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"Malnutrisi sering pada karsinoma hepatoselular (KHS), diakibatkan oleh anoreksia, penurunan asupan serta keadaan katabolik. Serial kasus bertujuan memberikan terapi gizi guna proses penyembuhan dan memperbaiki kualitas hidup. Empat orang pasien berusia 42–67 tahun, dengan KHS, penurunan berat badan 14,3–29,6% selama dua bulan hingga satu tahun. Tiga orang pro reseksi dan satu orang mendapat terapi paliatif dengan kanker kaheksia. Pemberian nutrisi disesuaikan keadaan klinis. Kebutuhan kalori berdasarkan Harris-Benedict. Sebelum pembedahan kebutuhan kalori total tercapai Setelah pembedahan, toleransi asupan baik, nutrisi ditingkatkan bertahap. Saat pulang keadaan umum stabil, kapasitas fungsional membaik, luka operasi baik.

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Malnutrition is common in hepatocellular carcinoma (HCC), caused by anorexia, decreased intake and catabolic state. The aim of this case series provide nutrition therapy to support the healing process and to improve quality of life. Patients were four people, age between 42–67 years, with HCC, weight loss 14,3–29,6 % for two months to one year. Three people with pro resection and one person had palliative therapy and cachexia cancer. Nutrition was given according to clinical state. Calorie requirement was based on Harris-Benedict. Total calorie needs was achieved prior to surgery, and good tolerance intake after surgery, nutrition enhanced gradually. Patients discharge from hospital with stable general condition, improved functional capacity, and good surgical wound healing."

"Penelitian ini bertujuan untuk mengetahui alat skrining malnutrisi yang sesuai untuk pasien kanker dewasa rawat inap pra bedah sehingga malnutrisi cepat dikenali dan dapat diberikan dukungan nutrisi secara dini. Penelitian ini merupakan uji diagnostik alat skrining Malnutrition Screening Tool (MST) dan Royal Marsden Nutrition Screening Tool (RMNST) dengan Subjective Global Assessment (SGA) sebagai pembanding terhadap 58 pasien kanker rawat inap pra bedah yang masuk rumah sakit kurang dari 24 jam. Sensitivitas, spesifisitas, nilai duga positif (NDP), nilai duga negatif (NDN), dan area under the curve (AUC) dihitung untuk mengetahui metode yang paling baik diantara dua alat skrining dibanding standar baku. Hasil penelitian didapatkan prevalensi malnutrisi berdasarkan SGA sebesar 34,6%. Sensitivitas, spesifisitas, NDP, NDN, dan AUC MST berturut-turut adalah 88.9%, 97%, 94,12%, 94,28%, dan 93% sedangkan sensitivitas, spesifisitas, NDP, NDN, dan AUC RMNST masing-masing adalah 94.4%, 82.35%, 73,9%, 96,55%, and 88%. Hal ini menunjukkan bahwa RMNST lebih baik dibanding MST dalam menapis malnutrisi pada pasien kanker rawat inap pra bedah.

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This study aimed to determine malnutrition screening tool which appropriate for adult hospitalized pre-surgical cancer patients, therefore, malnutrition could be recognized quickly and nutritional intervention could be provided at an early stage. This study was a diagnostic test of Malnutrition Screening Tool (MST) and the Royal Marsden Nutrition Screening Tool (RMNST) compared to Subjective Global Assessment (SGA) on 58 cancer pre-surgical inpatients who were admitted to the hospital less than 24 hours. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) were calculated to evaluate the perfomance of tools compared the standard. The result showed that the prevalence of malnutrition by SGA was 34.6%, the sensitivity, specificity, PPV, NPV, and AUC of MST were 88.9%, 97%, 94,12%, 94,28%, and 93% respectively while the sensitivity, specificity, PPV, NPPV, and AUC of RMNST were 94.4%, 82.35%, 73,9%, 96,55%, and 88% respectively. This indicated that RMNST better than MST in screening malnutrition in the cancer pre-surgical inpatients."

