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"ABSTRAKLatar Belakang. Extracorporeal Shock Wave Therapy ESWT dosis tinggi efektif mengurangi ukuran deposit kalsium, skor nyeri, dan perbaikan lingkup gerak sendi LGS namun dikaitkan dengan efek samping nyeri. Belum terdapat data ESWT dosis menengah sama efektif dengan ESWT dosis tinggi. Tujuan. Membandingkan keefektifan ESWT dosis menengah dengan ESWT dosis tinggi pada tendinitis kalsifikasi rotator cuff. Metode. Uji klinis tersamar ganda terandomisasi pasien tendinitis kalsifikasi rotator cuff, 30 ndash; 70 tahun, skor VAS ge; 4. Dibagi kelompok, ESWT dosis tinggi dan ESWT dosis menengah. Terapi ESWT diberikan dua kali, jarak dua minggu, evaluasi pada 4, 8, 12 minggu setelah terapi. Hasil. Pada kedua kelompok terdapat perbedaan bermakna ukuran deposit kalsium, skor nyeri dan LGS sebelum terapi, setelah terapi, evaluasi 4, 8, 12 minggu setelah terapi p0,05 . Efek samping nyeri 100 ditemukan pada ESWT dosis tinggi, 12,5 pada ESWT dosis menengah p

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ABSTRACTBackground. Extracorporeal Shock Wave Therapy ESWT high doses effectively reduce calcium deposits size, pain scores, and repair range of motion ROM but associated with side effects of pain. There is no data medium dose ESWT as effective as high dose ESWT. Aim. Compared the effectiveness of medium dose ESWT with high dose ESWT in rotator cuff calcified tendinitis. Method. Double blind randomized clinical trials patients with rotator cuff tendinitis, 30 70 years old, VAS scores ge 4. Group divided high dose ESWT and medium dose ESWT. ESWT administered twice, two weeks apart, evaluation at 4, 8, 12 weeks after therapy. Results. In both groups there were significant differences in calcium deposit size, pain score and ROM before therapy, after therapy, evaluation 4, 8, 12 weeks after therapy p 0.05 . Side effects 100 pain were found in high dose ESWT, 12.5 in medium dose ESWT p "

"Latar Belakang: Plantar fasciitis merupakan penyebab tersering dari nyeri tumit inferior. Nyeri dapat menjadi kronik walaupun sudah mendapatkan terapi konservatif yang optimal. Perbandingan efektivitas antara ESWT dan terapi Ultrasound masih belum diketahui dengan jelas.Metode: Penelitian ini merupakan studi eksperimental. Sebanyak 24 subjek plantar fasciitis dengan rentang usia 26-43 tahun yang telah terdiagnosis melalui USG mengikuti penelitian ini. Subjek dikelompokkan secara konsekutif ke dalam grup ESWT GE, n=13 dan grup Ultrasound UG, n=11 dengan durasi intervensi tiga minggu. Keluaran primer yang dinilai adalah nyeri palpasi dan nyeri pagi hari pada area medial tuberositas calcaneus. Keluaran sekundernya adalah waktu tempuh uji jalan 15 meter.Hasil: Masing-masing grup menunjukkan perbaikan nyeri yang signifikan secara statistik tanpa adanya perbedaan bermakna antargrup. Waktu tempuh uji jalan 15 meter mengalami perbaikan yang tidak signifikan secara statistik pada kedua grup dan tidak terdapat perbedaan signifikan antargrup.Kesimpulan: ESWT sama efektifnya dengan terapi Ultrasound dalam memberikan perbaikan nyeri pada plantar fasciitis.

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Background: Plantar fasciitis is the most common cause of inferior heel pain. It may become chronic pain despite optimal conservative treatment. Comparison of effectiveness between ESWT an Ultrasound still unclear.

Methods: Experimental study on plantar fasciitis patient that diagnosed using Ultrasonography with range of age 26 63 years divided consecutively into ESWT group EG ESWT and stretching fascia plantaris gastrocnemius and Ultrasound group UG US and stretching fascia plantaris gastrocnemius for 3 weeks intervention. The primary outcomes were pain on palpation and morning pain on medial of calcaneal tuberosity. The secondary outcome was duration in performing 15 meters walk test.

