymorphism of c.-582 A>G  promotor HAMP  gene do  not  associate with the iron status  in  newly diagnosed severe ?-thalassemia patients.  [MKB. 2015;47(3):192-98]Key words: Ferritin, polymorphism of  c.-582 A>G  promotor HAMP gene, severe ?-thalassemia, transferrin ration DOI: 10.15395/mkb.v47n3.599
Indeks Prestasi Kumulatif (IPK) Tahap Sarjana dan Hasil Multidisciplinary Examination (MDE) sebagai Prediktor Kelulusan CBT UKMPPD pada Mahasiswa Fakultas Kedokteran Universitas Padjadjaran Periode 2015-2016 Pratiwi, Yuni Susanti; Susanah, Susi; Achadiyani, Achadiyani; Hilmanto, Dany
Jurnal Kedokteran Universitas Lampung Vol 1, No 2 (2016): JK UNILA
Publisher : Fakultas Kedokteran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23960/jk unila.v1i2.1636

Abstract

Uji Kompetensi Mahasiswa Program Profesi Dokter (UKMPPD) adalah uji kompetensi yang bersifat high-stake exam di tataran nasional sebagai salah satu upaya penjaminan mutu pendidikan tinggi bidang kesehatan sesuai dengan amanah UU No.12/2012. Kompetensi akan dicapai mahasiswa setelah melalui proses pembelajaran terstruktur berbasis kompetensi. Kurikulum, proses pembelajaran dan evaluasi pembelajaran yang sesuai dan berbasis kompetensi sejak tahap sarjana akan menjadi alur yang jelas untuk kelulusan mahasiswa pada UKMPPD. Penelitian ini dilakukan bertujuan untuk menganalisis apakah IPK tahap Sarjana dan skor MDE dapat menjadi prediktor kelulusan UKMPPD. Penelitian ini menggunakan rancangan deskriptif analitik dengan populasi adalah mahasiswa Fakultas Kedokteran Universitas Padjadjaran yang mengikuti UKMPPD periode Februari 2015 sampai dengan Agustus 2016 sebanyak 524 peserta. Analisis data menggunakan analisis uji korelasi (Pearson Correlation).Hasil penelitian diperoleh korelasi antara antara nilai IPK tahap Sarjana dengan skor CBT UKMPPD begitu juga dengan rata-rata skor MDE tahap Sarjana dengan skor CBT UKMPPD.Simpulan.Hal ini menunjukkan bahwa proses pembelajaran dan metode evaluasi pembelajaran berkaitan erat dengan kelulusan mahasiswa pada UKMPPD sebagai refleksi kompetensi mahasiswa. Hasil ini menunjukkan bahwa IPK dan rata-rata nilai MDE tahap sarjana dapat menjadi prediktor skor kelulusan CBT UKMPPD. Hal ini juga menunjukkan bahwa kelulusan mahasiswa pada UKMPPD merupakan suatu proses berkelanjutan dari tahap sarjana dan profesi. Penelitian selanjutnya pada aspek OSCEUKMPPD sebaiknya dilakukan untuk melengkapi analisis selanjutnya terkait hal ini. [JK Unila. 2016; 1(2)]Kata kunci:IPK, MDE, Skor CBT, UKMPPD
Burden of Pediatric Cancer Treatment: Results of Online Pediatric Cancer Registry Prototype 1 at A Third Referral Hospital in Indonesia Nur Melani Sari; Lelani Reniarti; Nur Suryawan; Susi Susanah; Kurnia Wahyudi
Althea Medical Journal Vol 4, No 3 (2017)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (606.214 KB) | DOI: 10.15850/amj.v4n3.1204

Abstract

Background: Despite the impressive progress of high-income countries, childhood cancer survival remains low in low and middle-income countries. Cancer is yet to be considered as a significant public health issue which has implicate only few pediatric cancer registry has been well established. The study aimed to describe the burden of pediatric cancer treatment in a third referral hospital in Indonesia through pediatric cancer registry.Methods: A-three-year retrospective analysis of 15 pediatric cancer diagnosed in children aged under 14 years was conducted at Dr Hasan Sadikin General Hospital, Bandung.  Data were extracted from Online Bandung Pediatric Cancer Registry Prototype 1 and analyzed for age, gender, type of cancer. The outcomes were classified as treatment abandonment, treatment refusal, interrupted treatment, death during treatment, and completed treatment.Results: Seven-hundred and seventy-three children, 452 males and 321 females, were diagnosed with 15 types of malignancies.  Peak incidence for each malignancy was different: at a young age was found in retinoblastoma and hepatoblastoma (mean; 3yo) while at adolescence in bone tumor and chronic myelocytic leukemia (9.1; 10 yo respectively). Distribution of the foremost malignancies recorded was: acute lymphoblastic leukemia (44.5%), retinoblastoma (15.2%), and non-Hodgkin lymphoma (8.9%). The cancer cure rate was very low (9.5%), treatment abandonment was still high (41.7%) and most patients died (27.8%) in the course of therapy either from advanced disease, infection, or late presentation. Meanwhile, 167 patients still continued the interrupted treatment.Conclusions: Cancer management is the burden for hospital, however the general outcome is very poor. 
Bleeding Patterns among Severe Hemophilia A and B Patients in West Java Muhammad Mufakkirul Islam; Susi Susanah; Amaylia Oehadian
Althea Medical Journal Vol 7, No 2 (2020)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v7n2.1941

