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THE DIFFERENCE OF NEUTROPHIL LYMPHOCYTE RATIO (NLR) IN CONVENTIONAL AND ELECTRIC SMOKERS Sarah, Diah Ayu Siti; Naftali, Zulfikar; Yusmawan, Willy; Suprihati, Suprihati
DIPONEGORO MEDICAL JOURNAL (JURNAL KEDOKTERAN DIPONEGORO) Vol 9, No 3 (2020): DIPONEGORO MEDICAL JOURNAL ( Jurnal Kedokteran Diponegoro )
Publisher : DIPONEGORO MEDICAL JOURNAL (JURNAL KEDOKTERAN DIPONEGORO)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (402.527 KB)

Background: Smoking is an unhealthy lifestyle causing health problems that may lead to high morbidity and mortality rates. One way to stop smoking habit is by replacing conventional cigarettes with electric cigarettes. Cigarette smoke exposure can trigger an inflammatory reaction that can be measured using Neutrophil Lymphocyte Ratio (NLR). Aim: Proving of NLR in electric smoker are higher than conventional smoker. Method: The research used descriptive analytic design. The number of samples were 34 people, divided into 17 people each group (conventional smoker and electric smoker). The subjects were asked to fill out a questionnaire and their blood samples were taken by 3 cc. Then, the blood samples were tested in a laboratory to obtain NLR values. The data was then analyzed using unpaired T-test. Â Result: NLR mean in the conventional smoker group is 1,364 Â± 0,28 and 1,791 Â± 0,49 in the electric smoker group. The unpaired T-test indicates there is significant difference in the value of NLR between conventional smoker and electric smoker (p=0,005). Â Conclusion: NLR in electric smoker are higher than conventional smoke.

Determinant of Voice Handicap Index Degree as Dysphonia PatientsÃ¢â‚¬â„¢ Quality of Life Indicator Yusuf, Muhammad; Dewi, Anna Mailasari Kusuma; Yunika, Kanthi; Yusmawan, Willy; Farokah, Farokah; Budiarti, Rery; Muyassaroh, Muyassaroh
JHE (Journal of Health Education) Vol 6 No 1 (2021): April 2021
Publisher : Universitas Negeri Semarang cooperate with Association of Indonesian Public Health Experts (Ikatan Ahli Kesehatan Masyarakat Indonesia (IAKMI))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/jhe.v6i1.42118

Background: Dysphonia will interfere with communication which will have an impact on social life such as depression, disrupt activities, work and can affect the quality of life. Dysphonia risk factors such as age, sex, duration of illness and etiology will affect the course of it. The purpose of this study was to identify risk factors for with the degree of Voice Handicap Index (VHI) as an indicator of dysphonia patients.Methods: Analytical descriptive study with cross-sectional design in dysphonia patients, the sample was determined as many as 62 who met the inclusion criteria. Quality of life was assessed by the VHI questionnaire. VHI degrees are classified into mild and moderate-severe. Data analysis using chi-square test and multivariate logistic regression. Results:Thirty-two (51.6%) subjects were women. Mean age was 47.26 +12.2. The most common causes of dysphonia (85.5%) were due to organic disorders and laryngopharyngeal reflux (LPR) is the most common cause (37.1%) of all organic dysphonia disorders. Analysis of risk factors for age, gender, etiology of dysphonia and duration of illness with VHI degree were p = 0.282, p =0.76, p= 0.067, p= 0.001, respectively. Duration of illness Ã¢â€°Â¥2 weeks has a 38.3x risk to severity VHI compared to <2 weeks. Conclusion: The duration of illness is a determinan related to of the degree of VHI that quality of life indicator in dysphonia patients. Key Words: Risk factors, Dysphonia, Voice Handicap Index

Determinant of Voice Handicap Index Degree as Dysphonia Patientsâ€™ Quality of Life Indicator Yusuf, Muhammad; Dewi, Anna Mailasari Kusuma; Yunika, Kanthi; Yusmawan, Willy; Farokah, Farokah; Budiarti, Rery; Muyassaroh, Muyassaroh
Journal of Health Education Vol 6 No 1 (2021): April 2021
Publisher : Universitas Negeri Semarang cooperate with Association of Indonesian Public Health Experts (Ikatan Ahli Kesehatan Masyarakat Indonesia (IAKMI))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/jhe.v6i1.42118

