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All Journal PREPOTIF : Jurnal Kesehatan Masyarakat Journal of Aafiyah Health Research (JAHR)
Reza, Muhammad Alfi
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Health Professions Public Health

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SCOPING REVIEW: TANTANGAN TRANSPLANTASI GINJAL DI NEGARA BERKEMBANG Reza, Muhammad Alfi; Suweleh, Yasser Zein; Ghiffary, Muamar; Fauzi, Ahmad Nur; Pramanugraha, Randi Satria
PREPOTIF : JURNAL KESEHATAN MASYARAKAT Vol. 8 No. 3 (2024): DESEMBER 2024
Publisher : Universitas Pahlawan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/prepotif.v8i3.38280

Abstract

Transplantasi ginjal merupakan salah satu solusi utama bagi pasien dengan gagal ginjal terminal, namun implementasinya di negara berkembang menghadapi berbagai tantangan besar. Oleh karena itu, penelitian ini bertujuan untuk memetakan dan menganalisis tantangan-tantangan utama dalam transplantasi ginjal di negara berkembang melalui pendekatan scoping review. Pendekatan scoping review digunakan untuk mengidentifikasi, memetakan, dan menganalisis berbagai bukti yang ada terkait dengan transplantasi ginjal di negara berkembang. Proses pencarian dilakukan secara sistematis di beberapa basis data, termasuk PubMed, Scopus, dan Google Scholar, dengan menggunakan kata kunci yang relevan seperti "kidney transplantation in developing countries", "challenges in kidney transplantation", dan "organ donation barriers". Artikel yang diterbitkan antara tahun 2018 hingga 2023 dipilih dan dievaluasi berdasarkan kriteria inklusi dan eksklusi yang telah ditetapkan. Hasil analisis menunjukkan bahwa tantangan medis utama dalam transplantasi ginjal di negara berkembang meliputi keterbatasan fasilitas medis, kurangnya tenaga medis terlatih, serta masalah terkait imunosupresan dan ketidaksesuaian HLA antara donor dan penerima. Tantangan sosial dan budaya juga berperan penting, dengan rendahnya kesadaran masyarakat mengenai pentingnya donor organ dan adanya stigma terkait donor hidup. Secara ekonomi, biaya tinggi untuk prosedur transplantasi dan perawatan pasca-operasi menjadi hambatan utama. Kebijakan yang lemah dan kurangnya regulasi donor organ turut memperburuk situasi ini. Kesimpulan penelitian ini adalah untuk mengatasi tantangan-tantangan tersebut, diperlukan peningkatan fasilitas medis, pelatihan tenaga medis, serta kebijakan yang mendukung donor organ.  
A Critical Appraisal of Global Guidelines on Obturator Nerve Block in TURP: Urological and Anesthetic Collaboration: Penilaian Kritis terhadap Pedoman Global tentang Blok Saraf Obturator pada TURP: Kolaborasi Urologi dan Anestesi Supardi, Alif Zulfikar; Reza, Muhammad Alfi; Krisna, Muhammad Sidharta; Wirawan, Nur Surya
Journal of Aafiyah Health Research (JAHR) Vol. 6 No. 1 (2025): JANUARY-JUNE
Publisher : Postgraduate Program in Public Health, Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52103/jahr.v6i1.2010

