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All Journal Jurnal Kedokteran Brawijaya Indonesian Journal of Tropical and Infectious Disease Majalah Kesehatan FKUB Molecular and Cellular Biomedical Sciences (MCBS) Journal of Epidemiology and Public Health CRJIM (Clinical and Research Journal in Internal Medicine)
Shinta Oktya Wardhani, Shinta Oktya
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Biochemistry, Genetics & Molecular Biology Dentistry Earth & Planetary Sciences Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Other

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A 44 Year Old Man with Chronic Myeloid Leukemia and Mass at Right Lower Leg Islamiah, Ahadini; Wardhani, Shinta Oktya
Jurnal Kedokteran Brawijaya Vol 29, No. 4 (2017)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2017.029.04.17

Abstract

Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder of primitive hematopoetic stem cells that is characterized by overproduction of myeloid series cells, splenomegaly, and leukocytosis. We reported a case of 44 years old male with CML who complained about swelling right leg and pain for 3 month. It had been diagnosed as CML for 3 years, and he took hydroxyurea but stopped for a year due to economic problem. The results of clinical examination, laboratory, biopsy, and radiology showed a result matched to CML with soft tissue mass. The results of Fine Needle Aspiration Biopsy (FNAB) of fragmented histiocytes leg mass, multinucleated giant cells, and atypical nucleated with a possibility of fibroma with atypical nucleated cells. Magnetic resonance imaging (MRI) showed multilocular lobulated soft tissue mass from the popliteal region to the cruris dextra, cyst mass high protein dd/solid tumor with vascular encasement and lesions in bone marrow replacement, and fluid collection on bursa parapatella. The patient was treated with hydroxyurea and showed clinical improvement and decreased mass size in the legs.
Nasopharyngeal Non Hodgkin Lymphoma Wardhani, Shinta Oktya; Kartikasari, Nanik Triana
Jurnal Kedokteran Brawijaya Vol 29, No. 3 (2017)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2017.029.03.15

Abstract

Non Hodgkin lymphomas (NHL) are tumors originating from lymphoid tissue, mainly from lymph nodes. These tumors may result from chromosomal translocation, infections, environmental factors, immunodeficiency states, and chronic inflammation. In general, the incidence of NHL is slightly higher in men than in women. The incidence of NHL nasopharynx is rare. A high degree of suspicion is required to avoid unnecessary radiologic and surgical procedures since NHL can be mistakenly diagnosed as carcinoma. We reported a 16 year old male patient with gradual epistaxis, hearing impairment, decreased body weight, and multiple nodules in right forehead, right axilla, right colli posterior, and left waist. The patient also suffered from inferior paraplegic extremities. The Head CT scan result showed carcinoma nasopharynx. After biopsy of nodules was done, it revealed differential diagnoses such as blastoma, Non Hodgkin lymphoma, and small cell carcinoma. Immunohistochemistry result showed Leucocyte Common Antigen (LCA) positive, and MRI thorax showed suspect of schwannoma. Based on the data, chemotherapy with regiment CHOP (cyclophosphamide, hydroxydaunorubicin, oncovin/vincristine, and prednisone) was given. The prognosis of NHL Nasopharynx was better than nasopharyngeal squamous cell carcinoma. The prognostic of NHL depends on the age, performance status, staging, extranodal involvement, serum Lactate Dehydrogenase (LDH) and response of therapy. The prognosis in our patient was poor.Keywords: Mass, Non Hodgkin Lymphoma, nasopharyngeal carcinoma, prognostic
Perempuan 17 tahun dan Laki-laki 15 tahun dengan Interdigitating Dendritic Cell Sarcoma (IDCS) Saraswati, Diyah; Wardhani, Shinta Oktya
Jurnal Kedokteran Brawijaya Vol 29, No. 4 (2017)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2017.029.04.18

