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All Journal International Journal of Integrated Health Sciences Majalah Kedokteran Bandung Althea Medical Journal Indonesian Journal of Cancer Majalah Kedokteran Sriwijaya Indonesian Journal of Rheumatology Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Indonesian Journal of Cancer
Amaylia Oehadian
Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Hasan Sadikin Bandung
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Overview of Anemia among Systemic Lupus Erythematosus Patients in Reproductive Age Women based on Reticulocyte Hemoglobin Equivalent (RET-He) Level and Reticulocyte Count Modjaningrat, Ismiana Fatimah; Oehadian, Amaylia; Ghozali, Mohammad; Hamijoyo, Laniyati
Indonesian Journal of Rheumatology Vol 9, No 2 (2017)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Anemia is a common manifestation found among patients with Systemic Lupus Erythematosus (SLE). It may be caused by iron-deficiency, autoimmune hemolytic, and chronic inflammation. Each anemia has different therapy approachments. Without adequatemanagement, anemia may lead to poor prognosis. By identifying the etiology of anemia, appropriate management could be conducted. Reticulocyte Hemoglobin Equivalent (RET-He) and reticulocyte count test may distinguish anemia based on its etiology. This study aimed to give scientific portrayed of the proportion of anemia based on its etiology among patients with SLE using RET-He and reticulocyte count.Method: This study involved women diagnosed with SLE underwent outpatient treatment in Rheumatology Clinic, Dr. Hasan Sadikin General Hospital during SeptemberOctober 2016. Data were collected from blood exam using 35-parameters hematology Sysmex by calculating levels of hemoglobin, RET-He, and reticulocyte count.Results: Seventy four female patients were volunteered as subject in this study with median of age was 29.5 (16-70) years old. Thirty four (46%) of 74 subjects weresuffering from anemia and 12 (35%) of them were between 25-34 years old. Proportion of iron-deficiency anemia, autoimmune hemolytic anemia, and chronic inflammatory anemia were 14 ( 41%), 13 (38%), and 7 (21%), respectively.Conclusion: Based on hemoglobin, RET-He, and reticulocyte count, iron-deficiency anemia is the most common anemia among patients with SLE in repoductive age.Keyword: Age, Anemia, Reticulocyte, RET-He, Systemic Lupus Erythematosus (SLE)
Therapeutic Responses of Imatinib and Nilotinib among CML Patients in Hasan Sadikin Hospital Bandung Sumantri, Agung Firmansyah; Oehadian, Amaylia; Wijaya, Indra; Vidyaniati, Putri; Rahmaniati, Rahmaniati
Indonesian Journal of Cancer Vol 12, No 3 (2018): July-September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (843.37 KB) | DOI: 10.33371/ijoc.v12i3.615

Abstract

Introduction: Chronic Myeloid Leukemia (CML) is a myeloproliferative malignancy with an estimated incidence in the world of 1-2 cases per 100,000 adults. The use of Tyrosine Kinase Inhibitors (TKI) as a therapy for CML is still the first choice for treatment, but some cases show a high level of resistance or intolerance to TKI therapy. This study aims to identify the therapeutic responses of imatinib and nilotinib among CML patients in Bandung.Method: This study is an analytical descriptive study of CML patients at Hasan Sadikin Hospital’s Hematology and Medical Oncology Outpatient Clinic in 2017. The total number of samples in this study is 244 patients, consisting of 199 patients with Imatinib therapy and 45 patients with Nilotinib therapy. The data is processed using SPSS Statistics 22.0 software.Result: The results showed that CML patients had a median age of 42 years, sex ratio of 1: 1 and the highest prevalence was in Bandung City (21.3%). Hematologic response is dominated by complete hematologic response, as high as 72.86% with Imatinib and 66.67% with Nilotinib. Molecular response 3-6 months post therapy is dominated by suboptimal response in as many as 36,8% with Imatinib and failure in as many as 50% with Nilotinib. Molecular response 12-18 months post therapy is dominated by failure in as high as 69,4% with Imatinib and 52,4% with Nilotinib.Conclusion: Based on the molecular response, the rates of suboptimal response and resistance are quite high. Regular monitoring standards of therapy for CML patients are needed to identify TKI resistance so alternative therapies can be provided to improve the outcomes.