Abstract

ABSTRACT Background: Obturator nerve block (ONB) is increasingly recognized as a crucial component in transurethral resection of the prostate (TURP) to prevent complications such as the obturator reflex, which can lead to intraoperative risks including bladder perforation. While ONB has been incorporated into various global clinical guidelines, its implementation remains inconsistent. Objective: This study critically examines the role of ONB in TURP by analyzing global guidelines, comparing different ONB techniques, and evaluating the integration of ONB with other surgical modalities to improve patient safety and procedural outcomes. Method: A comprehensive review of literature and clinical guidelines was conducted to assess the effectiveness, safety, and best practices related to ONB in TURP. Key parameters examined include the efficacy of ultrasound-guided ONB, multimodal approaches combining ONB with bipolar energy or laser techniques, and the impact of training programs for anesthesiologists. Results: Global guidelines from major urological and anesthesiology associations recommend ONB as a beneficial but non-mandatory procedure in TURP, particularly for high-risk patients. Evidence suggests that ultrasound-guided ONB improves procedural success rates and reduces complications. The combination of ONB with newer surgical modalities offers enhanced safety, and structured training programs can further facilitate its adoption in clinical practice. Conclusion: Although ONB is not universally required for TURP, its application significantly improves intraoperative safety. Standardizing protocols, expanding training programs, and integrating ONB with advanced surgical techniques can enhance the efficacy and reliability of TURP globally. Future research should focus on long-term outcomes and cost-effectiveness to refine clinical recommendations.
Impact of Head and Neck Radiotherapy on Perioperative Airway Management in Urological Surgeries: An Anesthetic and Vascular Perspective: Dampak Radioterapi Kepala dan Leher terhadap Manajemen Jalan Napas Perioperatif pada Bedah Urologi: Perspektif Anestesi dan Vaskular Ghiffary, Muamar; Reza, Muhammad Alfi; Sayati, Muhammad Satir; Awaluddin, Muhammad; Fauzi, Ahmad Nur
Journal of Aafiyah Health Research (JAHR) Vol. 6 No. 1 (2025): JANUARY-JUNE
Publisher : Postgraduate Program in Public Health, Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52103/jahr.v6i2.2026

Abstract

ABSTRACT Background: Radiotherapy is a primary treatment for various types of cancer, but it can cause long-term complications, including tissue fibrosis, vascular stenosis, and urological dysfunction. These effects influence anesthetic strategies, surgical technique selection, and postoperative management. Objective: This study aims to compare the effectiveness of endovascular techniques and open vascular reconstruction in managing post-radiotherapy vascular complications, as well as to evaluate the anesthetic and urological implications of radiation-induced tissue fibrosis. Method: This study reviews literature and clinical data on the effects of radiotherapy on the vascular system, airway, and urological system. The comparison between endovascular techniques and open vascular reconstruction is analyzed based on effectiveness, complication risks, and durability. Results: Endovascular techniques offer a minimally invasive approach with faster recovery but carry a higher risk of restenosis compared to open vascular reconstruction, which provides better long-term outcomes despite greater perioperative complications. In patients with post-radiotherapy fibrosis, carotid artery and jugular vein stenosis increase the risk of stroke, while radiation-induced urethral strictures require reconstructive approaches tailored to severity. In anesthesiology, patients with airway changes due to fibrosis are more safely managed with regional anesthesia and multimodal analgesia techniques. Conclusion: The management of post-radiotherapy patients requires a multidisciplinary approach involving anesthesiology, interventional radiology, urology, and vascular surgery specialists. Combining minimally invasive techniques with more aggressive reconstructive strategies can improve clinical outcomes in patients with vascular and urological complications resulting from radiotherapy.
The Role of Clusterin (CLU) in the Pathogenesis of Benign Prostatic Hyperplasia: Mechanisms and Potential as a Biomarker: Peran Clusterin (CLU) dalam Patogenesis Hiperplasia Prostat Jinak: Mekanisme dan Potensi sebagai Biomarker Reza, Muhammad Alfi; Krisna, Muhammad Sidharta; Diennillah, Fathannia Rizky; Putri, Jihan Asma; Yulianto, Andy
Journal of Aafiyah Health Research (JAHR) Vol. 5 No. 1 (2024): JANUARY-JUNE
Publisher : Postgraduate Program in Public Health, Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52103/jahr.v5i1.2036