"ABSTRAK Latar Belakang: Malnutrisi berdampak besar pada pasien kanker sehingga harusdievaluasi dengan Patient-Generated Subjective Global Assessment (PG-SGA),namun memakan waktu dan membutuhkan tenaga kesehatan terlatih. Pengukurankekuatan genggam tangan (KGT) memiliki keuntungan lebih singkat dan mudahdibandingkan PG-SGA, tetapi belum ada data titik potong dan akurasi diagnostikKGT pada pasien kanker di Indonesia. Tujuan: Mendapatkan titik potong dan akurasi diagnostik KGT sebagai penapismalnutrisi pasien kanker rawat jalan di RSCM.Metode: Penelitian potong lintang ini dilakukan pada pasien 18-59 tahun dipoliklinik onkologi RSCM selama 4 Mei-1 Oktober 2015. Titik potong KGTdianalisis menggunakan kurva ROC. Akurasi diagnostik KGT dinilai denganmenghitung sensitivitas, spesifisitas, NDP, NDN, RKP, dan RKN.Hasil: Proporsi pasien dengan status nutrisi baik, malnutrisi sedang, danmalnutrisi berat adalah17,4%, 64,2%, dan 18,4%. Titik potong optimal KGT pasien kanker lelaki dan perempuan berturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgfdengan sensitivitas 92,2% dan 73,9%, spesifisitas 54,6% dan 60,9%, NDP 92,2% dan 88,3%, NDN 54,6% dan 36,8%, RKP 2 dan 1,9, serta RKN 0,1 dan 0,4. Simpulan: Titik potong optimal KGT pasien kanker lelaki dan perempuanberturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgf. Akurasi diagnostik KGT pasienkanker lelaki dan perempuan sebagai penapis malnutrisi berturut-turut dinilai baik dan sedang.ABSTRACT Background: Malnutrition has a huge impact on cancer patients and therefore ithas to be evaluated using PG-SGA, but there are limitations such as the timeconsumingnature and the need of trained health personnels. Measurement ofHGS is faster and easier, but there is no sufficient information regarding its cutoffpointand diagnosticaccuracyfor cancerpatientsin Indonesia.Aim:defining cut-off point and diagnostic accuracy of HGS as a malnutritionscreening modality for outpatient cancer population at RSCM.Method: A cross-sectional study was conducted at RSCM oncology outpatientclinic from May 4th-October 1st, 2015. Subjects were 18-59 years old. Cut-offpoint and diagnostic accuracy of HGS were analyzed to generate sensitivity,specificity, PPV, NPV, LR+, and LR- .Result: The proportion of well nourished, moderately malnourished, and severelymalnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimalHGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgfrespectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV92.2% and 88.3%, NPV 54.6% and 36.8%, LR+ 2 and 1.9, and LR- 0.1 and 0.4. Conclusion: The optimal HGS cut-off point in male and female cancer patientswere ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as amalnutrition screening modality in male and female cancer patients were good and moderately good.;Background: Malnutrition has a huge impact on cancer patients and therefore ithas to be evaluated using PG-SGA, but there are limitations such as the timeconsumingnature and the need of trained health personnels. Measurement ofHGS is faster and easier, but there is no sufficient information regarding its cutoffpointand diagnosticaccuracyfor cancerpatientsin Indonesia.Aim:defining cut-off point and diagnostic accuracy of HGS as a malnutritionscreening modality for outpatient cancer population at RSCM.Method: A cross-sectional study was conducted at RSCM oncology outpatientclinic from May 4th-October 1st, 2015. Subjects were 18-59 years old. Cut-offpoint and diagnostic accuracy of HGS were analyzed to generate sensitivity,specificity, PPV, NPV, LR+, and LR- .Result: The proportion of well nourished, moderately malnourished, and severelymalnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimalHGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgfrespectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV92.2% and 88.3%, NPV 54.6% and 36.8%, LR+ 2 and 1.9, and LR- 0.1 and 0.4. Conclusion: The optimal HGS cut-off point in male and female cancer patientswere ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as amalnutrition screening modality in male and female cancer patients were good and moderately good."

