Rizka Fathoni Perdana
Department Of Otorhinolaryngology And Head-Neck Surgery, Faculty Of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya

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Transnasal Esophagoscopy Procedure in Outpatient Clinic at Dr. Soetomo General Academic Hospital Muhammad Qodri Anantomo; Rizka Fathoni Perdana
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 2 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i2.17971

Abstract

Background: Transnasal esophagoscopy is a small caliber flexible esophagoscopy technique that has the same as diagnostic accuracy as conventional esophagoscopy. In addition, this technique is safer than any other techniques and has patient tolerance. Aims: This study aims to analyze and evaluate the transnasal esophagoscopy (TNE) procedure in patients. Method: retrospectively approach was used in this study by taking data from the activity register of the broncho-esophagology division of outpatient unit of ORL-HNS Dr. Soetomo General Academic Hospital. TNE report book and patient medical records were collected to have the data. The observation period was 2013 to 2017. Result: patients who met the inclusion and exclusion criteria was 99 patients, with a male to female ratio of 2.3: 1. Most endoscopic findings were normal esophagus (56.57%). Existing abnormal findings included esophageal stenosis (18.18%), esophageal mucosal lesions (14.14%), and esophageal tumors (11.11%). TNE examination complications were found to be 1%. Conclusion: Transnasal esophagoscopy is widely used in patients aged 51-60 years with dysphagia, reflux or globus as the most common indications. TNE is quite safe to do in an outpatient hospital setting.
Profile of Patients with Ear, Nose, and Throat Foreign Bodies on Emergency Room, RSUD Dr. Soetomo in 2018 Raka Ihsanulhaj; Rizka Fathoni Perdana; Sahudi Abdul Mujib; Puguh Setyo Nugroho
Health Notions Vol 5, No 4 (2021): April
Publisher : Humanistic Network for Science and Technology (HNST)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/hn50401

Abstract

Foreign bodies in the ear, nose, and throat (ENT) is a common emergency case found in the emergency room. On 2016, it was found that 689 patients admitted to RSUD Dr. Soetomo’s emergency room due to foreign bodies on their ear, nose, or throat. This study aims to determine the profile of patients with foreign bodies on their ear, nose, or throat that admitted to Emergency Room, RSUD Dr. Soetomo in 2018. This type of research was a retrospective study using medical records of patients. The total of patients in this study was 802 patients. It was found that the most common foreign bodies was found on ear with 342 cases (42.64%), followed by nose with 265 cases (33.04%), and lastly throat with 195 cases (24.31%). The most common patients age group was 0-10 years with 376 cases (46.88%), followed by patients with age group more than 50 years with 93 cases (11.60%). There were more males patients with 445 patients (55.49%) rather than women with 357 patients (44.51%). The most common foreign bodies on ear was cotton with 173 cases (50.58%). The most common foreign bodies on nose was bead with 137 cases (51.70%). The most common foreign bodies on throat was fish bone with 166 cases (85.13%). The standard procedure for patients with foreign bodies was with extraction, extra procedure may be needed according to the condition of patients. Most of the patients showed no complication after the treatment. Keywords: foreign bodies; the ear, nose, and throat (ENT), profile of patients
Transnasal Esophagoscopy Examination in Outpatient Unit, Department of Otorhinolaryngology Head and Neck Surgery, Dr. Soetomo Hospital, Surabaya Rizka Fathoni Perdana
Folia Medica Indonesiana Vol. 56 No. 1 (2020): March
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (449.551 KB) | DOI: 10.20473/fmi.v56i1.24616