Results: 24 participants EG n 13, UG n 11 enrolled in this study. Mean age of EG 46.5 years and CG 43 years. Each group showed statistically significant improvement of pain reduction with no significant different between group. The duration of 15 meters walk test improved nonsignificant in each group dan did not show significant difference between group.

Conclusions: ESWT was no more effective than Ultrasound in reducing pain in patient with plantar fasciitis."

"Pendahuluan: Meskipun penghambat enzim fosfodiesterase tipe-5 (PDE5i) memilikiefek yang baik sebagai terapi lini pertama pada pasien dengan disfungsi ereksi (DE),masih terdapat tingkat kegagalan sebesar 30-40%. Extracorporeal shockwave therapy(ESWT) menjadi pilihan alternatif non-invasif yang berpotensi memberikan benefitpada pasien yang tidak bisa mengkonsumsi PDE5i. Studi ini bertujuan untukmembandingkan efikasi dari ESWT dengan PDE5i dalam menangani pasien DE yangmasih sensitif pengobatan, dengan menggunakan kuisioner IIEF-5 sebagai parameterhasilnya.Metode: Desain studi ini adalah kohort prospektif dengan sampel yaitu pasien DE yangberkunjung ke Rumah Sakit Muhammad Diamil, Padang pada bulan Februari hinggaApril 2018 yang memenuhi kriteria inklusi dan eksklusi yang telah ditentukansebelumnya. Pasien yang masuk ke dalam studi ini dibagi ke dua kelompok yaituESWT dan PDE5i. Terapi ESWT diberikan sesuai protokol standar satu kali per minggudengan interval 4 minggu dan PDE5i diberikan Tadalafil 10 mg satu kali sehari selama4 minggu. Hasil primer yang diukur adalah perubahan skor IIEF-5 dari sebelum dansesudah terapi. Perubahan dari derajat keparahan DE juga diukur dalam studi ini.Hasil: Terdapat 40 pasien yang termasuk dalam studi dari Februari hingga April 2018yang kemudian dialokasikan ke kelompok ESWT (n=20) dan PDE5i (n=20). Usia rataratapasien adalah 61.7±11.8, dengan waktu median sejak keluhan dirasakan yaitu 12(2-180) bulan. Parameter laboratorium menunjukan adanya perbedaan yang signifikandari kedua kelompok. Secara umum, terdapat peningkatan skor IIEF-5 sebesar 15% darisemua pasien, dengan median skor 3 (-12-16) (p 0.003). Peningkatan skor IIEF-5terjadi pada kedua kelompok, dengan kelompok ESWT yaitu 45% mengalamipeningkatan skor sebesar 4 (-12-16) (p 0.040); dan kelompok PDE5i yaitu 30%dengan peningkatan skor 0 (-4-7) (p 0.049). Akan tetapi, tidak terdapat perbedaansignifikan dalam hal peningkatan skor IIEF-5 antara kelompok ESWT dan PDE5i (p0.084).Kesimpulan: Kedua modalitas terapi yaitu ESWT dan PDE5i merupakan terapiindependen yang efektif dalam meningkatkan skor IIEF-5 pada pasien DE. TerapiESWT dapat menjadi terapi alternatif yang baik pada pasien yang tidak mampumengkonsumsi PDE5i, dengan memberikan hasil yang serupa dengan PDE5i.