PERBEDAAN EKSPRESI VASCULAR ENDOTHELIAL GROWTH FACTOR DAN EKSPRESI TISSUE FACTOR BERDASARKAN RESPONS TERAPI KEMORADIASI CISPLATIN PADA PENDERITA KARSINOMA NASOFARING STADIUM LANJUT Hendarsih, Een; Oehadian, Amaylia; Sumantri, Rachmat; Supandiman, Iman; Hernowo, Bethy S.
Majalah Kedokteran Bandung Vol 47, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Vascular endothelial growth factor (VEGF) merupakan faktor angiogenik yang berperan dalam angiogenesis tumor. Tissue factor (TF) merupakan inisiator utama pembekuan darah dan merangsang protein yang mengatur angiogenesis. Penelitian bertujuan mengetahui perbedaan ekspresi VEGF dengan ekspresi TF pada penderita KNF stadium lanjut berdasarkan respons terapi kemoradiasi. Dilakukan penelitian kohort prospektif pada penderita KNF stadium III, IVa, dan IVb berdasarkan AJCC edisi ke-7 tahun 2010. Ekspresi TF dan VEGF diperiksa dengan imunohistokimia dan respons kemoradioterapi dievaluasi dengan memakai Response Evaluation Criteria in Solid Tumours (RECIST) revisi versi 1.1 tahun 2009. Analisis statistik yang digunakan adalah Uji eksak Fisher. Selama penelitian Oktober 2012?Oktober 2013 didapatkan 35 penderita KNF yang memenuhi kriteria inklusi dan 5 orang dikeluarkan dari penelitian. Pada kelompok respons didapatkan 17 dari 23 penderita ekspresi VEGF ? 25%; 6 dari 23 penderita ekspresi VEGF <25%; 16 dari 23 penderita ekspresi TF ? 33%; 7 dari 23 penderita ekspresi TF <33% (p=1,000) serta pada kelompok tidak respons 5 dari 27 penderita ekspresi VEGF ?25%; 2 dari 7 penderita ekspresi VEGF <25%; 4 dari 7 penderita ekspresi TF ? 33%; 3 dari 7 penderita ekspresi TF <33% (p=0,657). Simpulan, tidak terdapat perbedaan ekspresi VEGF dengan ekspresi TF pada penderita KNF stadium lanjut berdasarkan respons terapi kemoradiasi. [MKB. 2015;47(1):49?54]Kata kunci: Karsinoma nasofaring, respons kemoradiasi, tissue factor, vascular endothelial growth factorDifferences between Vascular Endothelial Growth Factor Expression and Tissue Factor Expression Based on Cisplatin Chemoradiation Therapy Response in Advanced Stage Nasopharyngeal CancerVascular endothelial growth factor (VEGF) is a proangiogenic factor involved in the angiogenesis of NPC. Tissue factor (TF), the main initiator of blood coagulation, also signals protein that regulates angiogenesis. This study  analyzed the differences between VEGF expression and TF expression in tumor tissue based on chemoradiation therapy response. Prospective cohort study was performed in NPC patients stage III, IVa and IVb according to the AJCC VII staging system. TF expression and VEGF expression were measured by immunohistochemistry, and chemoradiotherapy responses was evaluated by RECIST version 1.1 2009. Statistical analysis was performed using Fisher Exact test. From October 2012 to October 2013, 35 NPC patients were eligible for this study and 5 patients were excluded. In response group, there were 73.9% patients with VEGF expression ?25%, 26.1% patients with VEGF expression <25%; 69.6% patients with TF expression ?33%, 30.4% patients with TF expression <33% (p=1,000) and in no response group, there were 71,4% patients with VEGF expression ? 25%; 28.6% patients with VEGF expression <25%, 57.1% patients with TF expression  ?33%, 42.9% patients with TF expression <33% (p=0.657). In conclusion, there are differences between VEGF expression and TF expression based on the chemoradiation therapy response, but they are not significantly different. [MKB. 2015;47(1):49?54]Key words: Nasopharyngeal carcinoma, chemoradiation response, tissue factor, vascular endothelial growth factor DOI: 10.15395/mkb.v47n1.397   