Abstract

Esophagoscopy is the standard examination standard for evaluation, diagnosis, screening and surveillance of esophageal diseases. Although it is often done, esophagoscopy costs a lot, is inconvenient, and risks complications, including cardiopulmonary complications because patients usually require routine sedation in the implementation of conventional esophagoscopic procedures. The purpose of this study is to get an overview of the results of the implementation of transnasal esophagoscopy in Department of Otorhinolaryngology Head and Neck Surgery, Division of Broncho-oesophagology, Dr. Soetomo Hospital, Surabaya, between 1 September 2012 and 30 April 2015. This study was a retrospective descriptive study with a population of all patients undergoing esophagoscopic examinations during this period. Data is taken from medical records of new patients undergoing transnasal esophagoscopy. Inclusion criteria were all patients who had been tested for transnasal esophagoscopy, and exclusion criteria were incomplete medical record data. There were 35 patients who underwent transnasal esophagoscopy examination at Department of Otorhinolaryngology Head and Neck Surgery, Division of Broncho-oesophagology, Dr. Soetomo Hospital, Surabayaduring the study period. The mean of patients who participated in the study was 54.17 ± 14.02. 23 male patients (63.89%), while 12 female patients or 34.11%. Indications of dysfagi are found in all age groups, most in the age group 51-70 years. Metastases in head and neck malignancies are found in the age group 31 - 50 years and 51 - 70 years. Indications for heartburn are found in the age group 21-50 years and 51-70 years. In conclusion, the results of transnasal esophagoscopic examination showed that most patients had a normal picture (60%) and a positive picture with an esophageal abnormality of 40%. The most common features are lesions in the mucosal esophagus lumen, scar, masses and stenosis.
NO ASSOCIATION OF RECURRENT RESPIRATORY PAPILLOMATOSIS AGGRESSIVENESS AND HUMAN PAPILLOMAVIRUS TYPE 6 AND 11 Rizka Fathoni Perdana; Sri Herawati; Bakti Suroso; Eduardus Bimo Aksono
Indonesian Journal of Tropical and Infectious Disease Vol. 6 No. 5 (2017)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (171.917 KB) | DOI: 10.20473/ijtid.v6i5.3705

Abstract

Recurrent Respiratory Papillomatosis (RRP) is the most common benign neoplasm of the larynx among children as a result of HPV infection mainly type 6 and 11. RRP is still considered as serious problem since papilloma in the airway can cause hoarseness and obstruction which later described as aggressive and non aggressive types. Patients underwent multiple surgeries to keep airway patency and in order to communicate vocally. Previous studies reported that HPV-11 was associated with a more aggressive disease course. This study aim is to determine the association of RRP aggressiveness with HPV-6 and 11. Papilloma specimens were taken from patients who underwent surgical treatment of RRP patients and subjected HPV typing. All 17 patients with completed data and epidemiologic questionaires were defined for their staging to disease severity. Informations in the database were analyzed to identity statistically significant relationship with HPV type and knowing the HPV type is to predict the disease course. 17 patients RRP (12 males and 5 females) with age at onset 3,15 + 2,28 years and age at diagnosis 3,81 + 2,51 years. Surgery was performed 2,71 ± 1,16 times per year and 9 patients treated more than 3 surgeries per year. 10 patients had distal papilloma and 11 patients had tracheotomy. Agrressive disease was show found in 14 patients among 17 patients. HPV-11 was detected in 10 patients, HPV-6 was detected in 7 patients. According to the statisitcal analysis (Chi square test), there is no relationship between HPV type and disease aggressiveness. HPV-6 and 11 are not the only cause that affect the aggressiveness of Recurrent Respiratory Papillomatosis.
MENINGKATKAN KEMAMPUAN DETEKSI DINI DAN PENATALAKSANAAN GANGGUAN PENDENGARAN DI KALIBARU KULON BANYUWANGI Puguh Setyo Nugroho; Rosa Falerina; Nyilo Purnami; Rizka Fathoni Perdana; Alfian Nurfaizi
Jurnal Layanan Masyarakat (Journal of Public Services) Vol. 5 No. 1 (2021): JURNAL LAYANAN MASYARAKAT
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jlm.v5i1.2021.95-102

