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Marwanto, Pigur Agus
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Nephroureterectomy for Pediatric Giant Wilms Tumor Marwanto, Pigur Agus; Ibrahim, Ibnu Sina
Health and Medical Journal Vol 7, No 3 (2025): HEME September 2025
Publisher : Universitas Baiturrahmah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33854/heme.v7i3.1820

Abstract

Introduction: Wilms' tumor most often occurs in children, with an average age of about 3 to 4 years. About 75% of cases occur in young children aged less than 5 years. These tumors usually develop in one kidney. In the United States, surgery is the first treatment for most Wilms tumors, followed by chemotherapy. According to the International Society of Pediatric Oncology, neoadjuvant chemotherapy is performed first, followed by surgery. Case Presentation: Two Years and six months child was referred to our hospital with giant abdominal mass with difficulty to determine its origin due to its large size. On examination, it was found that the abdomen was distended with a mass palpable in all of quadrant of abdomen. A contrast enhanced abdominal CT showed a solid lumpy mass in the left kidney with a size of 22.36 x 19.66 x 17.12 cm. The renal mass crossed the midline and filled most of the abdominal cavity. The contra lateral kidney shows normal function. Discussion: The most patient come with presenting complaint was abdominal mass (50%), and 35% of the patients presented with an abdominal lump. Western studies reported 74% of patients presenting with an abdominal mass. A study by Guruprasad et al reported that 90% of their patients presented with abdominal mass. Conclusion: Combination of Neoadjuvant chemotherapy and Surgery is important in the management of Wilms Tumor. Radical Nephrectomy and Ureterectomy can be performed safely if performed by an experienced surgeon 
Comparison of Quality of Life During Hormonal Therapy and Chemotherapy in Breast Cancer Patients at Dr. Moewardi Hospital: A Cross-Sectional Study Marwanto, Pigur Agus; Soewoto, Widyanti
Health and Medical Journal Vol. 8 No. 2 (2026): HEME May 2026
Publisher : Universitas Baiturrahmah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33854/heme.v8i2.1906

Abstract

Introduction: Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer-related death among women worldwide, accounting for 25% of all cancer cases and 15% of cancer-related mortality in women. Adjuvant therapies include chemotherapy, hormonal therapy, targeted therapy, radiation, or combinations thereof. The quality of life (QoL) of breast cancer patients varies depending on type of therapy, patient’s condition, and associated side effects. Evaluating QoL differences between hormonal therapy and chemotherapy is essential to assess treatment outcomes and guide clinical decisions. Methods: This cross-sectional study involved 240 breast cancer survivors treated at the Oncology Department of Dr. Moewardi Hospital. Selected participants using random sampling in two groups:  120 patients each groups undergoing chemotherapy and hormonal therapy. Data were collected through interviews and standardized questionnaires using the EORTC QLQ-C30 instrument. QoL data were categorized, and statistical analysis was performed using chi-square tests to examine associations between treatment type and QoL. Logistic regression was used to assess the strength of relationships between variables. Results: Groups receiving hormonal therapy, 116 (96.7%) reported good QoL, and 4 (3.3%) reported moderate QoL. In the chemotherapy group, 80 (66.7%) reported good QoL, 39 (32.5%) moderate, and 1 (0.8%) poor QoL. A statistically significant difference in QoL was observed between the two groups (p = 0.001). Dyspnoea was the only symptom that showed a significant association with treatment type (r = 0.208; p = 0.020). Across general health status, functional scales, and symptom scales, hormonal therapy was associated with better QoL outcomes than chemotherapy. Conclusion: There is a significant difference in the QoL of breast cancer patients undergoing hormonal therapy compared to chemotherapy. Hormonal therapy was a better overall QoL.
Comparative Environmental Sustainability of Reusable SUNS Proque Versus Level 3 PPE in COVID-19 Isolation Wards Bani, Dony Marthen; Ismail, Darmawan; Suwardi; Surya Adhnyana, Ida Bagus Budhi; Wibisono; Marwanto, Pigur Agus
Health and Medical Journal Vol. 8 No. 2 (2026): HEME May 2026
Publisher : Universitas Baiturrahmah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33854/heme.v8i2.2144

Abstract

Background: The COVID-19 pandemic led to an unprecedented surge in the use of disposable personal protective equipment (PPE), contributing to a substantial increase in medical waste and environmental pollution. While Level 3 disposable PPE is widely used to protect healthcare workers, its environmental sustainability remains a growing concern. Reusable PPE systems, such as the Surgeons of Universitas Sebelas Maret Protective Equipment (SUNS Proque), have been developed as alternatives to mitigate environmental impacts while maintaining adequate protection. Objective: This study aimed to compare the environmental sustainability of reusable SUNS Proque PPE and conventional Level 3 disposable PPE used in COVID-19 isolation wards. Methods: An observational analytical cross-sectional study was conducted at Dr Moewardi Hospital in Indonesia. A total of 56 healthcare workers (physicians, nurses, and sanitation staff) who had experience using both PPE types participated. Environmental sustainability was assessed using a validated 10-item Likert-scale questionnaire covering recyclability, reusability, waste volume, material characteristics, waste segregation, and circular economy principles. Statistical analyses included Chi-square tests, independent t-tests, and Eta correlation analysis. Results: SUNS Proque PPE demonstrated significantly higher overall environmental sustainability compared with Level 3 PPE (p < 0.001). Significant differences were observed in recyclability (p = 0.025), design for reuse (p = 0.002), waste volume reduction (p = 0.017; Eta = 0.772), and waste segregation (p = 0.013). Waste volume emerged as the strongest determinant differentiating the two PPE systems. Other indicators, including material toxicity and non-incineration processing, showed no statistically significant differences. Conclusion: Reusable SUNS Proque PPE offers superior environmental sustainability compared with conventional disposable Level 3 PPE, particularly through substantial waste reduction. Integrating reusable PPE into hospital infection control strategies may support environmentally sustainable healthcare systems without compromising occupational safety.
Co-Authors Bani, Dony Marthen Ibrahim, Ibnu Sina ISMAIL, DARMAWAN Surya Adhnyana, Ida Bagus Budhi Suwardi Wibisono Widyanti Soewoto, Widyanti