Abstract

Background: The clinical manifestations of hemophilia A (HA) and hemophilia B (HB)are quite similar; however, the bleeding characteristics of these two hemophilia types have been reported to be different. This study aimed to explore the bleeding patterns among patients with severe HA and severe HB.Methods: A cross-sectional study was conducted among patients with severe HA and HB registered at the West Java Indonesian Hemophilia Society. The inclusion criteria were patients with severe hemophilia diagnosed for at least one year. The bleeding patterns included bleeding episodes and bleeding types. The Mann-Whitney test was used to compare bleeding episodes and a chi-square test for bleeding types.Results: In total, 158 severe HA patients and 21 severe HB patients were included with a median bleeding frequency per patient per year for HA and HB was 24 (range 0–48) and 24 (range 5–48), respectively. The bleeding types in HA and HB were ecchymosis (69% vs. 66.7%), hematoma (62.7% vs. 61.9%), hemarthrosis (99.4% vs. 100%), epistaxis (46.8% vs. 38.1%), gum bleeding (87.3% vs. 95.2%), intracranial hemorrhage (15.2% vs. 9.5%), multiple hematomas (36.7% vs. 47.6%), hemarthrosis-hematoma (61.4% vs.61.9%), and hemarthrosis-ecchymosis (69% vs. 61.9%). However, there was no significant difference in all types of bleeding between HA and HB.Conclusions: There is no difference in the pattern of hemorrhage between severe HA and severe HB in West Java. However, the bleeding phenotypes in hemophilia has considerable implications in the therapeutic process. Further research is needed to optimize the treatment regimens.
Differences in Bleeding Episodes in Severe Hemophilia A Based on Nutritional Status Wenny Simamora; Susi Susanah; Amaylia Oehadian
Althea Medical Journal Vol 7, No 4 (2020)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v7n4.1938

Abstract

Background: Hemophilia A is a congenital bleeding disorder caused by the deficiency of coagulation factor VIII and is characterized by joint bleeding, especially in weight-bearing joints. An excess weight may cause bleeding in hemophilia due to increased joint tension. This study aimed to determine the differences in bleeding episodes between severe hemophilia A patients with and without excess weight.Method: A comparative observational analytic study was conducted in March-November 2019 using a cross-sectional design. Subjects were patients with severe hemophilia A registered in the Indonesian Hemophilia Society Association in West Java and had had severe hemophilia A for at least two years old with complete data on date of birth, height, weight, and bleeding intensity. Subjects were divided into groups with excess weight (excess weight) and without excess weight (non-excess weight). Nutritional status in adults was determined based on age-specific percentile BMI. Bleeding episodes were determined as frequency of bleeding in one year. The Mann-Whitney statistical test was used to observe the difference between groups.Result: Of 226 severe hemophilia A patients registered, only 155 patients were included. Of these, 121 patients did not have excess weight and 34 had excess weight. The median bleeding episodes of in the non-excess weight and excess weight groups were 24(1-48) and 24(8-48), respectively (p=0.761).Conclusion: There is no difference in bleeding episodes Between severe hemophilia A patients with excess weight and without excess weight. However, good nutrition education needs to be provided to these patients since excess weight may increase bleeding in joints.
pengaruh akupresur titik Nei Guan terhadap mual muntah akibat kemoterapi emetogenik tinggi pada penyandang kanker anak usia sekolah Triliana Purwadesi Yuliar; Susi Susanah; Ikeu Nurhidayah
Jurnal Keperawatan Padjadjaran Vol. 7 No. 1 (2019): Jurnal Keperawatan Padjadjaran
Publisher : Faculty of Nursing Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1740.024 KB) | DOI: 10.24198/jkp.v7i1.657