Abstract

Neoplasma yang berasal dari sel dendritik dan histiosit merupakan keganasan yang jarang terjadi, <1% dari semua neoplasma. Interdigitating dendritic cell sarcoma (IDCS) merupakan keganasan yang jarang terjadi yang berasal dari antigen-presenting cells sistem imun.  Keganasan ini seringkali melibatkan limfonodi, dan meskipun jarang dapat terjadi ekstranodal. Telah dilaporkan dua kasus dengan IDCS pada tulang. Kasus pertama, wanita 17 tahun dengan fraktur tulang paha kanan. Pemeriksaan radiologis menunjukkan fraktur 1/3 proksimal diafise dan lesi litik yang dicurigai fraktur patologis. Kasus kedua, laki-laki 15 tahun dengan massa pada region temporoparietal kanan. Pemeriksaan radiologis menunjukkan proses dengan lesi osteolitik pada calvaria yang dicurigai proses metastase. Analisa imunohistokimia pada kedua kasus tersebut menunjukkan antibodi anti S100 yang positif dan antibodi CD1a yang negatif. Pasien pertama telah mendapat kemoterapi dengan regimen CHOP (Siklofosfamid-Doksorubisin-Vinkristin-Prednison) sebanyak 6 siklus dan mengalami perbaikan secara klinis sedangkan kasus kedua kami kehilangan kontak. 
Effect of Chemotherapy and Hormonal Therapy on Bone Mineral Density in Patients with Breast Cancer in Saiful Anwar Hospital Malang Nurshanty, Ade; Wardhani, Shinta Oktya; Suryana, Bagus Putu Putra
Clinical and Research Journal in Internal Medicine Vol 1, No 1 (2020): New: The First Volume of Clinical and Research Journal in Internal Medicine
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.01.4

Abstract

Osteoporosis is an important health problem, and the number of patients who suffered from it is increasing. Breast cancer is a condition that has a  high risk of osteoporosis. Cancer induced bone disease results from the primary disease, metastatic process, or from therapies against the prime condition, causing bone fragility. Therefore, there are still different opinions regarding the therapeutic effect of breast cancer on bone mineral density. Aim: to determine the effect of chemotherapy and hormonal therapy on bone mineral density in patients with breast cancer in Saiful Anwar Hospital Malang. Method: this is a case-control study conducted in 30 patients with breast cancer who had undergone chemotherapy and hormonal therapy are compared to 30 patients without breast cancer as controls.  Bone Mineral Density (BMD) was measured by DEXA. Result: there are 53% of breast carcinoma patients having osteopenia and 13% having osteoporosis, with one patient has osteoporosis located in the femoral neck and three patients in lumbar (L1-L4). We obtain a significant T-score (p=0.02) in the great trochanter. Odds Ratio (OR) 0.233 with p = 0.008 showed a protective effect of chemotherapy and hormonal therapy for breast cancer to the bone density. Conclusion: the incidence of osteoporosis in the study was 13%, with the most location in the lumbar spine. Chemotherapy and hormonal therapy had a protective effect on BMD in patients with breast cancer in Saiful Anwar Hospital Malang.
Laporan Kasus: GAMBARAN HISTOPATOLOGI HODGKIN LIMFOMA KLASIK MENYERUPAI KARSINOMA PARU Yudanto, Hendy Setyo; Retnani, Diah Prabawati; Ervina, Rita; Wardhani, Shinta Oktya; Hermanto, Djoko Heri
Majalah Kesehatan Vol. 10 No. 3 (2023): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2023.010.03.6