Abstract

Hearing loss can disrupt communication, which has an impact on social, school, and work environments. Early detection and management of hearing loss can prevent it. The community is hoped to be contributed by raising awareness of hearing loss and its prevention. Therefore, educational activities in the form of counseling and training were carried out for various groups in Kalibaru Kulon village, Kalibaru Sub District, Banyuwangi District, East Java. The aim of the counseling and training on early detection of hearing loss for medical personnel is to increase their knowledge and skills at the Public Health Center (Puskesmas) to perform early detection and management of hearing loss. The purpose of hearing health counseling activities for “Satya Kencana” youth organizations is to increase their knowledge as a strategic age in the community to engage in early detection of hearing loss activities in the community. The training of medical personnel was conducted through lectures, practice skills, and questions and answers (Q&A), the average pre-test result was 47,67 (15,69) and the average post-test was 80,67 (22,73). The comparison of both results had significantly different results (p<0,0001). Hearing health counseling for “Satya Kencana” youth organizations was conducted with lectures and Q&A. The average pre-test result was 53,08 (13,72) and the average post-test result was 86,28 (20,81). The comparison of both results also showed significantly different results (p<0,0001).AbstrakGangguan pendengaran dapat mengganggu komunikasi yang berdampak pada lingkungan sosial, sekolah, dan pekerjaan. Gangguan pendengaran dapat dicegah dengan deteksi dan penatalaksanaan dini gangguan pendengaran. Diharapkan masyarakat dapat  berkontribusi dengan meningkatkan kesadaran terhadap gangguan pendengaran dan pencegahannya. Sehingga dilaksanakan kegiatan edukasi berupa penyuluhan dan pelatihan untuk berbagai kalangan di desa Kalibaru Kulon Kecamatan Kalibaru Kabupaten Banyuwangi Jawa Timur. Tujuan kegiatan penyuluhan dan pelatihan deteksi dini gangguan pendengaran untuk tenaga medis adalah meningkatkan pengetahuan dan keterampilan tenaga medis di puskesmas untuk melakukan deteksi dan penatalaksanaan dini gangguan pendengaran. Tujuan kegiatan penyuluhan kesehatan pendengaran untuk karang taruna Satya Kencana adalah meningkatkan pengetahuan karang taruna sebagai usia strategis di masyarakat untuk berperan serta dalam kegiatan deteksi dini gangguan pendengaran di masyarakat. Pelatihan tenaga medis dilakukan dengan metode ceramah, praktek ketrampilan, dan tanya jawab dengan hasil rata-rata pre test 47,67 (+15,69) dan rata-rata post test 80,67 (+22,73). Perbandingan hasil pre test dan post test  didapatkan hasil yang berbeda signifikan (p<0,0001). Penyuluhan kesehatan pendengaran untuk karang taruna Satya Kencana dilaksanakan dengan ceramah dan tanya jawab dengan hasil rata-rata pre test 53,08 (+13,72) dan rata-rata post test 86,28 (+20,81). Perbandingan hasil pre test dan post test didapatkan hasil yang berbeda signifikan (p<0,0001).
EDUKASI TENTANG GANGGUAN PENDENGARAN AKIBAT BISING KEPADA WARGA GENTENG KULON BANYUWANGI JAWA TIMUR Puguh Setyo Nugroho; Nyilo Purnami; Rosa Falerina; Rizka Fathoni Perdana; Yoga Rahmadiyanto; Chriscelia Valery So
Jurnal Layanan Masyarakat (Journal of Public Services) Vol. 5 No. 2 (2021): JURNAL LAYANAN MASYARAKAT
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jlm.v5i2.2021.356-363