Abstract

Salah satu pengobatan penyakit kanker pada anak adalah kemoterapi yang memiliki  efek samping mual muntah. Mual muntah pada penyandang kanker anak usia sekolah dapat mengakibatkan gangguan nutrisi, emosional, bermain dan fungsi sekolah. Hal ini dapat menurunkan kualitas hidup anak. Salah satu terapi adjuvan yang dapat menurunkan mual muntah setelah pemberian kemoterapi adalah akupresur yang bersifat non invasif dan tidak membahayakan. Akupresur titik Nei guan menggunakan metode penekanan pada pergelangan tangan.  Penelitian ini dilakukan untuk mengetahui pengaruh pemberian akupresur Nei Guan terhadap mual muntah kemoterapi emetogenik tinggi pada penyandang kanker anak usia sekolah.            Desain penelitian adalah kuasi eksperimen melalui pendekatan pre-post test design study with control dengan single blind. Responden terbagi atas kelompok kontrol dan kelompok intervensi yang masing-masing berjumlah 15 orang. Kedua kelompok mendapatkan antiemetik yang sama. Pengukuran mual dilakukan 3 kali pada pagi dan malam hari menggunakan instrumen Pediatric Nausea Assessment Tools (PeNAT), sedangkan interval muntah didokumentasikan setiap muntah dan retching. Data dianalisis dengan uji Mann Whitney dan uji t independent.            Hasil analisis pada kelompok kontrol menunjukkan rerata nilai mual cenderung mengalami kenaikan dan interval muntah yang lebih cepat dibandingkan dengan kelompok intervensi. Hasil kesimpulannya adalah secara klinis terdapat pengaruh akupresur titik Nei Guan terhadap mual muntah akibat kemoterapi emetogenik tinggi pada penyandang kanker  anak usia sekolah meskipun secara statistik belum bermakna (nilai p>0,05). Perawat diharapkan dapat melakukan monitoring mual muntah berkelanjutan dan akupresur dapat dipertimbangkan sebagai terapi adjuvan selain pemberian terapi farmakologi untuk menurunkan mual muntah.
Prevalence of Hematotoxic Effect of Intravenous Chemotherapy among Retinoblastoma Population in Tertiary Hospital in Bandung, Indonesia Jennifer Hadiman; Susi Susanah; Adhi Kristianto Sugianli
International Journal of Integrated Health Sciences Vol 7, No 1 (2019)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (484.591 KB) | DOI: 10.15850/ijihs.v7n1.1520

Abstract

Objective: To observe the prevalence of hematotoxic effect in retinoblastoma patients who were given intravenous chemotherapy with vincristine, etoposide, and carboplatin (VEC) regimen. Retinoblastoma is the second most common cancer in children in Indonesia. Standard chemotherapy agents used in retinoblastoma treatment is VEC given in 7 cycles intravenously. The most common side effect of VEC regimen is hematotoxic effect which might lead to chemotherapy failure.Methods: This study used descriptive method with cross sectional study design. Data were collected from medical records of retinoblastoma patients in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from 2014 until 2016 using total sampling technique.Results: Forty-six patients were included in this study. Of those subjects, 36 (78.3%) patients experienced hematotoxic effect. The most common hematotoxic effect occurred were anemia and neutropenia, that occurred in 32 (69.6%) and 18 (39.1%) patients, respectively. The most common hematotoxic effect severity occurred were grade 1 anemia, grade 1 leukopenia, grade 1 neutropenia, and grade 3 thrombocytopenia. Percentage of patients experienced anemia tended to increase until the 7th cycle. Seven (15.2%) patients had anemia prior to chemotherapy administration.Conclusion: The majority (78.3%) of the patients experienced hematotoxic effect on intravenous chemotherapy administration with VEC regimen. Anemia was the most common hematotoxic effect occurred.Keywords: Hematotoxic effect, intravenous chemotherapy, retinoblastoma 
Evaluasi Fungsi Ginjal pada Penyandang Talasemia-β Mayor Anak Berton Juniper Manurung; Susi Susanah; Dida A. Gurnida
Sari Pediatri Vol 21, No 2 (2019)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp21.2.2019.89-95

Abstract

Latar belakang. Informasi keterlibatan ginjal pada penyandang talasemia-β mayor anak masih sedikit. Disfungsi ginjal dipengaruhi berbagai faktor seperti anemia kronis, hipoksia kronis, dan hemosiderosis. Neutrophil gelatinase associated lipocaline urin (NGALu) merupakan penanda biologis dini yang sensitif dan spesifik terhadap gangguan ginjal. Tujuan. Menilai disfungsi ginjal pada penyandang talasemia-β mayor anak menggunakan NGALu.Metode. Penelitian dengan rancang potong lintang dilaksanakan Oktober–November 2018. Subjek adalah penyandang talasemia β mayor anak di RS. Hasan Sadikin yang menggunakan kelasi besi deferiprondan dipilih secara consecutive sampling. Heteroanamnesis pada orang tua mengenai riwayat penyakit dan frekuensi transfusi. Terhadap subjek penelitian dilakukan pemeriksaan feritin serum, kreatinin serum, dan NGALu. Uji statistik menggunakan uji korelasi rank Spearman dengan nilai kemaknaan p<0,05.Hasil. Sebanyak 71 subjek yang memenuhi kriteria penelitian, terdiri dari 46 laki-laki dan 25 perempuan. Kadar rerata kreatinin serum 0,38±0,08 mg/dL, median feritin 2897,1 ng/mL, median NGALu 13,8 ng/mL. Peningkatan kadar NGALu ditemukan 11 (15%) subjek. Didapatkan korelasi negatif antara frekuensi transfusi dan kadar NGALu (r= -0,294, p=0,006). Tidak terdapat korelasi baik antara feritin serum dengan kreatinin serum maupun feritin serum dan NGALuKesimpulan. Disfungsi ginjal sudah terindikasi terjadi pada penyandang talasemia-β mayor anak.