Abstract

Limfoma Hodgkin merupakan neoplasma limfoid berasal dari  sel B dengan ciri-ciri adanya sel Reed-Sternberg  dengan latar belakang sel-sel radang,  Limfoma Hodgkin yang melibatkan organ paru terjadi sekitar 15% hingga 40% kasus. Angka kejadian Limfoma Hodgkin ekstra nodal khususnya paru sekitar 3,6%. Seorang pasien wanita usia 31 tahun dengan keluhan batuk lama dan  sakit tenggorokan selama satu tahun, dan telah mendapatkan pengobatan rutin, didapatkan penurunan berat badan disertai benjolan pada ketiak kanan berukuran 5 cm,  dan dilanjutkan dengan pemeriksaan penunjang radiologi thorak, computed tomography (CT) dengan mengesankan terdapat massa pada paru kanan, kemudian dilanjutkan dengan biopsi dan pulasan imunohistokimia dan di simpulkan sebagai Limfoma Hodgkin, serta  pasien menjalani kemoterapi. Biopsi jarum halus atau Fine Needle Aspiration Biopsy (FNAB) pada aksila dapat mengetahui adanya metastasis karsinoma, sarkoma atau Limfoma.  Pemeriksaan histopatologi pada sediaan biopsi paru dan dilanjutkan dengan pulasan immunohistokimia Cytokeratin (-), CD45 (-), CD20 (-), CD3 (-) pada sel tumor,  Ki67 low proliferation index, CD30 (+),  dan PAX5 (+), sehingga didapatkan gambaran Limfoma Hodgkin. Limfoma Hodgkin merupakan neoplasma limfoid berasal dari sel B yang sering mengenai nodul limfoid, mengandung sel mononuklear displastik besar  dan sel-sel Multinucleated Reed-Sternberg cells yang dikelilingi oleh sel-sel radang campuran non neoplastik, seperti limfosit kecil, eosinophil, netrofil, histiosit dan sel plasma. Dari kasus ini disimpulkan bahwa Limpoma Hodgkin ekstranodul yang melibatkan organ paru merupakan kasus yang jarang terjadi, dengan open biopsy dan perlu dipertimbangkan pemeriksaan immunohistokimia  merupakan cara definitif untuk menegakkan diagnosis Limfoma Hodgkin.
KORELASI PROFIL HEMATOLOGI DAN TROMBOPOIETIN DENGAN TERJADINYA PERDARAHAN PADA PASIEN SIROSIS HEPATIS Firani, Novi Khila; Fatonah, Siti; Wardhani, Shinta Oktya; Supriono; Gonius, Andry; Mustofa Aidid
Majalah Kesehatan Vol. 11 No. 3 (2024): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2024.011.03.2

Abstract

Sirosis hepatis adalah penyakit kronis hati yang ditandai adanya fibrosis hati yang dapat menyebabkan abnormalitas fungsi hati baik pada metabolisme maupun sintesis faktor koagulasi. Perdarahan akut saluran cerna atas merupakan akibat hipertensi portal dan kegagalan fungsi hati memproduksi faktor pembekuan darah pada sirosis hepatis. Belum diketahui bagaimana korelasi parameter hematologi dan trombopoietin dengan terjadinya perdarahan pasien sirosis hepatis. Tujuan penelitian ini untuk mengetahui korelasi kadar hemoglobin, leukosit, trombosit dan trombopoietin dengan terjadinya perdarahan pada pasien dengan sirosis hepatis. Desain studi ini adalah observasional analitik pada pasien sirosis hepatis yang dirawat di RSUD dr. Saiful Anwar Malang, yang memenuhi kriteria inklusi dan eksklusi. Analisis statistik menggunakan uji komparasi dan uji korelasi Spearman. Hasil penelitian didapatkan sejumlah 35 orang pasien sirosis hepatis. Kadar trombopoietin yang lebih tinggi pada pasien sirosis yang mengalami perdarahan dibandingkan pasien sirosis tanpa perdarahan. Kadar hemoglobin lebih rendah pada pasien sirosis yang mengalami perdarahan dibandingkan yang tanpa perdarahan. Terdapat ko relasi yang bermakna antara kadar hemoglobin (r = -0,653; p < 0,05) dan kadar trombopoietin (r = 0,355; p < 0,05) dengan terjadinya perdarahan pasien sirosis hepatis. Tidak ada perbedaan yang signifikan kadar leukosit dan trombosit pada pasien sirosis yang mengalami perdarahan dan tanpa perdarahan. Dari penelitian ini dapat disimpulkan bahwa kondisi perdarahan pada pasien sirosis hepatis berkorelasi dengan penurunan kadar hemoglobin dan peningkatan kadar trombopoietin.
Correlation between soluble urokinase plasminogen activator receptor with CD4 T lymphocyte and WHO clinical staging of HIV infection Wardhani, Shinta Oktya; Burhan, Niniek; Ismanoe, Gatoet; Yudani, Tri
Indonesian Journal of Tropical and Infectious Disease Vol. 1 No. 1 (2010)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (476.276 KB) | DOI: 10.20473/ijtid.v1i1.3720