Abstract

AbstractNoise can have an impact on hearing loss. Changes in hearing thresholds due to noise are some temporary but others potentially permanent. The impact of hearing loss must be controlled so the quality of life will not decrease. A cross-sectional study to assess the quality and increasing knowledge about noise-induced hearing loss was implemented with lectures, discussions and a pre-test before the activity and a post-test after the activity to assess the knowledge development. The polling was conducted to assess the participants' attitudes and psychomotor skills. The study was followed by 77 participants, most of whom were aged 20-30 years, namely 23 (30%). It was found that 16 people (20%) had complaints of hearing loss, 18 people (24%) often used headsets and earphones, 18 (23%) people worked in noisy places. The average pre-test result was 35.06 (+13.72) and the post-test was 77.9 (+20.81). Comparison of pre-test and post-test results of hearing health education obtained different results (p < 0.0001) significantly. Noise-induced hearing loss is permanent deafness and cannot be treated with medicine or surgery. Prevention is the most important thing from noise-induced hearing loss. The counseling education about noise-induced hearing loss on community must always be performed as an prevention and early detection.Keywords: deafness, noise induce hearing loss, prevention, education AbstrakBising dapat berdampak terhadap gangguan pendengaran. Perubahan batas pendengaran akibat bising yang bersifat sementara, dan perubahan batas pendengaran akibat bising yang bersifat menetap. Dampak gangguan pendengaran harus dikendalikan agar tidak menimbulkan penuruna kualitas kehidupan. Studi cross sectional untuk menilai kualitas dan upaya peningkatan pengetahuan tentang gangguan pednegaran akibat bising dilaksanakan dengan ceramah, diskusi dan dilakukan pre test sebelum kegiatan dan post test setelah kegiatan untuk menilai peningkatan pengetahuan. Survei jajak pendapat dilakukan untuk menilai sikap dan psikomotor peserta. Studi diikuti 77 peserta, usia terbanyak di usia 20 – 30 tahun yaitu 23 orang (30%). Didapatkan 16 orang (20%) mengalami keluhan gangguan pendengaran, 18 orang (24%) sering menggunakan headset dan earphone,18 (23%) orang bekerja di tempat bising.  Hasil rata-rata pre test 35,06  (+13,72) dan rata-rata post test 77,9 (+20,81). Perbandingan hasil pre test dan  post  test  penyuluhan  kesehatan  pendengaran  didapatkan  hasil  yang  berbeda signifikan (p < 0,0001). Tuli akibat bising merupakan tuli yang bersifat menetap dan tidak dapat diobati dengan obat maupun pembedahan, pencegahan merupakan hal yang terpenting dari tuli akibat bising atau noise induced hearing loss.Kegiatan edukasi penyuluhan gangguan pendengaran akibat bising harus senantiasa dilakukan di masyarakat sebagai upaya pencegahan dan deteksi dini.Kata kunci: Tuli, gangguan pendengaran karena bising, pencegahan, edukasi 
MENINGKATKAN KUALITAS PENDIDIKAN UNTUK ANAK DENGAN BERKEBUTUHAN KHUSUS TUNA RUNGU DAN WICARA DI SLB B DI ERA PANDEMI Puguh Setyo Nugroho; Nyilo Purnami; Rosa Falerina; Rizka Fathoni Perdana; Yoga Rahmadiyanto; Chriscelia Valery So
Jurnal Layanan Masyarakat (Journal of Public Services) Vol. 5 No. 2 (2021): JURNAL LAYANAN MASYARAKAT
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jlm.v5i2.2021.364-371