Background: Dysphonia will interfere with communication which will have an impact on social life such as depression, disrupt activities, work and can affect the quality of life. Dysphonia risk factors such as age, sex, duration of illness and etiology will affect the course of it. The purpose of this study was to identify risk factors for with the degree of Voice Handicap Index (VHI) as an indicator of dysphonia patients.Methods: Analytical descriptive study with cross-sectional design in dysphonia patients, the sample was determined as many as 62 who met the inclusion criteria. Quality of life was assessed by the VHI questionnaire. VHI degrees are classified into mild and moderate-severe. Data analysis using chi-square test and multivariate logistic regression. Results:Thirty-two (51.6%) subjects were women. Mean age was 47.26 +12.2. The most common causes of dysphonia (85.5%) were due to organic disorders and laryngopharyngeal reflux (LPR) is the most common cause (37.1%) of all organic dysphonia disorders. Analysis of risk factors for age, gender, etiology of dysphonia and duration of illness with VHI degree were p = 0.282, p =0.76, p= 0.067, p= 0.001, respectively. Duration of illness â‰¥2 weeks has a 38.3x risk to severity VHI compared to <2 weeks. Conclusion: The duration of illness is a determinan related to of the degree of VHI that quality of life indicator in dysphonia patients. Key Words: Risk factors, Dysphonia, Voice Handicap Index

Faktor Risiko Air Bone Gap Pada Otitis Media Supuratif Kronik Inardi, Yoke Kurniawan; Widodo, Pujo; Naftali, Zulfikar; Yusmawan, Willy
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 1 (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Latar belakang : Kehilangan pendengaran merupakan komplikasi otitis media kronik (OMSK) yang paling sering, jenis kehilangan pendengaran yang tersering adalah tuli konduktif, yang disebabkan oleh adanya air bone gap (ABG), ABG pada pasien OMSK mempunyai variasi yang berbeda-beda dan karakter yang khas berdasarkan faktor risiko. Tujuan : Menganalisis hubungan faktor risiko dengan ABG pada penderita OMSK. Metode : Penelitian desain observational analitik retrospektif di RSUP Dr Kariadi Semarang pada bulan September 2018 - Januari 2019. Data diambil dari rekam medis. jumlah sampel ditentukan sebanyak 100. Analisis data dengan uji chi-square. Hasil : Jenis kelamin laki-laki 46 orang, wanita 54 orang, rerata usia 32 tahun. Status osikula, lama sakit, kolesteatom, luas perforasi membran telinga berhubungan terhadap ABG (p <0,05). Kesimpulan : Faktor risiko (status osikula, lama sakit, kolesteatom, perforasi membran timpani) berhubungan dengan air bone gap pada penderita OMSK. Kata kunci : Air bone gap, faktor risiko, otitis media supuratif kronik. Background: Hearing loss is the most frequent complication of chronic otitis media (CSOM), hearing loss is usually caused by conductive deafness caused by the presence of an air bone gap (ABG). ABG in CSOM patients has different variations and distinctive characters based on the factors. Objective: To analyze the relationship of risk factors ABG in CSOM patients. Methods: Observational analytic study with a retrospective observational analytic design at Dr. Kariadi Hospital Semarang in September 2018 - January 2019. Subjects were 100 patients. Data retrieval is done based on medical records about history taking, physical examination and investigation. Data were analyzed by Chi-square test. Results: A total male 46 and female. Avarage age 32 years. Oscular status, duration of illness, cholesteatom, area of ??ear membrane perforation associated with ABG (p <0.05). Conclusion: Risk factors (osicular status, duration of illness, cholesteatom, tympanic membrane perforation) associated with air bone gap in CSOM patients. Keywords: Chronic supurative otitis media, air bone gap, risk factors