"Latar belakang: Karsinoma nasofaring merupakan salah satu keganasan yang dapat menyebabkan malnutrisi. Radioterapi dan kemoterapi merupakan bagian dari terapi yang dapat menimbulkan berbagai efek samping yang dapat mempengaruhi status gizi. Tujuan dari tata laksana nutrisi adalah meminimalkan penurunan massa tubuh, meningkatkan kualitas hidup, serta menurunkan angka mortalitas dan morbiditas. Tata laksana nutrisi yang diberikan meliputi pemberian makronutrien, mikronutrien, nutrient spesifik, konseling dan edukasi. Metode: Pasien serial kasus ini berjumlah empat orang dan berusia antara 38?69 tahun. Keempat pasien menjalankan terapi kemoradiasi. Hasil skrining pasien menggunakan malnutrition screening tools (MST) adalah SOH2. Kebutuhan energi total pasien dihitung menggunakan Harris-Benedict yang dikalikan dengan faktor stress sebesar 1,5. Pemantauan yang dilakukan meliputi keluhan subyektif, kondisi klinis, tanda vital, antropometri, massa lemak, massa otot, kapasitas fungsional, pemeriksaan kekuatan genggam tangan, analisis asupan, dan laboratorium. Monitoring dan evaluasi dilakukan secara teratur untuk memantau pencapaian target nutrisi. Hasil: Dukungan nutrisi pada keempat pasien dapat meningkatkan asupan, meminimalkan penurunan massa tubuh dan kapasitas fungsional pada pasien KNF yang menjalankan terapi kemoradiasi. Kesimpulan: Dukungan nutrisi yang diberikan pada pasien KNF yang menjalankan terapi kemoradiasi dapat meminimalkan penurunan status gizi dan kapasitas fungsional pasien. "

"Studi serial kasus ini bertujuan untuk mengetahui pengaruh tata laksana nutrisi perioperatif pada pasien kanker saluran cerna yang menjalani pembedahan elektif dalam menurunkan angka morbiditas dan lama rawat di rumah sakit. Tindakan pembedahan yang dilakukan pada pasien kanker saluran cerna yang sudah mengalami malnutrisi berkaitan dengan serangkaian reaksi inflamasi yang berpotensi memperberat kondisi malnutrisi yang pada akhirnya memperberat gangguan sistem imun. Studi kasus dilakukan terhadap empat pasien dewasa dengan malnutrisi yang direncanakan menjalani pembedahan elektif akibat kanker saluran cerna di divisi Bedah Digestif Departemen Bedah RSUPN dr. Cipto mangunkusumo. Dukungan nutrisi diberikan semenjak periode pra pembedahan sampai dengan periode pasca pembedahan. Penentuan kebutuhan dihitung dengan menggunakan rumus Harris Benedict. Protein diberikan sebesar 1,8?2 g/kgBB kecuali pada satu orang pasien diberikan sebesar 0,8 g/kgBB/hari karena adanya gagal ginjal kronis. Lemak diberikan sebesar 25% dan sisanya berupa karbohidrat. Mikronutrien yang diberikan berupa kapsul multivitamin-multimineral. Hasil studi ini mendapatkan bahwa bahwa pemberian dukungan nutrisi perioperatif yang optimal dapat mempertahankan fungsi fisiologis, berat badan dan kapasitas fungsional serta memberikan kontrol glikemik yang baik pada periode pra pembedahan dan memperbaiki berbagai parameter status nutrisi termasuk fungsi imun pasca pembedahan walaupun tidak didapatkan peningkatan berat badan.

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This case series study aimed to investigate the effect of perioperative nutritional support in gastrointestinal cancer patients who underwent elective surgery in reducing morbidity and and length of hospitalization. Surgery which was performed in patients with gastric cancer who had experienced malnutrition associated with a series of inflammatory reactions that could potentially aggravate the condition of malnourished which in turn aggravate the immune system disorders. The case study was carried out on four adult patients suffer from malnutrition due to elective surgery for gastric cancer at the Surgical Division of The Department of Digestive Surgery RSUPN dr. Cipto Mangunkusumo. The nutritional support was gave since the preoperative to postoperative period. Determination of energy needs was calculated using the Harris benedict equation. Protein was given by 1.8 to 2 g/kg body weight/day except in one patient given at 0.8 g/kg body weight/day due to chronic renal failure. Fats were given by 25% and the rest were given as carbohydrate. Micronutrient was given in the form of multivitamin-multimineral capsule. The results of this study found that the provision of perioperative nutritional support could maintain optimal preoperative physiological function, body weight and functional capacity as well as provide good glycemic control and improve the nutritional status parameters including immune function after surgery althought there were not increased in body weight."

