Characteristics of Mediastinal Tumor Patients in Cipto Mangunkusumo National Hospital Jakarta

Tumor mediastinum mewakili keragaman penyakit di berbagai negara. Di Indonesia, khususnya di Rumah Sakit Nasional Cipto Mangunkusumo, masih kekurangan karakteristik epidemiologi, klinis, radiologi, dan karakteristik histopatologi dari tumor mediastinal.Tujuan: untuk menentukan karakteristik kasus-kasus tumor mediastinum berbasis rekam medis. Metode: penelitian retrospektif ini didasarkan pada data yang telah dilaporkan dalamChest meetingsyang diselenggarakan oleh Divisi Pulmonologi Penyakit Dalam Rumah Sakit Cipto Mangunkusumo dari Januari 2007 sampai Desember 2008. Saat penelitian, terdapat 27 kasus tumor mediastinum.Hasil: kebanyakan pasien didiagnosis tumor mediastinum pada usia di atas 40 tahun (56%) dan lebih dari separuh pasien berjenis kelamin laki-laki (67%). Dari 13 pasien (52%) telah dipastikan bahwa 9 dari mereka memiliki riwayat merokok. Tiga gejala yang paling umum ditemukan di antaranya batuk, terengah-engah, dan terjadinya penurunan berat badan. Jenis histologis yang paling umum dari tumor adalah thymoma (33%). Tujuh belas pasien (63%) di antaranya pernah menjalani pembedahan. Radioterapi oleh 44% pasien dan kemoterapi oleh 26% pasien.Kesimpulan: peneliti menangani 27 kasus tumor mediastinum dari Januari 2007 hingga Desember 2008. Lebih dari separuh kasus terjadi pada usia di atas 40 tahun dan thymoma adalah temuan histopatologis yang paling umum

Demographic, Clinic, Radiologic, and Histopathologic Pattern of Patient with Mediastinal Mass Who Died During Treatment at Cipto Mangunkusumo Hospital Jakarta

Banyak penyakit dapat timbul atau melibatkan mediastinum. Penyakit-penyakit tersebut adalah tumor primer, metastase, kista, dan infeksi akut atau kronis. Mendiagnosis massa mediastinum seringkali menjadi tantangan mengingat diperlukan standar diagnosis dan rencana perawatan. Meningkatkan risiko pasien dan memutuskan kapan harus melakukan perawatan agresif akan memberikan hasil akhir yang lebih baik dalam menurunkan angka kesakitan dan kematian. Saat ini, pola demografi, klinik, radiologi, dan histopatologi pasien dengan massa mediastinum yang meninggal selama perawatan di RS Cipto Mangunkusumo belum dilaporkan.Tujuan: mendapatkan pola demografi, klinik, radiologi, dan histopatologi pasien dengan massa mediastinum yang meninggal selama perawatan di RS Cipto Mangunkusumo dalam kurun waktu sepuluh tahun terakhir.Metode: penelitian ini merupakan studi cross-sectional deskriptif. Penelitian dilakukan antara April 2010 sampai Juli 2010 dengan mengumpulkan dan mempelajari catatan medis pasien dengan massa mediastinum yang didiagnosis selama Januari 2000 sampai Desember 2009 di RS Cipto Mangunkusumo, kemudian diproses dengan program SPSS versi 16.0.Hasil: terdapat 201 pasien yang didiagnosis memiliki massa mediastinum di RS Cipto Mangunkusumo selama sepuluh tahun terakhir. Delapan puluh delapan catatan medis tidak ditemukan sehingga hanya ada 113 sampel yang diteliti. Empat puluh lima sampel (39,8%) dari 113 sampel meninggal selama perawatan di rumah sakit.Kesimpulan: ada sedikit perbedaan dalam pola demografi, klinik, radiologi, dan histopatologi pasien dengan massa mediastinum yang meninggal selama pengobatan di RS Cipto Mangunkusumo dibandingkan dengan penelitian lain. Tingkat kematian selama pengobatan tinggi. Diagnosis yang tepat pada stadium dini sangat diperlukan untuk menurunkan angka kesakitan serta angka kematian dan pasien memperoleh hasil akhir yang lebih baik

