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OPTIMASI PENGGUNAAN FAKTOR EKSPOSI PADA PEMERIKSAAN BLASS NIER OVERZICHT (BNO) PADA PASIEN DENGAN BERAT BADAN 60-70KG Rifa Afifah; Widya Mufida; Amril Mukmin
Journal of Innovation Research and Knowledge Vol. 5 No. 3: Agustus 2025
Publisher : Bajang Institute

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Background: The abdomen is a body part frequently examined through radiography to diagnose conditions such as acute abdomen, meteorism, or ileus. Proper exposure factor settings, particularly for patients weighing 60–70 kg, are crucial for obtaining high-quality diagnostic images while minimizing radiation doses. This study aims to analyze the optimization of exposure factor usage in abdominal radiography for patients weighing 60–70 kg at Sunan Kudus Islamic Hospital. Method: This research employed a descriptive qualitative method with a case study approach. Data collection was conducted in May 2025 at the Radiology Installation of Sunan Kudus Islamic Hospital. The sample consisted of three patients undergoing abdominal examinations. Data were gathered through observations, interviews with one radiology specialist and three radiographers, as well as documentation of projections. Data were analyzed through reduction and narrative presentation based on theoretical references for conclusions. Result: The examinations were performed with AP Supine, semi-sitting, and Left Lateral Decubitus (LLD) projections using exposure settings of 75–80 kV and 20–25 mAs. The resulting images displayed clear anatomical structures such as lumbar vertebrae, pelvic collar, and both large and small intestines, without significant noise. The radiographs were able to detect conditions such as obstructive ileus, pneumoperitoneum, and meteorism with localized ileus in the mid-abdomen. All patients received high- quality images without the risk of excessive radiation. Conclusion: The exposure settings of 75–80 kV and 20–25 mAs are effective for patients weighing 60-70kg. It is recommended to establish specific Standard Operating Procedures (SOP) regarding exposure factors for patients within this weight range at the Radiology Installation of Sunan Kudus Islamic Hospital

Studi Kasus Prosedur Pemeriksaan Ct Scan Urografi Klinis Batu Ginjal di Instalasi Radiologi RSUD Brebes Yuti Meriani; Fisnandya Meita Astari; Amril Mukmin
JURNAL RISET RUMPUN ILMU KEDOKTERAN Vol. 4 No. 2 (2025): Agustus : Jurnal Riset Rumpun Ilmu Kedokteran
Publisher : Pusat riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/jurrike.v4i2.6416

Urinary tract examination with the CT-Scan modality is considered superior to other imaging modalities because it produces better image resolution, clear anatomical details, and is able to accurately detect abnormalities. At the Radiology Installation of Brebes Hospital, the CT-Scan Urography examination is carried out without fasting requirements. Patients are only asked to remove metal objects from the abdominal area and hold urination before the examination begins. This aims to keep the urinary bladder (VU) fully filled so that it facilitates the evaluation of the anatomy of the urinary system, especially in detecting kidney stones which are the main complaints of patients. This study aims to find out in detail the procedure for CT-Scan Urography clinical urography of kidney stones, as well as the reasons why patients are asked to hold urination and are not asked to fast before the procedure is performed. The research method used is a mix method, which is a combination of qualitative and quantitative, with data collection through observation, interviews, and documentation. The research sample consisted of 3 patients who underwent CT-Scan Urography clinical examination of kidney stones at the Radiology Installation of Brebes Hospital. The results of the study showed that the procedure started from the patient's preparation, such as removing metal objects, drinking mineral water, and holding urination so that the VU was fully filled, thus helping the visualization of organs and urinary tract. This examination does not require fasting because the CT-Scan modality is able to provide a clear picture of the anatomy of the urinary tract without interference from the digestive system. These findings confirm that the CT-Scan Urography procedure at Brebes Hospital is simple, effective, practical, and provides optimal diagnostic results for patients.

ANALISIS KUALITAS CITRA SNR DAN CNR PADA PEMERIKSAAN MANUS DENGAN MENGGUNAKAN PHYTON Rida Amila; Amril Mukmin; Anisa Nur Istiqomah
Journal of Innovation Research and Knowledge Vol. 5 No. 5 (2025): Oktober 2025
Publisher : Bajang Institute