"Malnutrisi sering dialami oleh pasien kanker dan dapat menyebabkan penurunan kualitas hidup. Oleh karena itu, identifikasi awal pasien yang berisiko malnutrisi harus dilakukan pada semua pasien kanker, namun hingga saat ini, belum ada baku emas alat skrining yang digunakan di bagian rawat jalan radioterapi. Penelitian ini merupakan studi potong lintang yang dilakukan untuk membandingkan skrining malnutrisi Malnutrition Screening Tool (MST) dan Abridged Patient-Generated Subjective Global Assessment (abPG-SGA) pada 144 pasien kanker yang akan menjalankan radioterapi di RSUPNCM, dengan Patient- Generated Subjective Global Assessment (PG-SGA) sebagai baku emas. Didapati sebanyak 41% pasien berisiko malnutrisi (PG-SGA). Skrining MST dinilai mudah dan cepat dengan rerata waktu pengerjaan 21 detik, dan memiliki nilai sensitivitas 84,75%, spesifisitas 77,65%, nilai prediksi positif (NPP) 0,73, nilai prediksi negatif (NPN) 0,88, dan nilai area under the ROC curve (AUC) 0,812. Skrining abPG-SGA memiliki sensitivitas 98,31%, spesifisitas 92,94%, NPP 0,91, NPN 0,99, AUC 0,956, dan rerata waktu pengerjaan 2 menit 24 detik. Kesimpulan yang dapat diambil adalah abPG-SGA merupakan alat skrining yang lebih baik dan akurat untuk digunakan di bagian rawat jalan radioterapi.

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Malnutrition is common among cancer patients and can lead to decreased quality of life. Therefore, early identification of patients at risk of malnutrition should be performed in all cancer patients, but until now, there is no gold standard of nutrition screening tool that should be used in outpatient radiotherapy setting. This study was a cross-sectional study conducted to compare Malnutrition Screening Tool (MST) and Abridged Patient-Generated Subjective Global Assessment (abPG-SGA) as nutrition screening tools in 144 radiotherapy outpatients against Patient-Generated Subjective Global Assessment (PG-SGA) as the gold standard. Forty-one percent of patients were at risk of malnutrition (PG- SGA). The MST was a simple and quick tool with an average of 21 seconds. It had 84.75% sensitivity, 77.65% specificity, positive predictive value (PPV)=0.73, negative predictive value (NPV)=0.88, and area under the ROC curve (AUC)=0.812. The abPG-SGA yielded 98.31% sensitivity, 92.94% specificity, PPV=0.91, NPV=0.99, AUC=0.956, and it took an average of 2 minutes 24 seconds. In conclusion, the abPG-SGA is a better and more accurate screening tool in outpatient radiotherapy setting."

"Peran seorang apoteker di rumah sakit salah satunya yaitu pemantauan terapi obat pasien. Pemantauan terapi obat dilakukan untuk menganalisa masalah terkait obat atau Drug Related Problem (DRP) yang terjadi pada pasien selama masa perawatan di rumah sakit. Dalam hal ini dilakukan pemantauan terapi obat pada salah satu pasien di RSUP Persahabatan dengan diagnosis Kanker Nasofaring T4N3M0 dengan Malnutrisi High Risk Refeeding Syndrome dan Penurunan Kesadaran Akibat Suspek Metastasis Intrakranial. Pasien kanker nasofaring (KNF) sering mengalami malnutrisi dengan prevalensi 35% dan sekitar 6,7% mengalami malnutrisi berat. Kejadian malnutrisi pada pasien KNF dipengaruhi oleh efek kemoradiasi terutama komplikasi oral berupa disfagia dan xerostomia. Maka dari itu, pasien yang mengalami malnutrisi membutuhkan asupan nutrisi yang cukup. Namun, pemberian nutrisi pada pasien malnutrisi dapat berisiko terjadinya Refeeding Syndrome (RFS). Refeeding Syndrome terjadi ketika pemberian nutrisi yang berlebih pada pasien malnutrisi kronik dalam waktu yang terlalu cepat atau singkat. Malnutrisi juga dapat ditandai dengan rendahnya kadar elektrolit dalam tubuh seperti hiponatremia, hipokalemia, hipomagnesia, hipofosfatemia, dan hipokalsemia. Oleh karena itu, pasien malnutrisi perlu dilakukan pemantauan kadar elektrolit dan asupan nutrisinya agar tetap seimbang serta pemantauan terapi pengobatan lainnya yang diterima pasien. Masalah terkait obat (MTO) yang ditemukan dalam proses pengobatan pasien meliputi ada indikasi tanpa obat, pemilihan obat kurang tepat, dan dosis terlalu tinggi. Peneliti memberikan rekomendasi terapi pada setiap MTO yang ditemukan selama masa perawatan pasien serta melakukan pemantauan terapi hingga obat dikonsumsi oleh pasien.