RESPON PEMUDA ASAL PULAU MAKEAN TERHADAP PANDEMI COVID-19

Many studies on the Covid-19 pandemic have explored various socio-cultural aspects related to this pandemic. Choosing a locus on Makean Island, this article focused on the responses of young villagers in Makean to the Covid-19 pandemic. The concept of response used in this article refers to the perspectives of environmental anthropology and psychological anthropology, namely the human response to external stimuli. In this context of study, we examined the responses of Makean Island youths to external stimuli, namely the COVID-19 pandemic and policies related to the pandemic. Using a combination of quantitative survey and qualitative ethnographic procedures, this study found several forms of responses to the COVID-19 pandemic. The responses we found were mainly in the area of ??seeking information about this pandemic: the level of trust in the existence of Covid-19, the perception of the risk of contracting Covid for both oneself and community, and the responses to pandemic mitigation policies, especially related to Covid-19 vaccinations. Another important finding is that although many Makean youths consider Covid-19 as dangerous, and they are at risk of contracting it, most of them do not view vaccination as the best preventive measure and therefore plan to take other preventive measures. This can be interpreted as a form of soft resistance to government policies that require all citizens to get vaccinated against Covid-19

Obstructive Sleep Apnea and Atherosclerosis

Obstructive sleep apnea (OSA) is a sleep respiratory disorder characterized by recurrent episodes of complete or partial airway obstruction, resulting in apneas or hypopneas. OSA could contribute to atherosclerosis through direct and indirect mechanisms.Endothelial dysfunction, sympathetic stimulation, and proinflammatory cytokine modulation caused by OSA play significant role to an atherosclesrotic event. Other risk factors of atherosclerosis like hypertension and diabetes mellitus also associated with OSA. Animal and clinical studies recently showed promising data to prove association between OSA, atherosclerosis, and its risk factors. However, provided data has not showed consistent result. In the future, demand of further research both basic and clinical sciences need to be fulfilled

The Association of Gastropods and Seagrass in Coastal Waters of Beruk Island of North Rupat of Riau Province

This study was conducted in July 2013 in the coastal waters of Beruk Island, Riau. This study was aimed to describe the species composition, distribution, density of seagrass and gastropods, its was also directed to know the distribution of gastropods based on the distribution of seagrass. The survey methods was used in this study. The results showed that there were 279 individuals of gastropod. Those consisted of six species, i.e. Strombus urceus, Ellobium sp, Nerita costata, Conus nobilis, Littorina sp, and Gibbula ardens. There were two seagrass species used as habitat by gastropod, i.e. Enhalus acoroides and Halophila ovalis. Distribution patterns of gastropods in Beruk Island were generally uniform, and varied at each station. The analysis showed that C. nobilis found at all stations, this indicated that these waters were suitable for the survival of C. nobilis, as well as the seagrass species of E. acoroides was also found in all stations

Rapid premixing fuel-water injector in burner combustion

The alternative fuel is attract good attention from worldwide especially for renewable and prevention energy such as biodiesel. Biodiesel is one of the hydrocarbon fuels and it has potential for external combustion. This research used biodiesel Crude Palm Oil (CPO) as fuels in which have been blend with diesel. Biodiesel Crude Palm Oil base (CPO) is free from sulfur and produced by esterification and trans-esterification reaction of vegetable oil with low molecular weight alcohol, such as ethanol or methanol. Rapid mixing injector uses for external combustion especially open burner system. Therefore, the objectives of this research are to investigate the effects of mixture formation between biodiesel and water on using rapid mixing injector and to analyze the influence of mixture formation on flame propagation and combustion characteristics together with the effect of water content on the gas emissions are analyzed. The disadvantages of CPO are high toxic emissions such as NOX and CO while it can cause the reduction on performance of burner system. However, high toxic emission can be solved by using a new concept injector with fuel-water-air premixing. The additional water in combustion process can be reduced the NOX emissions. The results of this research focuses on the mixture formation of spray, flame and exhaust gas emissions. CPO biodiesel has longer spray length and bigger spray area than diesel, but the spray angle is smaller than diesel. Based on flame image, it shows that the flame color between pure fuels and fuel-water mix fuel is totally difference compare to each other. Water mix with fuel has the brightness color and shorter flame than fuels. The exhausts gaseous tested are CO, CO2, HC and NOX. In this research, water premix of percentage up to 15vol% and blending biodiesel ratio was varied from 5vol% - 15vol%. The result shows that increasing of water content will affected decrement of CO, CO2 and HC emissions but increasing the NOX emissions