Gambaran eGFR Menurut CKD-EPI pada Penderita Thalassemia Mayor di Rumah Sakit Dr. Hasan Sadikin Bandung Doloksaribu, Rismauli; Husna, Rizka; Oehadian, Amaylia
Majalah Kedokteran Bandung Vol 49, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v49n1.980

Abstract

Peningkatan harapan hidup penderita thalassemia menyebabkan manifestasi penyakit pada berbagai organ, termasuk ginjal. Estimated glomerular filtration rate (eGFR) adalah penghitungan untuk mendeteksi gangguan dini fungsi ginjal, cara ini lebih dipercaya dibandingkan nilai kreatinin serum. The National Kidney Foundation merekomendasikan Chronic Kidney Disease  Epidemiology Collaboration (CKD-EPI) untuk mengestimasi laju filtrasi glomerulus. Penelitian ini bertujuan mengetahui gambaran eGFR menurut CKD-EPI  pasien thalassemia. Penelitian menggunakan metode deskriptif. Data diambil dari penderita thalassemia mayor rawat jalan di Klinik  Hematologi Onkologi Medik, Rumah Dr. Sakit Hasan Sadikin Bandung, mulai 1 Februari sampai dengan 31 Maret 2016. Diperiksa kadar kreatinin serum dan penghitungan eGFR berdasar atas CKD-EPI. Dari 108 subjek penelitian, didapatkan usia rata-rata 18 tahun dengan jumlah wanita sebanyak 61,1 %. Gambaran eGFR berdasarkan CKD-EPI: menunjukkan hiperfiltrasi glomerulus pada mayoritas pasien dengan eGFR >120 mL/menit.  Pemeriksaan fungsi ginjal pasien thalassemia diperlukan untuk memantau gangguan fungsi ginjal dan untuk pemilihan penggunaan jenis kelasi besi. [MKB. 2016;49(1):22–7]Kata kunci: CKD–EPI, eGFR, thalassemia eGFR Profile Based on CKD-EPI of Thalassemia Mayor Patients in Dr. Hasan Sadikin General Hospital BandungIncreased life expectancy of thalassemia patients has a consequence of various manifestations of the diseases in many organs including kidney. Estimated glomerular filtration rate (eGFR) can be used for detecting early renal dysfunctions due to the fact that this calculation is more accurate compared to creatinine serum measurement. The National Kidney Foundation recommends Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) for estimating GFR. The aim of this descriptive study was to describe eGFR profile based on CKD-EPI in thalassemia patients. Data were collected from ambulatory patients visiting the Hematology Oncology Medical Clinic of Dr. Hasan Sadikin General Hospital during the period of February 1, 2016 to March 31, 2016. Subjects were patients with thalassemia major. Creatinine serum level  and calculated eGFR based on CKD-EPI were evakyated.  One hundred and eightsubjects with a median age of 18 years participated in this study with 61.1%  of them were female. According to the Kidney Disease Improving Global Outcomes  ( KDIGO) 2012, the eGFR calculation based on CKD-EPI showed that the majority of patients experience glomerular hyperfiltration (eGFR >120 ml/mnt). In this study, most Thalassemia major patients showed glomerular hyperfiltration. Renal function test is needed to monitor renal function abnormalities and to choose  the type of iron chelation therapy to be implemented. [MKB. 2016;49(1):22–7]Key words: CKD-EPI, eGFR, thalassemia
Hypercoagulable State dan Diabetes Melitus Tipe 2: Korelasi antara Fibrinogen dan HbA1c Aprijadi, Hery; Sumantri, Rachmat; Heri, Trinugroho; Irani, Pandji; Oehadian, Amaylia; Arifin, Augusta Y. L.