Kejadian Mielosupresi Pada Penderita Kanker Kepala Dan Leher Yang Mendapat Kemoterapi Cisplatin Dan Carboplatin Di RSUP Dr. Kariadi Semarang Dewi, Nila Santia; Yusmawan, Willy; Budiarti, Rery
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 1 (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Latar belakang : Kemoterapi bersifat sistemik dan non selektif sehingga tidak hanya sel kanker yang mati tetapi juga sel normal. National Comprehensive Cancer Network (NCCN) merekomendasikan Platinum-based sebagai rejimen kemoterapi untuk kanker kepala dan leher terutama Cisplatin dan Carboplatin. Cisplatin dan Carboplatin dapat menyebabkan efek samping mielosupresi. Tujuan : Membuktikan bahwa terdapat perbedaan kejadian mielosupresi pada penderita Kanker Kepala dan Leher (KKL) yang mendapat kemoterapi Cisplatin dan Carboplatin. Metode : Penelitian observasional dengan desain penelitian kohort prospektif di klinik THT-KL, bangsal dan bagian rekam medis instalasi rawat jalan/rawat inap RSUP Dr. Kariadi Semarang. Sampel ditentukan sebanyak 90 orang dan mendapat kemoterapi platinum based dengan salah satu komponen berupa Cisplatin atau Carboplatin sebanyak 3 seri. Analisis data dengan uji Pearson Chi-square dan Fisher’s exact test. Hasil : Subyek penelitian 90 orang, 45 orang mendapatkan Paclitaxel Cisplatin dan 45 orang mendapatkan regimen Paclitaxel Carboplatin. Hasil penelitian ini didapatkan 48,9% pasien stadium IV, histopatologi terbanyak WHO 3 (83,3%). Rerata usia terbanyak 50-59 tahun, dan diagnosis terbanyak pada KNF (66,7%). Secara keseluruhan kemoterapi seri I menunjukkan Carboplatin menyebabkan perubahan kadar hemoglobin (p=1,000) dan leukosit (p=0,292) dengan jumlah subyek lebih banyak dibanding Cisplatin. Sedangkan pada kemoterapi seri III, Carboplatin menyebabkan perubahan kadar hemoglobin (p=<0,023), leukosit (p=0,670), dan trombosit (p=1,000) lebih banyak dibandingkan Cisplatin. Simpulan : Kadar hemoglobin berbeda bermakna pada pasien yang mendapatkan kemoterapi Carboplatin seri III (p<0,023). Kata kunci : Kemoterapi Cisplatin/Carboplatin., kanker kepala dan leher, mielosupresi. Background : Chemotherapy is systemic and non-selective so it often results in not only cancer cells dying but normal cells will also die. The National Comprehensive Cancer Network (NCCN) recommends Platinum-based chemotherapy regimens for head and neck cancer, especially Cisplatin and Carboplatin. Cisplatin and Carboplatin chemotherapy can cause one of the side effects of myelosuppression. Myelosuppression is a decrease in cell production of leukocytes, erythrocytes, and / or platelets. Objective : Proving the difference incidence of myelosuppression in head and neck cancer patients receiving Cisplatin and Carboplatin chemotherapy. Methode : An observational study with a prospective cohort study design in ENT clinic, ward and medical record department of outpatient installation Dr. Kariadi Semarang. Samples was determined by 90 people and received platinum based chemotherapy with one component in the form of Cisplatin or Carboplatin in 3 series. Data analysis by Pearson Chi-square and Fisher’s exact test. Result : The study subjects were 90 people, 45 people received Paclitaxel Cisplatin regimen and 45 people received Paclitaxel Carboplatin regimen. The results of this study found 48.9% of patients in stage IV conditions with the most histopathological types were WHO 3 (83.3%). Overall series I chemotherapy shows Carboplatin causes changes in hemoglobin (p=1,000) and leukocyte (p=0,292) levels with a greater number of subjects than Cisplatin. Where as in series III chemotherapy, Carboplatin causes more changes in hemoglobin (p=<0,023), leukocyte (p=0,670) and platelet (p=1,000) levels than Cisplatin. Conclusions : Hemoglobin level was significantly different in patients who received Carboplatin series III chemotherapy (p<0,023). Keywords : Chemotherapy, head and neck cancer, myelosuppression, Cisplatin, Carboplatin.

PENGARUH SUPLEMENTASI KOENZIM Q10 TERHADAP KADAR LAKTAT DEHIDROGENASE PENDERITA LIMFOMA NON-HODGKIN YANG MENJALANI KEMOTERAPI DI RSUP Dr.KARIADI SEMARANG Kusulistyo, Farryanto; Suprihati, Suprihati; Yusmawan, Willy; Antono, Dwi; Budiarti, Rery; Farokah, Farokah; Widodo, Pujo
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