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One of the roles of a pharmacist in a hospital is monitoring patient drug therapy. Monitoring drug therapy is carried out to analyze drug-related problems or Drug Related Problems (DRP) that occur in patients during the hospital treatment period. In this case, drug therapy monitoring was carried out on one of the patients at Friendship Hospital with a diagnosis of Nasopharyngeal Cancer T4N3M0 with Malnutrition High Risk Refeeding Syndrome and Decreased Consciousness Due to Intracranial Metastatic Suspects. Nasopharyngeal cancer (KNF) patients often experience malnutrition with a prevalence of 35% and about 6.7% experience severe malnutrition. The incidence of malnutrition in KNF patients is influenced by the effects of chemoradiation, especially oral complications in the form of dysphagia and xerostomia. Therefore, patients who experience malnutrition need adequate nutritional intake. However, providing nutrition to malnourished patients can be at risk of Refeeding Syndrome (RFS). Refeeding Syndrome occurs when overnutrition in chronically malnutrition patients is too fast or short. Malnutrition can also be characterized by low levels of electrolytes in the body such as hyponatremia, hypokalemia, hypomagnesemia, hypophosphatemia, and hypocalcemia. Therefore, malnutrition patients need to monitor electrolyte levels and nutritional intake to remain balanced and monitor other treatment therapies received by patients. Drug-related problems (MTO) found in the patient's treatment process include no drug indications, improper drug selection, and too high doses. Researchers provide therapy recommendations on each MTO found during the patient's treatment period and monitor therapy until the drug is consumed by the patient."

"Pasien rawat inap di rumah sakit dengan keganasan sering terjadi malnutrisi. Deteksi dini malnutrisi mempercepat terapi awal nutrisi sehingga mengurangi morbiditas dan mortalitas. Penelitian ini merupakan studi uji diagnostik membandingkan MST dan PG-SGA dengan SGA pada pasien kanker ginekologik rawat inap di RSUPN Cipto Mangunkusumo sebanyak 66 orang pada bulan April 2015. Pengumpulan data menggunakan formulir skrining, pemeriksaan fisik, dan pengukuran antropometri. MST memiliki sensitivitas 70%, spesifisitas 88%, PPV 90%, NPV 65%, AUC 0,79. PG-SGA mempunyai sensitivitas 100%, spesifisitas 92%, PPV 95%, NPV 100%, AUC 0,96. Terdapat perbedaan signifikan lama waktu pengerjaan di antara ketiganya, dengan waktu tercepat dimiliki oleh MST. Prevalensi malnutrisi berdasarkan SGA sebesar 60,6%. PG-SGA merupakan alat skrining yang sesuai dalam mendeteksi malnutrisi pasien kanker ginekologik rawat inap.

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Malnutrition is a common problem in hospitalized patients with malignancies. Early recognition of malnutrition leads to appropriate nutritional care plans and reduces rate of both morbidity and mortality. This diagnostic test study which comparing between MST and PG-SGA against SGA, was conducted on 66 hospitalized gynecologic cancer patients in April 2015. Data collection was obtained using screening tool forms, physical examination, and anthropometric measurement. According to SGA, 60.6% of patients were malnourished. MST had a sensitivity of 70% and a specificity of 88%. The PPV of MST was 90%, NPV 65%, and AUC value was 0.79. PG-SGA had a sensitivity of 100% and a specificity of 92%. The PPV of PG-SGA was 95%, NPV 100%, and AUC value was 0.96. There were a significant difference in time spent applying questionnaires between these screening tools, and MST had the quickest among three. PG-SGA is suitable screening tool for detecting risk of malnutrition in hospitalized patients with gynecologic cancer."