Abstract

ABSTRACT Background: Benign Prostatic Hyperplasia (BPH) is a common urological condition characterized by excessive proliferation of prostate epithelial and stromal cells, leading to lower urinary tract symptoms. Clusterin (CLU), a multifunctional glycoprotein, has been implicated in various cellular processes, including apoptosis regulation, inflammation, and autophagy. However, its exact role in BPH pathogenesis remains unclear. Objective: This study aims to analyze the role of CLU in the molecular mechanisms underlying BPH and evaluate its potential as a biomarker for disease progression. Method: A comprehensive analysis of recent literature was conducted to examine CLU expression in BPH tissues and its interactions with inflammatory pathways, hormonal regulation, and cellular homeostasis mechanisms such as apoptosis and autophagy. The study also reviewed CLU’s involvement in epithelial-stromal interactions and its correlation with disease severity. Results: Increased CLU expression in hyperplastic prostate tissues is associated with chronic inflammation, contributing to aberrant cell proliferation and apoptosis resistance. CLU interacts with inflammatory markers such as TNF-α and IL-6, promoting a microenvironment conducive to disease progression. Additionally, CLU is involved in autophagy dysregulation, which may further sustain cellular survival and resistance to apoptosis. Evidence suggests that hormonal factors, particularly androgens and estrogens, regulate CLU expression, linking it to prostate tissue remodeling. These findings highlight CLU as a potential biomarker for assessing BPH severity and progression. Conclusion: CLU plays a critical role in BPH pathogenesis by modulating inflammatory responses, apoptosis, and cellular homeostasis. Its increased expression in hyperplastic prostate tissues suggests that it may serve as a novel biomarker for disease progression. However, further studies are needed to validate its clinical applicability and explore targeted therapies aimed at CLU modulation to improve BPH management.
The Long-Term Urological Consequences of Anabolic Steroid Abuse: A Narrative Review: Konsekuensi Urologi Jangka Panjang dari Penyalahgunaan Steroid Anabolik: Sebuah Narasi Reza, Muhammad Alfi; Krisna, Muhammad Sidharta; Diennillah, Fathannia Rizky; S. , Suriani; Yulianto, Andy
Journal of Aafiyah Health Research (JAHR) Vol. 5 No. 2 (2024): JULY-DECEMBER
Publisher : Postgraduate Program in Public Health, Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52103/jahr.v5i2.2037

Abstract

ABSTRACT Background: Anabolic-Androgenic Steroids (AAS) have been widely used to enhance muscle mass and physical performance. However, their prolonged use has been associated with various adverse effects on urological health, including hypogonadism, infertility, erectile dysfunction (ED), and benign prostatic hyperplasia (BPH). Suppression of the hypothalamic-pituitary-gonadal (HPG) axis due to AAS leads to significant hormonal imbalances and long-term reproductive consequences. Objective: This study aims to review the urological effects of AAS, focusing on their impact on testosterone levels, spermatogenesis, erectile function, and prostate health. The review highlights potential risks and clinical implications for individuals using AAS. Method: A narrative review was conducted by analyzing relevant studies from PubMed, Scopus, and Science Direct published between 2014-2024. Articles were selected based on their relevance to the impact of AAS on urological health, particularly hypogonadism, infertility, ED, and BPH. Data from clinical trials, cohort studies, and systematic reviews were synthesized to provide a comprehensive analysis. Results: Chronic AAS use significantly reduces endogenous testosterone production, leading to hypogonadism and associated symptoms such as fatigue, decreased libido, and mood disturbances. Studies indicate a strong correlation between AAS use and impaired spermatogenesis, with some cases resulting in irreversible infertility. Moreover, AAS users have a higher prevalence of ED compared to non-users due to hormonal imbalances and psychological factors. Excessive androgen stimulation is also linked to an increased risk of prostate enlargement, potentially leading to urinary complications. Conclusion: The long-term use of AAS poses substantial risks to urological health, necessitating awareness and early intervention. Regular medical monitoring and cessation strategies are essential to mitigate these adverse effects. Further research is needed to develop effective rehabilitation and treatment options for individuals experiencing AAS-related urological complications.
Co-Authors Diennillah, Fathannia Rizky Fauzi, Ahmad Nur Ghiffary, Muamar Krisna, Muhammad Sidharta Muhammad Awaluddin, Muhammad Pramanugraha, Randi Satria Putri, Jihan Asma S. , Suriani Sayati, Muhammad Satir Supardi, Alif Zulfikar Suweleh, Yasser Zein Wirawan, Nur Surya Yulianto, Andy