LATAR BELAKANG : Peningkatan kadar LDH dikenal sebagai penanda tumor yang menggambarkan aktivitas tumor termasuk tumor sel germinal, sarkoma dan LNH. Koenzim Q10 bekerja sebagai kofaktor dalam Siklus Krebs yang berperan dalam mengatasi kondisi kekurangan ATP dalam sel melalui reaksi reduksi dan oksidasi. TUJUAN : Membuktikan pengaruh pemberian koenzim Q10 terhadap kadar LDH penderita LNH yang mendapat kemoterapi di RSUP Dr.Kariadi, Semarang. METODE : Penelitian intervensi dengan desain randomized pre and post test double blind control group design. Subyek yang ditentukan sebanyak 34 orang. Subjek penelitian adalah penderita LNH yang mendapat kemoterapi dengan pemberian terapi selama 21 hari. Kelompok penelitian dibagi menjadi 2, yaitu kelompok perlakuan (penderita LNH yang mendapat kemoterapi, dan koenzim Q10 100mg/hari) sebanyak 17 orang, serta kelompok kontrol (penderita LNH yang mendapat kemoterapi dan plasebo) sebagai sisanya. Analisis data dengan deskriptif dan uji hipotesis HASIL : Terdapat perbedaan signifikan sebelum dan setelah intervensi, dimana terjadi penurunan kadar LDH pada kelompok perlakuan sedangkan pada kelompok kontrul justru terjadi peningkatan kadar LDH. KESIMPULAN : Kadar LDH pada pasien LNH yang diberikan koenzim Q10, lebih baik dibandingkan tanpa pemberian koenzim Q10. Terdapat perbedaan bermakna secara statistik pada penelitian ini Kata Kunci : Limfoma Non-Hodgkin (LNH); Lactate Dehidrogenase (LDH); Koenzim Q10, prognosis

The Effect of 1% Povidone Iodine Mouthwash on The Incidence of Oral Mucositis and Odynophagia in Patients with Head and Neck Malignancy Handayani, Peny; Budiarti, Rery; Yusmawan, Willy; Antono, Dwi; Dewi, Anna Mailasari Kusuma; Widodo , Pujo
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.854

BACKGROUND: Oral mucositis is an injury of normal mucosal tissue with an acute inflammation of the oral, tongue, and pharyngeal mucosa after exposure to chemo-radiotherapy. Post chemoradiotherapy oral mucositis is commonly accompanied by painful swallowing or odynophagia. Povidone iodine 1% is an antiseptic mouthwash that widely used to prevent infections in the oral cavity. OBJECTIVE: The aim of this study was to determine the effect of 1% povidone iodine mouthwash on the incidence of oral mucositis in patients with head and neck malignancy at Dr. Kariadi General Hospital Semarang. METHOD: This study was single random blinded experimental study, with total samples of 44 patients with head and neck malignancy after chemoradiotherapy. The samples divided into treatment group of 22 samples with 1% povidone iodine mouthwash and control group of 22 samples with NaCl 0.9% recruited using single random sampling at Dr. Kariadi Semarang General Central Hospital in 2022. The effect of 1% povidone iodine mouthwash on the incidence of oral mucositis and odynophagia was analyzed using the Fischer Exact and Mann Whitney test. RESULT: In the 1% povidone iodine mouthwash group day 15th, 21 patients (95.5%) were found without mucositis and 1 patient (4.5%) with mucositis oral grade I. In the 1% povidone iodine mouthwash group, 21 people (4.5%) were found without odynophagia and 1 people (4.5%) had odynophagia. There was an association between oral mucositis and odynophagia on povidone iodine 1% group (p < 0.05). CONCLUSION: Povidone iodine 1% mouthwash can affect the incidence of oral mucositis in patients with head and neck carcinoma. Povidone iodine 1% mouthwash can reduce the incidence of oral mucositis and odynophagia compared to placebo in patients with head and neck carcinoma.

Comparison Of Clinical Response Between Combine Chemotherapy 5 Fluorourasil - Platinum Based And Ifosfamid - Taxane - Platinum Based In Recurrent Nasopharyngeal Carcinoma Sanjaya, Rio; Yusmawan, Willy; Antono, Dwi; Marliyawati, Dwi; Yunika, Kanti
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 3 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i3.926