Abstract

The urokinase-type plasminogen activator (uPA) and its receptor play a key role in pericellular proteolysis, cell migration and signal transduction. Previous study showed that suPAR could be used as an independent prognostic marker of disease progression in HIV-1 patients.1,17 Immune status of HIV patient and progressivity of disease are important parameters used as clinical concideration before initiating anti retroviral treatment and for monitoring treatment effectivity. Recently immune status of HIV patients is determined by CD4 T lymphocyte counting which represents the remaining healthy lymphocyte T expressing CD4 that very expensive and need special laboratory equipment. Destruction and shedding of T lymphocyte, macrophage and natural killer cell will deliver soluble urokinase plasminogen activator receptor, a surface protein which is expressed by those cells and can be measured by ELISA8,9,11. This study objective is to determine correlation between suPAR plasma concentration and CD4 T lymphocyte and WHO clinical stagging of HIV infection. Study subjects. Fifty four naieve HIV-1-infected patients (32 males, and 22 females) are participant in a cross sectional study enrolled on 22 November 2007 until 31 july 2008 at the department of infectious disease Saiful Anwar Hospital, Malang, Indonesia. Blood sampling. Two blood samples were drawn before treatment, CD4 counts were measured with an Epics XL-MCL Coulter flowcytometer. EDTA plasma for suPAR measurement was stored at -80°C. Data are presented as mean±standart deviation. P<0.05 is considered significant. Statistical calculations were done using SSPS 15. Patients (n = 54) enrolled and clustered according to WHO clinical stage ( I - IV) at inclusion. All HIV-infected patients had measurable levels of plasma suPAR with a median value of 8,9 ng/mL(range 1,65-29,7 ng/mL). Pearson correlation demonstrated a weak but significant negative between suPAR and CD4 T lymphocyte count (p=-0.634, p<.0005). suPAR level positively correlated with the WHO-defined clinical stages (P< .0005, spearman correlation test, r=0,87). There were significant difference between each stage i.e I(1,6± o,61ng/mL), II(3.04±1.03 ng/mL), III (10.53±7.1ng/mL) and IV (20.42±10.81ng/mL) (P< .0005, Spearman test). In addition pearson correlation demonstrated a weak but significant negative correlation between suPAR and CD4 count (p=-0.66; P<.0005). There were negative significant correlatio between CD4 count and suPAR level, suggested that suPAR could provide as a complementary biological marker for HIV-1 although it can not replace the CD4 count. SuPAR plasma concentration and clinical stage give significantly correlation with WHO clinical staging of HIV infection.
Tailored CML Treatment in Indonesia, Let’s See More Wardhani, Shinta Oktya
Clinical and Research Journal in Internal Medicine Vol. 4 No. 2 (2023): Volume 4 No 2, November 2023
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2023.004.02.01

Abstract

Green Tea Yoghurt with Encapsulated Lacticaseibacillus paracasei E1 Improves Hepatocyte Damage in High-Fat High-Fructose Diet Mice by Reducing MDA and Increasing SOD Fadlilah, Dawama Nur; Izati, Rahmi; Al Faizah, Belinda Nabiila; Kavitarna, Septhyanti Aprilia; Ardiansyah, Esha; Sa'adah, Nur Alfi Maghfirotus; Atho'illah, Mochammad Fitri; Arifah, Siti Nur; Soewondo, Aris; Jatmiko, Yoga Dwi; Wardhani, Shinta Oktya; Barlianto, Wisnu; Rifa'i, Muhaimin
Molecular and Cellular Biomedical Sciences Vol 8, No 3 (2024)
Publisher : Cell and BioPharmaceutical Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21705/mcbs.v8i3.501