Perancangan Mesin Selektif Laser Sintering Skala Laboratorium

Metoda pelaksanaan proses produksi yang berkembang saat ini yaitu Additive Manufacturing. Metoda Additive Manufacturing adalah suatu metoda membuat produk dari model CAD 3D, langsung menjadi produk 3D yang utuh, dengan cara pembuatan lapis demi lapis. Additive Manufacturing berguna untuk memperpendek waktu yang dibutuhkan dari perancangan sampai manufaktur. Terdapat banyak tipe Additive Manufacturing, salah satu cara pengelompokkannya adalah berdasarkan bahan baku yang akan diproses. Selective Laser Sintering merupakan bagian dari Additive Manufacturing dengan bahan baku berupa powder (serbuk). Perancangan sebuah mesin Selective Laser Sintering skala laboratorium bisa dijadikan acuan untuk pembuatan mesin Selective Laser Sintering, dengan cara menggambarkan skematis sistem, melakukan pemilihan mekanisme, pemilihan komponen, pemilihan bahan dan proses, serta perencanaan. Dari hasil perancangan yang telah dilakukan, dapat disimpulkan bahwa, proses perancangan dan perencanaan mesin Selective Laser Sintering skala laboratorium merupakan tahap awal yang harus dilakukan sebelum dilakukannya proses pembuatan. Keyword: Additive, Manufacturing, Selective, Laser, Sinterin

An analysis of mobile banking acceptance by Malaysian customers

Today, the advancement of mobile technologies has provided an opportunity for financial providers in introducing new financial innovations. One of the emerging financial innovations introduced by financial providers is mobile banking. This study adopts a technology acceptance model (TAM) to investigate factors that determine an individual?s intention to use mobile banking among bank customers in Labuan and Kota Kinabalu. The TAM includes perceived credibility, perceived self-efficacy and normative pressure. Our results support the extended TAM in predicting bank customers? behavioural intention to use mobile banking. Determinants are perceived usefulness, perceived ease of use, perceived credibility and perceived self-efficacy. Normative pressure was found to be a weak determinant in explaining bank customers? intention to use mobile banking. The study also demonstrates the significant effect of perceived ease of use on behavioural intention through perceived usefulness

Short-term Survival of Acute Respiratory Distress Syndrome Patients at a Single Tertiary Referral Centre in Indonesia

Aim: to identify the 28-day short-term survival rate in patients with acute respiratory distress syndrome (ARDS). Methods: this is a retrospective cohort study conducted at a tertiary referral hospital in Jakarta, Indonesia. We conducted the study for 10 months and data was extracted from medical records between October 2015 and August 2016. The primary end point of the study was 28-day short-term survival rate using the initial date of ARDS diagnosis as the index time. Overall survival rate was analyzed using Kaplan-Meier test and multivariate Cox regression analysis. Results: there were 101 ARDS subjects during 10 months of study. The overall rate of  28-day survival was 47.5% and the median time of survival was 10 days (95% CI 2.47–17.52). The survival rate in ARDS patients was reduced significantly at the first week after the diagnosis of ARDS was made, which indicated that the highest mortality occured in the first week. Subjects with APACHE II score of >20 had a hazard ratio (HR) of 2.45 (95% CI 1.40-4.28) and those with moderate-severe of ARDS had HR of 2.27 (95% CI 1.25-4.12). Conclusion: the short-term survival rate of ARDS in developing countries  including Indonesia is still low and early management with optimal treatment provided within the first week may improve the survival rate

Recent Management of Patients with Advanced Epidermal Growth Factor Receptor Mutation Non-small Cell Lung Cancer: Role of Afatinib and Lesson Learned for Developing Countries

Lung cancer is a devastating disease with a high incidence, mortality and morbidity rate, especially in developing countries. Conventional treatment with cytotoxic chemotherapy has some limitations attributed to chemoresistance and toxicity. Recent advances have shown that first generation Tyrosine Kinase Inhibitor (TKI), Gefitinib and Erlotinib, and the newest available second generation Tyrosine Kinase Inhibitor (TKI), Afatinib, have the potential to be an option in the management of patients with epidermal growth factor receptor/ EGFR mutation positive advanced/ metastatic non-small cell lung cancer. Afatinib works by binding to EGFR irreversibly, thus inactivating the tyrosine kinase receptor. Some studies demostrated that Afatinib first-line may result in longer progression free survival (PFS) and better disease control, and as an alternative for patients who intolerance to Gefitinib or Erlotinib. In Indonesia, the era of National Health Insurance has been implemented and National Health Insurance has covered treatment for cancer, including first generation TKIs, Gefitinib dan erlotinib, for patients with EGFR mutation positive advanced/ metastatic non-small cell lung cancer at Cipto Mangunkusumo National Hospital. Afatinib, as one of the newest available second generation TKI, may be given free of charge too as an alternative if the National Health Insurance will be covered in the future. Further research is needed to know the efficacy and adverse effects that may occur in patients from developing countries.