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Latar Belakang: Kualitas citra radiografi memiliki peran penting dalam menunjang ketepatan diagnosis, terutama pada pencitraan bagian tubuh dengan struktur kompleks seperti manus. Penilaian kualitas citra dapat dilakukan secara objektif menggunakan parameter Signal to Noise Ratio (SNR) dan Contrast to Noise Ratio (CNR). Penelitian ini bertujuan untuk menganalisis peningkatan kualitas citra radiografi manus berdasarkan nilai SNR dan CNR setelah dilakukan pengolahan menggunakan filter Gaussian melalui bahasa pemrograman Python. Metode: Penelitian ini menggunakan pendekatan kuantitatif eksperimental dengan data berupa 10 citra radiografi manus format DICOM dari Instalasi Radiologi RSUD Panembahan Senopati Bantul. Citra diolah menggunakan Python melalui Google Colab dengan tahapan unggah data, penghubungan ke Google Drive, pemilihan ROI secara manual, penerapan filter Gaussian, dan perhitungan nilai mean, standar deviasi, noise, SNR, serta CNR. Nilai-nilai tersebut dibandingkan sebelum dan sesudah pengolahan untuk menilai peningkatan kualitas citra. Hasil: pengolahan citra dengan filter Gaussian secara signifikan meningkatkan kualitas citra radiografi manus. Nilai SNR meningkat sebesar 35,90%, dari 78 menjadi 106, yang mengindikasikan perbandingan sinyal terhadap gangguan noise menjadi lebih baik. CNR juga mengalami peningkatan sebesar 3,30%, dari 6 menjadi 6,198, menunjukkan bahwa objek dan latar belakang citra menjadi lebih mudah dibedakan. Nilai noise menurun sebesar 36,75%, dari 2 menjadi 1,264, yang berarti noise pada citra berhasil ditekan. Terjadi peningkatan pada nilai mean intensity sebesar 0,68%, dari 119 menjadi 119,805, serta penurunan standar deviasi intensitas sebesar 5,23%, dari 14 menjadi 13,267. Kesimpulan: Pengolahan citra radiografi manus menggunakan filter Gaussian dalam program Python terbukti dapat meningkatkan kualitas citra secara kuantitatif, terutama dalam hal kontras dan kejernihan tampilan struktur. Pendekatan ini dapat menjadi alternatif praktis dalam analisis citra radiografi digital tanpa harus mengubah parameter eksposi. Pengembangan kedepan disarankan program dilengkapi tampilan interaktif DICOM viewer agar pemilihan ROI lebih cepat serta otomatis ROI dengan deteksi objek untuk meningkatkan akurasi dan konsisten

Studi Kasus Pemeriksaan Radiologi Colon in Loop Post Colostomy pada Kasus Colitis di Instalasi Radiologi RSUD Banyumas Nova Erliyani; Amril Mukmin; Retno Wati
JURNAL RISET RUMPUN ILMU KEDOKTERAN Vol. 4 No. 3 (2025): Desember : Jurnal Riset Rumpun Ilmu Kedokteran
Publisher : Pusat riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/jurrike.v4i3.6810

Colitis is an inflammatory characterized by thickening of the mucosal wall of the colon. The Colon In Loop examination is one of the diagnostic procedures for colitis, utilizing contrast media to assess the functional condition of the colon. At the Radiology Installation of RSUD (Regional General Hospital) Banyumas, the radiological procedure for Colon In Loop was performed on post-colostomy patients, thus differs from previous studies. This study aims to identify the examination procedure of Colon In Loop at RSUD Banyumas, the rationale for using Anteroposterior (AP) and Lateral projections, and the reason for not performing evacuation before the administration of negative contrast media. This qualitative descriptive study employed a case. The subjects included three radiographers, one radiology nurse, and one radiology specialist. The object of study was the Colon In Loop Post Colostomy examination procedure in colitis cases. Data were collected through observation, interviews, documentation. Data analysis involved data reduction and data presentation. confirmed with theory, and narrative presentation leading to conclusions. Result shows contrast media consisting of 250 grams of barium sulfate dissolved in 1000 ml of water (25% w/v). The examination is performed in stages followed by AP and Lateral projection imaging to evaluate contrast distribution in the colon. Negative contrast media administration is performed without prior evacuation to enhance patient comfort and reduce examination time. When administering negative contrast media, evacuation is not performed before air is introduced. This is done based on the patient's condition, to shorten the examination time, and due to considerations regarding the quality of barium sulfate; thus, evacuation could impair barium adherence to the colon mucosa. In conclusion, AP and lateral projections are considered adequate for establishing a diagnosis of colitis. The omission of evacuation is based on patient condition, time efficiency, and the suboptimal quality of barium. It is recommended to perform evacuation and increase barium concentration to improve adherence to the colon mucosal wall.