Abstract

Background: Obesity is a global epidemic caused by excessive body fat, which is increasing free fatty acids in the liver, causing oxidative stress and liver cell damage. Green tea yogurt (GTY) with encapsulated Lacticaseibacillus paracasei E1 (GTY-LpE1) might have a beneficial effect in reducing liver cell damage. This study was conducted determine GTY-LpE1 effect on superoxide dismutase (SOD) expression, malondialdehyde (MDA) expression and liver histopathology in high-fat high-fructose diet (HFFD) mice. Material and Methods: A completely randomized design (CRD) with 7 groups, including normal diet (ND) group, HFFD group, 1.3 mg/kg BW simvastatin (SIM)-administered HFFD group, 5 g/kg BW probiotic yoghurt (PY)-administered HFFD (PY), 2.5 g/kg BW GTY-administered HFFD (2.5 GTY), 5 g/kg BW GTY-administered HFFD (5 GTY), and 10 g/kg BW GTY-administered HFFD (10 GTY). The diet was given for 16 weeks, followed by oral administration of sim/yoghurt during the last 4 weeks. Mice were sacrificed and the liver was collected. SOD and MDA expression were analyzed by flow cytometry. Histopathology analysis was done by evaluating hematoxylin-eosin (HE) staining of the liver.Result: The percentage of necrotic cells were 34.55, 34.31, and 21.95%, when treated with 2.5, 5, and 10 g/kg BW with GTY-administered HFFD, respectively, these were lower than the ones in the HFFD group (69.49%). The percentage of MDA expression were 15.55, 18.69, and 22.42%, respectively, these were lower than the ones in the HFFD group as well. The percentage of SOD expression were 9.49, 7.85, and 11.11%, respectively, these were higher than the ones in the HFFD group (3.44%). Conclusion: GTY-LpE1 could decrease the number of necrotic cells in the HFFD mice livers and improve the hepatocyte damage by reducing MDA expression and enhancing SOD expression. GTY-LpE1 can be used as an alternative food to control obesity.Keywords: alginate, chitosan, encapsulation, green tea, probiotic
An Epidemiological Study Incidence Rates of Risk Factors for Colorectal Cancer's Early Symptoms in the Community in Gondanglegi District, Malang, East Java, Indonesia: An Epidemiological Study Hermanto, Djoko Heri; Nurarifah, Nina; Brahmantyo, Herwindo Pudjo; Alfiani, Nadia; Dharmesta, Naya Adi; Ardiyanti, Putri; Qhadafy, Arif; Wardhani, Shinta Oktya
Journal of Epidemiology and Public Health Vol. 9 No. 2 (2024)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2024.09.02.12

Abstract

Background: Colorectal cancer (CRC) is one of the most common types of cancer worldwide. CRC is most typical symptom is hematochezia while the risk factors encompass sex, age, genetic predispositions, history of colorectal polyps or cancer, chronic inflammatory bowel diseases, physical exercise, and specific dietary choices, including high red meat intake, fried food, and low fiber consumption. This study aims to screen the risk factors of colorectal cancer.Subjects and Method: This research was conducted on residents in the Sepanjang village, Malang Regency, involved in community service by the Internist Association of Malang. Community service was carried out in July 2023 and 148 residents were involved in collecting data on risk factors for colorectal carcinoma. Data collection was carried out using a questionnaire with a cross-sectional approach. The questionnaire assesses the presence of symptoms of bloody stools and several habits related to colorectal carcinoma risk factors, including age, gender, exercise routine, and dietary history. Data presentation and analysis were carried out as in the table.Results: Among the risk factors listed assessed using the questionnaire, Men (p=0.021), lack of exercise (p= 0.008), consumption of fried food (p= 0.021), and consumption of instant noodles (p= 0.013) significantly affect the prevalence of hematochezia.Conclusion: Men, lack of exercise, consumption of fried food, and consumption of instant noodles significantly affect the hematochezia indicating CRC.
Co-Authors Al Faizah, Belinda Nabiila Alfiani, Nadia Ardiansyah, Esha Ardiyanti, Putri Aris Soewondo Atho'illah, Mochammad Fitri Brahmantyo, Herwindo Pudjo Burhan, Niniek Dharmesta, Naya Adi Ervina, Rita Fadlilah, Dawama Nur Gatoet Ismanoe Gonius, Andry Herman Bagus Trianto, Herman Bagus hermanto, djoko heri Islamiah, Ahadini Izati, Rahmi Kartikasari, Nanik Triana Kavitarna, Septhyanti Aprilia Muhammad Anshory, Muhammad Mustofa Aidid Novi Khila Firani Nurarifah, Nina Nurshanty, Ade Qhadafy, Arif Retnani, Diah Prabawati Rifa'i, Muhaimin Sa'adah, Nur Alfi Maghfirotus Saraswati, Diyah Siti Fatonah Siti Nur Arifah, Siti Nur Supriono Suryana, Bagus Putu Putra Wisnu Barlianto YOGA DWI JATMIKO Yudani, Tri Yudanto, Hendy Setyo