Majalah Kedokteran Bandung Vol 46, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Hiperkoagulabilitas merupakan penyebab kelainan vaskular pada diabetes melitus tipe 2 (DM tipe 2). Fibrinogen merupakan petanda hiperkoagulabilitas akibat inflamasi sistemik. Kadar HbA1c dipakai untuk menilai kadar gula darah jangka panjang dan berhubungan dengan petanda inflamasi. Terdapat perbedaan hasil penelitian terdahulu tentang bagaimana hubungan antara kadar fibrinogen dan HbA1c. Ada yang menyatakan hubungan bermakna dan ada pula yang tidak. Tujuan penelitian ini untuk melihat adakah korelasi antara fibrinogen dan HbA1c. Penelitian ini merupakan penelitian potong lintang pada penderita rawat jalan DM tipe 2 di RS Dr. Hasan Sadikin Bandung selama Januari−Juli 2010. Kriteria inklusi penderita DM tipe 2 yang baru didiagnosis, normotensi, kadar hemoglobin normal, serta tes fungsi hati dan ginjal normal. Dilakukan pemeriksaan kadar fibrinogen, trigliserida, dan HbA1c. Kriteria eksklusi yaitu mendapat obat antiagregasi trombosit, obat antidiabetik oral, atau menderita penyakit autoimun. Analisis statistik berupa Spearman dan regresi digunakan pada penelitian ini. Terdapat 63 subjek yang diikutkan dalam penelitian. Semua subjek memiliki kadar HbA1c lebih dari 6,5% (rata-rata 8,21±2,5%). Terdapat 33 penderita (53%) dengan kadar fibrinogen di atas harga normal (rata-rata 416,75±102,7 mg/dL). Tidak terdapat korelasi yang bermakna antara kadar fibrinogen dan HbA1c. Simpulan, tidak terdapat korelasi antara kadar fibrinogen dan HbA1c. Meskipun demikian subjek dengan diabetes melitus cenderung mempunyai kadar fibrinogen yang tinggi. [MKB. 2014;46(1):48–51]Kata kunci: Diabetes melitus tipe 2, fibrinogen, HbA1c, hypercoagulable state Hypercoagulable State and Type 2 Diabetes Mellitus: the Correlation between Fibrinogen and HbA1cHypercoagulability has been suggested as a result of type 2 diabetic mellitus vascular disease. Fibrinogen is a marker of hypercoagulability due to systemic inflammation. HbA1c level is used to measure long-term blood glucose level. There was inconsistent findings about the correlation between fibrinogen level and HbA1c. Previous study found a significant correlation between fibrinogen levels and HbA1c, while other study showed different results for this finding. The aim of this study was to determine the correlation between fibrinogen and HbA1c. A cross-sectional study was performed in outpatients type 2 diabetes mellitus (DM) in Dr. Hasan Sadikin General Hospital Bandung during January−July 2010. Patients with newly diagnosed type 2 DM, normotension, normal hemoglobin level, normal liver function test and normal kidney function test were included in this study. Fibrinogen, trigliseride, and HbA1c levels were examined. The exclusion criteria were patients taking antiplatelet drugs or oral antidiabetic and had autoimmune diseases. Spearman and regression analysis were used in this study. Sixty three subjects were included in this study. All subjects had HbA1c level more than 6.5% (mean 8.21±2.5%). Thirty three patients (53%) had fibrinogen level of more than the normal limit (mean 416.75±102.7 mg/dL). The mean of trigliseride level was 235.32±131.3 mg/dL. No significant correlation between fibrinogen and HbA1c. In conclusion, there is no correlation between the fibrinogen levels and HbA1c. However, subjects with diabetes mellitus tend to have high fibrinogen levels. [MKB. 2014;46(1):48–51]Key words: Fibrinogen, HbA1c, hypercoagulable state, type 2 diabetes mellitus DOI:  10.15395/mkb.v46n1.227
Perbandingan Akurasi Berbagai Formula untuk Mengestimasi Laju Filtrasi Glomerulus pada Penderita Karsinoma Nasofaring Stadium Lanjut Sebelum Mendapat Kemoterapi Cisplatin Nissa, Camelia Khairun; Oehadian, Amaylia; Martakusumah, Abdul Hadi; Dewi, Yussy Afriani
Majalah Kedokteran Bandung Vol 47, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Cisplatin adalah obat sitotoksik dengan efektivitas tinggi dan digunakan secara luas, termasuk pada karsinoma nasofaring (KNF). Salah satu keterbatasan penggunaan cisplatin adalah nefrotoksisitas, terutama pada tubulus ginjal. Formula HARUS 15-30-60 dan HADI merupakan formula baru dalam menilai laju filtrasi glomerulus (LFG) dengan memperhitungkan  fungsi tubulus. Penelitian ini bertujuan mengetahui perbandingan akurasi formula Cockroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), HARUS 15-30-60, dan HADI dengan klirens kreatinin dalam menilai LFG pada penderita KNF stadium lanjut. Dilakukan penelitian analitik komparatif dengan rancangan potong lintang. Data diambil dari rekam medik penderita KNF yang akan mendapat kemoterapi cisplatin di Departemen Ilmu Penyakit