Studi Kasus Prosedur Pemeriksaan Colon in Loop pada Pasien Pediatrik dengan Kasus Hirschprungs di RSUD Brebes Abid Muhammad Fathul Islam; Ildsa Maulidya Mar'athus Nasokha; Amril Mukmin
JURNAL RISET RUMPUN ILMU KESEHATAN Vol. 4 No. 2 (2025): Agustus : Jurnal Riset Rumpun Ilmu Kesehatan
Publisher : Pusat riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/jurrikes.v4i2.5363

Colon In Loop examination is an important radiographic procedure in the evaluation of Hirschsprung cases in pediatric patients. At Brebes Regional Hospital, there are differences in procedures compared to existing literature, especially in the method of administering contrast media and the projections used. This study aims to review and examine the Colon In Loop examination procedure in pediatric patients with Hirschsprung cases at Brebes Regional Hospital. This study uses a qualitative descriptive approach with a case study method. Data were collected through observation, interviews, and documentation involving three radiographers and one radiologist as research subjects. Data analysis techniques were carried out through data reduction, data presentation, and drawing conclusions. Results Colon In Loop examination in pediatric patients at Brebes Regional Hospital was performed without any special preparation for the patient. Contrast media was used with a stepwise method, namely 50cc in the first stage and added 50cc in the second stage. The projections used included AP (Antero Posterior) and AP oblique to overcome visualization limitations. The Colon In Loop examination procedure at Brebes Regional Hospital differs from the literature regarding the method of contrast media insertion and additional projections. This provides better visualization for Hirschsprung's diagnosis in pediatric patients.

Prosedur Pemeriksaan Radiografi Vertebrae Cervical pada Kasus Phlegmon di Instalasi Radiologi RSUD Kota Yogyakarta Sefiana Nurul Hikmah; Amril Mukmin; Ayu Mahanani
JURNAL RISET RUMPUN ILMU KEDOKTERAN Vol. 4 No. 1 (2025): April : Jurnal Riset Rumpun Ilmu Kedokteran
Publisher : Pusat riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/jurrike.v4i1.4997

Phlegmon is a serious infection affecting the maxillofacial area. Cases of phlegmon cause more than 50% mortality before the development of antibiotics, and 90% are due to acute infection of molar teeth. Examination of cervical vertebrae can help the diagnosis by using AP Axial, Lateral, right posterior oblique (RPO)/left posterior oblique (LPO) projections of 15º-20º cephalad, and right anterior oblique (RAO)/left anterior oblique (LAO) 15º-20º caudad while in the Radiology Installation of Yogyakarta City Hospital, using AP Axial projection 15º cephalad, Lateral and oblique (RPO and LPO) with perpendicular beam direction without other modalities such as MRI and CT Scan. This study aims to further examine radiographic examination procedures and projections of RPO and LPO with perpendicular ray directions. This type of research is qualitative with a case study approach at the Radiology Installation of Yogyakarta City Hospital from September 2024 to May 2025. Data were collected by observation, documentation and interviews with 3 radiographers and 1 radiology specialist. Data analysis was done by data reduction, data presentation and conclusion drawing. The results showed 3-position photographs to evaluate the overall condition of the cervical vertebrae and surrounding tissues. RPO and LPO projections are not angled according to the applicable SOP and have no significant effect, because the main focus of phlegmon is soft tissue evaluation and is not related to the evaluation of nerve abnormalities in the intervertebral foramen. However, for phlegmon cases with serious severity, other modalities such as MRI, CT scan or ultrasound should be added in order to detect soft tissue and the cause of phlegmon for further action.

EXAMINATION TECHNIQUES FOR TEMPOROMANDIBULAR JOINT (TMJ) CLINICAL SUBLUXATION AT THE RADIOLOGY DEPARTMENT OF RSUD BANYUMAS Siti Nurjanah Podomi; Amril Mukmin; Tris Budiyono
Journal of Innovation Research and Knowledge Vol. 5 No. 8 (2026): Januari 2026
Publisher : Bajang Institute

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Background: Radiographic examination of the temporomandibular joint (TMJ) is an important procedure for assessing the structural condition of the joint, particularly in cases of subluxation. At the Radiology Department of RSUD (Regional General Hospital) Banyumas, this procedure is generally performed using the axiolateral projection with the Schuller method in accordance with the standard operating procedure (SOP). However, in practice, an additional AP Axial Towne projection is often used to obtain more comprehensive diagnostic results, especially for patients with a history of trauma or complex complaints. Methods: This study employed a descriptive qualitative approach using a case study method. Data were collected through direct observation, interviews with radiographers and radiologists, and documentation of patient radiographs. During the data reduction phase, collected notes and recordings were transcribed and subsequently coded using open coding techniques. Results: The addition of the AP Axial Towne projection provided enhanced visualization of the osseous structures of the TMJ, particularly the condyle and mandibular fossa. This additional projection allows radiographers to identify abnormalities such as fractures or positional changes of the condyle that may not be clearly visible using the Schuller projection alone. Conclusion: The inclusion of the AP Axial Towne projection in TMJ examinations for clinical subluxation is both effective and clinically relevant. The researchers recommend adding the Law method projection for TMJ assessment, as it uses a minimal beam angulation, reducing distortion, preventing muscle spasm, and providing more accurate anatomical representation. In addition, using a high kV technique is recommended to minimize the radiation dose received by patients.

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