"Pada penderita kanker paru terjadi inflamasi sistemik dan dapat dilihat dengan peningkatan rasio netrofil limfosit di mana pemeriksaan ini lazim dilakukan di Rumah Sakit. Inflamasi sitemik dapat menyebabkan anoreksi sehingga asupan pada penderita kanker paru menurun dan memengaruhi status gizinya. Kejadian malnutrisi yang tinggi pada pasien paru dapat berakibat lamanya rawat inap, turunnya kualitas hidup, dan dapat memengaruhi keberhasilan terapi kanker sehingga terapi nutrisi yang cepat dan tepat sangat perlu dilakukan. Salah satu diagnostik status gizi pada penderita kanker yaitu dengan menggunakan kriteria ASPEN yang terdiri dari penurunan asupan, penurunan berat badan, penurunan massa otot dan massa lemak subkutan, akumulasi cairan general atau lokal, dan kapasitas fungsional. Dikatakan malnutrisi jika terdapat dua dari enam kriteria tersebut. Penelitian ini merupakan studi potong lintang yang bertujuan untuk mengetahui hubungan status gizi dengan rasio netrofil limfosit pada pasien kanker paru di RSUP Persahabatan. Data diambil dari wawancara, pemeriksaan fisis, pemeriksaan laboratorium, dan rekam medis pasien poliklinik onkologi RSUP Persahabatan (n =52). Pada penelitian ini subjek sebagian besar berjenis laki-laki (61,5%), rentang usia terbanyak antara 50-60 tahun (38,5%), memiliki riwayat merokok (55,8%) dengan indeks Brinkman berat (30,8%). Lebih dari 50% subjek dengan asupan energi dan protein dibawah rekomendasi asupan untuk pasien kanker. Sebagian besar subjek penelitian berisiko malnutrisi atau malnutrisi sedang (38,5%) dan sebanyak 67,3% mengalami malnutrisi. Pada penelitian ini subjek dengan nilai rasio netrofil limfosit tinggi sebanyak 38,5% dan rendah sebanyak 61,5%. Tidak terdapat hubungan antara status gizi dengan rasio netrofil limfosit pada penelitian ini (p = 0,35).

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Systemic inflammation in patients with lung cancer can be seen by the increase in the neutrophil lymphocyte ratio where these examinations are common in hospitals. Systemic inflammation can cause anorexia, with the result that nutrition intake of lung cancer patients decreases and affects their nutritional status. High incidence of malnutrition in lung cancer patients can result in length of stay, decreased quality of life, and can affect the treatment of cancer therapy, therefore prompt and appropriate nutritional therapy is essential. One of the diagnostics of nutritional status for lung cancer patients is by using the ASPEN criteria which consist of decreased nutritional intake, weight loss, decreased muscle mass and subcutaneous fat mass, general or local fluid accumulation, and functional capacity. Malnutrition can be seen if there are two of the six criteria. This study is a cross-sectional study which aimed to determine the association between nutritional status and the ratio of lymphocyte neutrophils in lung cancer patients at Persahabatan Hospital. Data were taken from interviews, physical examinations, laboratory analysis, and patients medical records in the oncology polyclinic of Persahabatan Hospital (n = 52). The subjects of the study were mostly male (61.5%), the largest age range was between 50-60 years (38.5%), had a history of smoking (55.8%) with a severe Brinkman index (30.8%). More than 50% of the subjects with energy and protein intake were below the recommended intake for cancer patients. Most of the study subjects were at risk of malnutrition or moderate malnutrition (38.5%) and 67.3% of them were experiencing malnutrition. The subjects with the highest neutrophil lymphocyte ratio value were 38.5% and the lowest value were 61.5%. Overall, there was no relationship between nutritional status and the ratio of neutrophil to lymphocytes in this study (p = 0.35)."