Dalam Rumah Sakit Dr. Hasan Sadikin Bandung mulai Agustus 2012 sampai Agustus 2013. Data dianalisis menggunakan ANOVA dan uji concordance correlation coefficient (CCC). Subjek penelitian terdiri atas 70 subjek, 28 perempuan (40%) dan 42 laki-laki (60%), dengan usia rata-rata 42±12,3 tahun. Estimasi LFG berdasarkan MDRD, CG, dan HADI berbeda dengan klirens kreatinin (p<0,05), sedangkan estimasi LFG berdasarkan HARUS 15-30-60 tidak berbeda (p>0,05). Formula HARUS 15-30-60 memiliki CCC 0,401, lebih besar daripada CG (CCC=0,387), HADI (CCC=0,258), dan MDRD (0,136). Simpulan, formula HARUS 15-30-60 lebih akurat dibanding dengan formula CG, HADI, dan MDRD dalam menilai LFG pada penderita KNF stadium lanjut. [MKB. 2015;47(1):42–8]Kata kunci: Cockroft-Gault, formula HADI dan HARUS 15-30-60, klirens kreatinin, laju filtrasi glomerulus,  modification of diet in renal diseaseAccuracy Comparison of Various Formulas for Estimating Glomerular Filtration Rate in Advanced Nasopharyngeal Carcinoma Patients before Cisplatin AdministrationCisplatin is a widely used and highly effective cytotoxic agent, including for nasopharyngeal carcinoma (NPC). One of the side effects of cisplatin is nephrotoxicity, especially in tubulus. HARUS 15-30-60 and HADI are new formulas for estimating glomerular filtration rate (GFR) which also calculate tubular function. The aim of this study was to compare the accuracy of Cockroft–Gault (CG), modification of diet in renal disease (MDRD), HARUS 15-30-60 and HADI formula with creatinine clearance in assessing GFR. This was a cross-sectional study with comparative design in patients with advanced NPC before administration of cisplatin in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Data were collected from August 2012 to August 2013 and analyzed using ANOVA and concordance correlation coefficient test (CCC). There were 70 patients, consisted of 28 (40%) females and 42 (60%) males with the mean age of 42±12.3 years. LFG estimations based on MDRD, CG, and HADI were different from the creatinine clearance  (p<0.05), whereas no difference was found between HARUS 15-30-60 and creatinine clearance (p>0.05). HARUS 15-30-60 with creatinine clearance had CCC 0.401 was greater than CG (CCC=0.387), HADI (CCC=0.258), and MDRD (CCC=0.136). In conclusion, HARUS 15-30-60 formula is more accurate than CG, HADI, and MDRD formula in assessing renal function (GFR) in patients with advanced NPC. [MKB. 2015;47(1):42–8]Key words: Cockroft-Gault, creatinine clearance, estimated glomerular filtration rate, HADI and HARUS 15-30-60 formula, modification of diet in renal disease DOI: 10.15395/mkb.v47n1.396   
Hypercalcemia of Malignancy: Clinical Characteristics and Treatment Outcome Wijaya, Indra; Oehadian, Amaylia; Sumantri, Rachmat
Majalah Kedokteran Bandung Vol 46, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Hypercalcemia is one of the most common paraneoplastic syndromes in hospitalized malignancy patients. The aim of this study was to determine the clinical characteristics and treatment outcome in hypercalcemia of malignancy. This was a study using medical records of patients with malignancy hospitalized in the Departement of Internal Medicine, Dr. Hasan Sadikin Hospital Bandung between December 2008 and March 2011. Statistical analysis was performed by Wilcoxon and Mann-Whitney tests. There were 40 patients with hypercalcemia of malignancy, consisted of 22 hematologic malignancies and 18 solid tumors. Disturbance of consiousness were found in 4, dehydration in 18, constipation in 6, and nausea and vomiting in 6 subjects. In 16 subjects, no symptoms were found. All subjects received rehydration with normal saline. Bisphosphonate was given in 26 subjects. The difference of decreasing ion calcium level, between the groups who were treated with or without bisphosphonate was 0.59 (0.01–1.17) mg/dL, p=0.0001. In conclusion, hematologic and solid tumors are found in about the same proportion in hypercalcemia associated malignancy. Treatment either with or without bisphosphonate shows good results. [MKB. 2014;46(2):111–17]Key words: Bisphosphonate, hypercalcemia of malignancy, rehydrationHiperkalsemia pada Keganasan: Karakteristik Klinik dan Luaran TerapiHiperkalsemia merupakan salah satu sindrom paraneoplasma yang sering ditemukan pada pasien keganasan. Tujuan penelitian ini untuk mengetahui karakteristik klinis dan respons terapi penderita dengan hiperkalsemia pada keganasan. Penelitian ini menggunakan data rekam medis pasien yang dirawat di Departemen Penyakit Dalam Rumah Sakit Dr. Hasan Sadikin Bandung periode Desember 2008–Maret 2011. Analisis statistik menggunakan Uji Wilcoxon. Dari 40 penderita dengan