BACKGROUND : Recurrence of Nasopharyngeal Carcinoma (NPC) is the emergence of a tumor remission after administration of chemoradiation based on symptoms and several examinations. The combination of chemotherapy in recurrent NPC still gives good results. The combine of regimens used is still varied and not much study has been done to assess the clinical response. OBJECTIVE : To compare the clinical response between administration of combination 5 Fluorouracil-Platinum based (5-FU) and Ifosfamide-taxan-platinum based (IFO) in recurrent NPC. METHOD :. This observational study used electronic medical record (ERM) data at the ENT oncology clinic at Dr. Kariadi General Hospital for the period January 2020-January 2022. The number of samples that suited to the inclusion and exclusion criteria was 44 subjects divided into two groups of 22 subjects respectively. The chi-square test was used to assess differences in alteration of clinical symptoms, tumor mass size, neck lymph node enlargement, tumours stage reduction, and the effect of confounding factors on response to therapy in both groups. RESULTS : The highest number of patients with recurrent NPC were aged ≥45 Years old and male (75%). WHO type 3 is the most common (95.5%) and ECOG status 1 (95.5%). There was no significant difference administration of the combination of 5-FU with IFO in alteration of clinical symptoms (p=0.500), shrink tumor size (p=0.347), reduction of neck lymph node size (p=0.164), and reduction tumor staging (p=0.347). There was no relationship from confounding factors to clinical response between the administration of the two groups. CONCLUSION : Administration of 5 Fluorouracil-platinum based combination chemotherapy did not provide a better clinical response in terms of clinical symptoms, changes in primary tumor size, neck lymph node size, and decreased tumor stage compared to the Ifosfamide-taxane-platinum based combination based on recurrent NPC.

The Relationship Between Obesity and Allergies with Olfactory Disorders in Covid-19 Patients Pratama, Yudistira; Kusuma Dewi, Anna Mailasari; Muyassaroh; Hariyati, Riece; Yusmawan, Willy
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 3 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i3.949

Background: The prevalence of olfactory disorders is around 68% - 85% which occurs in COVID-19 patients with obesity and allergies as risk factors. The abnormalities olfactory pathways can cause by inflammatory response in adipose tissue in obese patients and excessive inflammation due to hyperreactivity of the immune system to allergens in allergic patients. This study aims to analyze the relationship between obesity and allergies to the occurrence of olfactory disorders in COVID-19. Method: It was an observational study during pandemic. Subjects were adult COVID-19 patients in the dr. Kariadi Hospital from June to July 2021. Patient with complete medical record ask for olfactory and allergic questionnaire. Patient with nasal tumor were excluded. Result: We found 100 subjects who meet the criteria. There was a significant difference in smell disturbances between obese and non-obese subjects. (p = 0.019, OR 4.99). There was a significant difference (p=0.001) in complaints of olfactory disorders between allergic and non-allergic subjects, whereas all allergic subjects experienced olfactory disorders. Conclusion: Obesity and allergies are corelated with impaired smell in COVID-19 patients.

The Effect of Coenzym Q10 on Doxorubicin-induced Cardiotoxicity in Non Hodgkin's Lymphoma Patients Dewi, Julita Melisa; Antono, Dwi; Nugroho, Nur Iman; Yusmawan, Willy; 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.v11i2.1089

BACKGROUND : Non-Hodgkin's Lymphoma is a primary malignancy in the Lymph Nodes and lymphoid tissue originating from B lymphocytes, T lymphocytes and Natural Killer (NK) cells. Therapy for Non-Hodgkin's Lymphoma chemotherapy can be given alone or combined with radioactive therapy. Doxorubicin is a chemotherapy drug used for lymphoma with side effects, one of which is cardiotoxic effects. AIMS : To prove that coenzyme Q10 can reduce the cardiotoxic effect of doxorubicin chemotherapy in non-Hodgkin's lymphoma patients METHOD : Intervention study with a randomized pre and post test double blind control group design with 34 NHL patients undergoing chemotherapy. The treatment group received additional therapy with coenzyme Q10 300mg/day for 12 weeks while the controls received placebo. The cardiotoxic effects examined were assessed based on the results of Electrocardiography and Echocardiography. RESULT : The treatment group with coenzyme Q10 supplementation after the 4th chemotherapy showed a decrease in echocardiography results in 3 patients (18%) and in the control group 17 patients (100%). There was a significant difference in the echocardiography results of the treatment and control groups (p=0.001). There were no drug side effects in both groups CONCLUSION : Coenzyme Q10 supplementation provides an improvement in the cardiotoxic effects of doxorubicin in non-Hodgkin's lymphoma patients, on echocardiography, but not on Electrocardiography.

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