Abstract

AbstractA child with a hearing and speech impairment has the same right to education as all children. An equal access to education as an investment to their future. The Acceleration of Digitization and restrictions on activities that occurred during the pandemic and the fourth industrial revolution have led to a challenge of education process, especially for hearing and speech impairments students. This cross-sectional study aims to discover the quality of education and evaluate the knowledge gained from participating in an educational course by giving pre-test and post-test questionnaire. A polling method was conducted to assess the participants' attitudes and psychomotor. This study was attended by 627 respondents including SLB B teachers 267 respondents (43%), parents of students 191 respondents (30%) and the public 169 respondents (27%).  The average pre-test score was 47,67 (+15,69) and the post-test average was 80,67 (+22,73). A mean difference between pretest and post-test score was significant at p < 0.0001. The principles of the education for a child with a hearing and speech impairment is to building children's independence by 293 respondents (23%), using innovative methods of teaching 143 respondents (20%) and increase the utilization of educational facilities and infrastructure 64 respondents (10%).  The strategies to teach a child with a hearing and speech impairment is using innovative methods, starting with understand the children’s character and needs. One of the keys to a successful academic experience for children with disabilities is a productive and supportive relationship between parents and teachers.Keywords : Hearing impairment, speech impairment, educational, independence AbstrakAnak dengan tuna rungu dan wicara memiliki hak dasar. Salah satu hak dasar adalah mendapatkan akses pendidikan yang berkualitas untuk  memberikan bekal untuk kehidupan masa depan.  Pandemi, revolusi industri 4.0 terjadi percepatan digitalisasi informasi yang terjadi dan pembatasan fisik menjadi tantangan terhadap proses pendidikan untuk anak tuna rungu dan wicara. Studi cross sectional untuk menilai kualitas dan upaya peningkatan kualitas pendidikan dilaksanakan dengan seminar pendidikan dan dilakukan pre test sebelum kegiatan dan post test setelah kegiatan untuk menilai peningkatan pengetahuan. Survei jajak pendapat dilakukan untuk menilai sikap dan psikomotor peserta. Studi ini diikuti oleh 627 responden meliputi guru SLB B 267 orang (43 %), orang tua anak didik191 orang (30 %) dan masyarakat umum 169 orang (27 %). Aspek pengetahuan didapatkan hasil pre test 47,67 (+15,69). Hasil rata rata post test 80,67 (+22,73). Perbandingan hasil pre test dan post test  didapatkan hasil yang berbeda signifikan (p<0,0001) sehingga didapatkan peningkatan pengetahuan sebelum dan setelah kegiatan. Sedangkan fokus pendidikan untuk anak tuna rungu dan wicara adalah menumbuhkan kemandirian anak di masa depan 293 orang (47 %), inovasi metode pembelajaran 143 orang (23 %), 127 orang (20 %) dan Penguatan sarana dan prasarana pembelajaran 64 orang (10 %). Perlu inovasi dalam metode pendidikan untuk anak tuna rungu dan tuna wicara. Inovasi dimulai dengan memahami karakter dan kebutuhan anak tuna rungu dan wicara. Kolaborasi antara segenap elemen orang tua dan guru menjadi kunci keberhasilan pendidikan untuk anak tuna rungu dan tuna wicara yang bertujuan untuk kemandirian dan bekal di masa depanKata kunci : Tuna rungu dan tuna wicara, pendidikan, kemandirian 
SIGN LANGUAGE TRAINING FOR HEALTH STAFF Puguh Setyo Nugroho; Nyilo Purnami; Rosa Falerina; Rizka Fathoni Perdana; Yoga Rahmadiyanto; Hendra Kurnia Rakhma; Sumarman Sumarman; Sriati Sriati
Jurnal Layanan Masyarakat (Journal of Public Services) Vol. 6 No. 1 (2022): JURNAL LAYANAN MASYARAKAT
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jlm.v6i1.2022.99-108

Abstract

Effective communication is a pillar of excellent service in the healthcare unit. Communication among health workers, hearing impaired and speech impaired will cause obstacles to services. Sign language skills need to be possessed by health workers in communicating with people who are deaf and speech impaired. Socializing sign language and developing sign language skills for health workers in health services. After participating in the training, health workers are expected to know and have sign language skills. Community service activities in the form of sign language training for health workers in health services are carried out with lectures, quiz, discussions and practice of sign language skills. Activities are carried out through online method. The activity was attended by 1,593 participants. The most participants were midwives (570 participants-35.8%), nurses (518 participants -32.5%) and doctors (191 participants -12%). A total of 1,333 participants (83.7%) experienced communication problems with the hearing impaired and speech impaired. The training was felt to be useful by 1,215 participants (76.3%). The average result of the pre-test quiz was 33.54 (+13.11) and the average post-test quiz was 61.23 (+10.41). Comparison of pre-test and post-test results of hearing health education obtained statistically significant differences (p < 0.0001). The benefits of training activities are felt to be useful and needs to be intensified to improve the quality of services and the quality of life for people who are hearing impaired and speech impaired.
EARLY DETECTION TRAINING OF HEARING DISORDERS IN THE ERA OF THE COVID 19 PANDEMIC FOR HEALTH PERSONNEL AT GENTENG KULON BANYUWANGI HEALTH CENTER, EAST JAVA Puguh Setyo Nugroho; Nyilo Purnami; Rizka Fathoni Perdana; Rosa Falerina; Hendra Kurnia Rakhma
Jurnal Layanan Masyarakat (Journal of Public Services) Vol. 6 No. 1 (2022): JURNAL LAYANAN MASYARAKAT
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jlm.v6i1.2022.129-142