"Pasien kanker serviks berisiko tinggi mengalami malnutrisi. Asupan makanan yang tidak adekuat, peningkatan kebutuhan, penurunan aktivitas fisik dan hiperkatabolisme, mendorong terjadinya malnutrisi. Kondisi ini dapat terjadi selama sakit maupun pada saat pengobatan, yang dapat memengaruhi status gizi pasien. Prevalensi malnutrisi pada pasien kanker serviks sebesar 48−66% dan meningkat hingga 82% setelah mendapat terapi. Pasien kanker serviks, 25% mengalami cachexia dan 33−69% mengalami sarkopenia. Penurunan massa otot yang merupakan penyusun utama massa bebas lemak (MBL), secara negatif memengaruhi efektivitas terapi dan kelangsungan hidup pasien. Bioelectrical impedance analysis (BIA) adalah alat tervalidasi untuk mengukur MBL sebagai bagian dari diagnosis malnutrisi, namun tidak selalu tersedia di fasilitas kesehatan. Penelitian menunjukkan bahwa kekuatan genggam tangan (KGT) dapat dijadikan sebagai prediktor MBL. Pengukuran KGT dengan handheld dynamometers (HHD) yang relatif murah, valid, dan andal, masih jarang digunakan. Penelitian ini bertujuan untuk melihat hubungan antara KGT dan MBL pada pasien kanker serviks yang menjalani radioterapi di Poliklinik Radioterapi RSCM. Penelitian menggunakan desain potong lintang pada subjek usia 18−60 tahun. KGT dinilai menggunakan Jamar digital HHD. MBL dinilai menggunakan BIA single frequency Omron® HBF−375. Terdapat 54 subjek dengan median usia 49 tahun, mayoritas stadium III, tidak terdapat metastasis dan komorbid, dan mendapat radioterapi saja. Mayoritas subjek tergolong BB lebih, dengan rerata asupan energi 20,79 ± 6,70 kkal/kgBB/hari, median asupan protein 0,68 (0,05−1,87) g/kgBB/hari, dan rerata asupan lemak 31,22 ± 8,81% dari energi total. Mayoritas asupan energi, protein dan lemak tergolong kurang dibandingkan dengan rekomendasi ESPEN. Rerata KGT 23,54 ± 5,16 kg dan rerata MBL 36,40 ± 6,03 kg. Dilakukan uji korelasi antara KGT dan MBL. Terdapat korelasi positif yang cukup antara KGT dan MBL pada pasien kanker serviks yang menjalani radioterapi (r = 0,346, p = 0,010). KGT berkorelasi positif kuat dengan MBL (r = 0,601, p = 0,001) pada pasien kanker serviks yang hanya menjalani radioterapi (n=28). Pemeriksaan KGT kemungkinan dapat memprediksi MBL, sehingga dapat membantu diagnosis malnutrisi lebih dini dan mencegah luaran buruk pada pasien kanker serviks yang menjalani radioterapi, terutama di fasilitas kesehatan yang tidak tersedia BIA. Penelitian lebih lanjut diperlukan untuk mendapatkan formulasi dalam memprediksi MBL dari KGT.

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Cervical cancer patients are at high risk for malnutrition. Inadequate food intake, increased energy and protein requirements, decreased physical activity and hypercatabolism in cancer patients lead to malnutrition. This condition can occur during illness or during treatment, which can affect the nutritional status of the patient. The prevalence of malnutrition in cervical cancer patients was 48−66% and increased to 82% in patients receiving therapy. Patients with cervical cancer, 25% were cachectic and 33%–69% were sarcopenic. Loss of muscle mass, which are the main constituents of fat free mass (FFM), negatively impact therapeutic efficacy and survival in cervical cancer patients. Bioelectrical impedance analysis (BIA) is a validated tool for measuring FFM, as part of malnutrition, but it is not always available in health facilities. Research shows that hand grip strength (HGS) can be used as a predictor of FFM. HGS measurement with handheld dynamometers (HHD) which is relatively cheap, valid, and reliable, is still rarely used. This study aims to examine the relationship between HGS and FFM in cervical cancer patients undergoing radiotherapy at the Radiotherapy Outpatients Clinic of Dr. Cipto Mangunkusumo Hospital. The study used a cross-sectional design on subjects aged 18−60 years. HGS was assessed using a Jamar digital hand dynamometer. FFM was assessed using the BIA single frequency Omron® HBF−375. A total of 54 study subjects with a median age of 49 years, the majority were in stage III, had no metastases, received radiation therapy only, and had no comorbidities. Most of the subjects were classified as overweight and obes, with a mean of energy intake 20.79 ± 6.70 kcal/kgBW/day, a median of protein intake 0.68 (0.05−1.87) g/kgBW/day, and an average of fat intake 31.22 ± 8.81% of the total energy. The majority of the energy, protein and fat intakes were less than the ESPEN recommendations. The mean HGS in the subjects was 23.54 ± 5.16 kg and the mean FFM was 36.40 ± 6.03 kg. Correlation test was conducted between HGS and FFM. There was a moderately positive correlation between HGS and KGT in cervical cancer patients undergoing radiotherapy (r = 0.346, p = 0.010). HGS was strongly positive correlation with FFM (r = 0.601, p = 0.001) in cervical cancer patients undergoing radiotherapy only (n=28). HGS maybe able to predict FFM for early diagnose of malnutrition and prevent poor outcomes in cervical cancer patients undergoing radiotherapy, especially in health facilities where BIA isn’t available. Further research is needed to get a formulation in predicting FFM from HGS."