hiperkalsemia pada keganasan, didapatkan 22 keganasan hematologi dan 18 tumor padat. Gejala klinis yang ditemukan adalah gangguan kesadaran pada 4 subjek, dehidrasi pada 18 subjek, konstipasi pada 6 subjek, mual dan muntah pada 6 subjek. Pada 16 subjek tidak ditemukan gejala. Semua subjek mendapatkan rehidrasi dengan NaCl 0,9%. Dua puluh enam subjek mendapat terapi bisfosfonat. Perbedaan penurunan kadar kalsium ion antara kelompok yang mendapatkan bisfosfonat dan tidak adalah 0,59 (0,01–1,17) mg/dL, p=0,0001. Simpulan, proporsi keganasan penyebab hiperkalsemia hampir sama antara keganasan hematologi dan tumor padat. Terapi rehidrasi dengan NaCl 0,9% tanpa atau disertai bisfosfonat memberikan hasil yang baik. [MKB. 2014;46(2):111–17]Kata kunci: Bisfosfonat, hiperkalsemia pada keganasan, rehidrasi DOI: 10.15395/mkb.v46n2.283
Intracranial Metastasis as the Initial Presentation of a Young Woman with Luminal B Her-2 Positive Stage 4 Breast Cancer Gultom, Santi Christiani; Oehadian, Amaylia
International Journal of Integrated Health Sciences Vol 8, No 1 (2020)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v8n1.1886

Abstract

Objective: Breast cancer is the second most common cause of brain metastasis (BM) among all of the solid cancers, with metastases occurring in 10%–16% of patients and in as many as 30% of autopsy studies. Breast cancer-related BM usually has a poor prognosis and survival rate in the absence of any treatment within 2 months. Survival after BM is related to the subtype of the primary tumor. Human epidermal growth factor-2 (HER-2)-positive patients have a significantly better prognosis compared with other subtypes. The prognosis for the majority of patients with BM remains poor, despite local and systemic therapies, with a median survival of around 10 months.Methods: This case is interesting because our patient is very young, diagnosed with BM before breast cancer was identified, bit still surviving 12 months after her BM diagnosis. A 19-year old woman presented with seizures, vomit and headaches.Results: A cranial CT-scan showed an intracranial mass. The intracranial tumor was removed, and yielded a histopathological result of metastatic adenocarcinoma. Further examination found a lump in her right breast. She was diagnosed with intracranial metastatic stage 4 luminal B Her 2(+) breast cancer. She was referred for WBRT, a mastectomy, chemotherapy with docetaxel cyclophosphamide 4 cycles, followed by 12 cycles of trastuzumab, and continued treatment with tamoxifen and goserelin. The last PET-Scan showed no residual disease.Conclusion: Breast cancer as the primary tumor should be considered in women with a metastatic brain tumor. With appropriate treatment, even stage IV luminal B breast cancer with BM can still have a long life with good quality.
Bleeding Patterns among Severe Hemophilia A and B Patients in West Java Muhammad Mufakkirul Islam; Susi Susanah; Amaylia Oehadian
Althea Medical Journal Vol 7, No 2 (2020)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v7n2.1941

Abstract

Background: The clinical manifestations of hemophilia A (HA) and hemophilia B (HB)are quite similar; however, the bleeding characteristics of these two hemophilia types have been reported to be different. This study aimed to explore the bleeding patterns among patients with severe HA and severe HB.Methods: A cross-sectional study was conducted among patients with severe HA and HB registered at the West Java Indonesian Hemophilia Society. The inclusion criteria were patients with severe hemophilia diagnosed for at least one year. The bleeding patterns included bleeding episodes and bleeding types. The Mann-Whitney test was used to compare bleeding episodes and a chi-square test for bleeding types.Results: In total, 158 severe HA patients and 21 severe HB patients were included with a median bleeding frequency per patient per year for HA and HB was 24 (range 0–48) and 24 (range 5–48), respectively. The bleeding types in HA and HB were ecchymosis (69% vs. 66.7%), hematoma (62.7% vs. 61.9%), hemarthrosis (99.4% vs. 100%), epistaxis (46.8% vs. 38.1%), gum bleeding (87.3% vs. 95.2%), intracranial hemorrhage (15.2% vs. 9.5%), multiple hematomas (36.7% vs. 47.6%), hemarthrosis-hematoma (61.4% vs.61.9%), and hemarthrosis-ecchymosis (69% vs. 61.9%). However, there was no significant difference in all types of bleeding between HA and HB.Conclusions: There is no difference in the pattern of hemorrhage between severe HA and severe HB in West Java. However, the bleeding phenotypes in hemophilia has considerable implications in the therapeutic process. Further research is needed to optimize the treatment regimens.