Abstract

The COVID 19 pandemic impacts the early detection of hearing impairment. Socialization is needed in the form of early detection education of hearing loss in the era of the COVID 19 pandemic to health workers in the front line. The purpose of educational activities is to improve the knowledge and skills of health workers to conduct early detection of hearing impairment in the era of the COVID 19 pandemic. The condition of the COVID 19 pandemic changed the interaction pattern between people, including in education and training activities in the field of health. Education with on line means is becoming a common thing to do today. This training activity is conducted on line and off line methods with limited participants. The training for health workers was carried out using an off line method and was attended by 39 participants. The average result of the pre test was 45.20 (+ 15.69), and the average post test was 80.67 (+ 22.73). Comparison of the pre test and post test results with the t-test, the results were significantly different (p < 0.0001). The training with the on line method was attended by 1,145 participants. The results of the average pre test score were 55.30 (+15.61), and the post test average score was 72.82 (+21.61). Comparison of the pre test and post test scores with the t-test results was significantly different (p < 0.0001). On line and off line methods in training activities provide significant results in increasing the knowledge of health workers so that the pandemic does not hinder the implementation of training activities to increase the knowledge of health workers in an effort to improve the quality of life of the community, in this case, hearing.
EHANCING COMMUNITY SERVICE ACTIVITIES ON EARLY DETECTION AND MANAGEMENT OF HEARING IMPAIRMENT IN THE ERA OF THE COVID-19 PANDEMIC Puguh Setyo Nugroho; Nyilo Purnami; Rizka Fathoni Perdana; Rosa Falerina; Alfian nurfaizi
Jurnal Pengabdian Masyarakat Dalam Kesehatan Vol. 3 No. 2 (2021): OCTOBER 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jpmk.v3i2.25545

Abstract

PENDAHULUAN: Telinga adalah salah satu organ yang paling penting  dari  akal , yang memungkinkan manusia untuk mendengar, menerima informasi, berkomunikasi, dan bersosialisasi dengan orang lain. Gangguan pendengaran akan menghambat kehidupan dan sosialisasi manusia. Anak-anak yang lahir dengan gangguan pendengaran akan menjadi tuna rungu; karena itu, gangguan pendengaran harus dideteksi dan bertindak dini dan menyeluruh. Wabah COVID-19 berdampak pada deteksi dini dan gangguan pendengaran. Sosialisasi berupa edukasi tentang deteksi dini dan gangguan pendengaran di era pandemi COVID-19 kepada tenaga medis garis depan yang diperlukan. Kegiatan edukasi tersebut bertujuan untuk meningkatkan pengetahuan dan keterampilan tenaga medis untuk melakukan deteksi dini dan penanganan gangguan pendengaran dalam pandemi COVID-19.METODE: Kondisi wabah COVID-19 juga telah mengubah pola interaksi manusia, termasuk kegiatan pendidikan dan pelatihan di bidang medis. Pendidikan online kini sudah menjadi praktik yang lumrah. Studi Penyanyi mengikuti kegiatan Metode edukasi DetEksi dini Dan Gangguan pendengaran di era Pandemi COVID-19.HASIL: Seminar dengan metode online ini dilaksanakan dengan ceramah dan tanya jawab (Tanya Jawab) yang diikuti oleh 1.4 84 peserta. Skor rata-rata dari tes awal adalah 55. 05 (+ 15,61) dan skor rata-rata post-tes adalah 72. 00 (+ 21,61). Perbandingan hasil kedua dengan uji-t memberikan hasil yang berbeda nyata (p <0,0 5 ).KESIMPULAN: Metode online dalam kegiatan pendidikan menunjukkan hasil yang signifikan dalam meningkatkan pengetahuan tenaga medis.