Neutrophil-to-Lymphocyte Ratio and Covid-19 Symptom-based Severity at Admission M. Fuad; Amaylia Oehadian; Delita Prihatni; Marthoenis Marthoenis
Althea Medical Journal Vol 8, No 1 (2021)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v8n1.2255

Abstract

Background: Increased Neutrophil-to-Lymphocyte Ratio (NLR) is an independent risk factor for mortality in Covid-19 patients and is considered as an early warning sign of Covid-19 severity. This study aimed to observe the differences in NLR at admission between patients with mild, moderate, and severe symptoms of Covid-19 treated in a referral hospital in Banda Aceh, Indonesia.Methods:  A total of 114 patients with Covid-19 admitted to a referral hospital in Banda Aceh, Indonesia, during March–September 2020 were included in this study. Demographic information and baseline laboratory data, including the NLR, were collected. Descriptive and inferential statistics were used to analyze the data. Results: The median NLR at admission was higher among patients with moderate to severe symptoms than those with mild symptoms [6.54 (2.80–97.00, IQR 4.81–9.44) vs 2.27 (0.79–5.07, IQR 1.43-2.98), p <0.001]. Covid-19 patients who died had a higher NLR than those who survived [10.88 (4.17–47.50, IQR 7.00–15.17) vs 6.15 (2.80–97.00, IQR 4.63–8.50), p 0.02]. Patients with moderate-severe symptoms had an initial NLR of 4.63–8.50 and decreased to 2.75–5.43 at the end of the treatment had a greater chance of survival. There was an increased probability of death in patients with moderate-severe symptoms whose initial NLR was 7.00–15.17, which was then elevated to 14.33–23.25.Conclusion: Different NLR at admission is seen among Covid-19 patients with mild and moderate-severe symptoms, leading to significantly different outcomes. The NLR can be used as a simple parameter to determine the severity of the disease and predict the outcome of Covid-19 patients.
Co-Authors A.A. Ketut Agung Cahyawan W Abdul Hadi Martakusumah Agnes Rengga Indrati Agung Firmansyah Sumantri Agung Firmansyah Sumantri Andiyang R. Diredja Andri Reza Rahmadi Augusta Y. L. Arifin Bachti Alisjahbana Bethy S. Hernowo Camelia Khairun Nissa Dania Artriana Riswandi Delita Prihatni Doloksaribu, Rismauli Een Hendarsih Evan Susandi Fransisca Fransisca Gultom, Santi Christiani Guntur Darmawan Hery Aprijadi Husna, Rizka Iman Supandiman Indra Wijaya Ismiana Fatimah Modjaningrat Jeffery Malachi Candra Kiki Akhmad Rizki Laniyati Hamijoyo Laniyati Hamijoyo Laniyati Hamijoyo, Laniyati Lisda Amalia M. Fuad Marthoenis, Marthoenis Modjaningrat, Ismiana Fatimah Mohammad Ghozali Mohammad Ghozali, Mohammad Muhammad Mufakkirul Islam Pandji Irani Putri Vidyaniati Putri Vidyaniati Putri Vidyaniati Putri Vidyaniati Rachmat Sumantri Rahmaniati Rahmaniati Rahmaniati, Rahmaniati Ria Bandiara Susi Susanah Tonggo Gerdina Panjaitan Trinugroho H Fadjari, Trinugroho H Trinugroho Heri Uun Sumardi, Uun Wenny Simamora Yeny Tanoyo Yussy Afriani Dewi