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Introduction: Though phosphodiesterase type 5 inhibitors(PDE5i) is a beneficial firstlinetherapy for Erectile dysfunction (ED), failures were reported in 30-40% patients.Extracorporeal shock wave therapy (ESWT) became a potential non-invasive option forpatients who cannot tolerate PDE5i. This study would like to compare the efficacy ofESWT with PDE5i in treating treatment naïve ED, using IIEF-5 as an outcomeparameter.Methods: This prospective cohort study recruited patients with ED from MuhammadDjamil Hospital Padang within the period of February-April 2018, using predeterminedinclusion and exclusion criteria. Included patients were assigned for ESWT and PDE5iintervention groups. ESWT were given using standardized protocol once a weekinterval for 4 weeks and PDE5i were given using Tadalafil 10 mg once daily for 4weeks. Primary outcome measure was changes in IIEF-5 score between pre and posttreatment, and improved in severity condition for each patient were reported.Results:Forty patients treated for ED were included in the study from the period ofFebruary-April 2018 allocated to ESWT treatment group (n=20) and PDE5i treatmentgroup (n=20). Patients were at mean age of 61.7±11.8, with complaints persisting for amedian time of 12(2-180) months. Laboratory parameters showed a comparable levelbetween two treatment groups. Overall IIEF-5 Score response of the patients wasreported to improve in 15% of the patients, with a median score improvement of 3(-12-16) (p 0.003). Similar improvements were reported in each treatment group; ESWT in45% of the patients with score improvement of 4(-12-16) (p 0.040); PDE5i in 30% ofthe patients with score improvement of 0(-4-7) (p 0.049).However, difference in scoreimprovements between the ESWT group and PDE5i group were not statisticallysignificant (p 0.084).Conclusion: Both ESWT and PDE5i are beneficial as independent therapy for ED inimproving IIEF-5 score of the patients. ESWT may become a treatment of choice whenpatients cannot tolerate PDE5i, providing comparable outcome with PDE5i."

"[ABSTRAKPengambilan keputusan untuk pemilihan peralatan medis merupakan proses yangkompleks sehingga membutuhkan metode yang objektif. Metode Analitik hirarkiProses (AHP) merupakan salah satu metode yang digunakan clinical engineer,yang sesuai dengan acuan untuk menjalankan Health Technology Assesssment(HTA) dan Kajian analisis kebutuhan bagi rumah sakit. Penelitian ini bertujuanuntuk mengaplikasikan metode AHP dalam pemilihan mesin extracorporealshockwave lithotripsy (ESWL) di Rumah Sakit X. Keberhasilan metode AHP inidapat menjadi tolok ukur baru atau evidence base untuk metode pengambilankeputusan pemilihan peralatan medis di rumah sak;

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ABSTRACTThe decision for selecting medical equipment is a complex proses that needs acertain objective method.. Analytic hierarchy process (AHP) is one of decisionsupport system of clinical engineers which is appropriate in conducting HealthTechnology Assesssment ( HTA ) and needs analysis in hospital. This research isto apply the AHP method in selecting Extracorporeal Shockwave Lithotripsy(ESWL) in X hospital. The successful application of this method can become anew parameter or evidence base in using decision support system in the hospital, The decision for selecting medical equipment is a complex proses that needs acertain objective method.. Analytic hierarchy process (AHP) is one of decisionsupport system of clinical engineers which is appropriate in conducting HealthTechnology Assesssment ( HTA ) and needs analysis in hospital. This research isto apply the AHP method in selecting Extracorporeal Shockwave Lithotripsy(ESWL) in X hospital. The successful application of this method can become anew parameter or evidence base in using decision support system in the hospital]"

"ESWL telah berkembang menjadi pilihan pertama untuk terapi batu pielum ginjal dan kaliks superior atau media dengan ukuran le; 20 mm, dan pada batu ureter proksimal dengan ukuran < 10 mm. Meskipun begitu, terdapat banyak faktor yang sangat mempengaruhi keberhasilan dari pengguanaan ESWL, dimana salah satu parameter pentingnya adalah frekuensi gelombang kejut permenit. Peneilitian ini bersifat deskriptif retrospektif dengan pendekatan metoda cross-sectional. Sampel untuk diambil dengan total sampling, yaitu seluruh pasien yang dilakukan tindakan ESWL pada 1 Januari 2012- 31 Desember 2014 yang tidak memiliki batu multiple, tidak ada batu radiolsen, tidak ada kelainan anatomi traktus urinarius, dan usia diatas 17 tahun. Pasien dilakukan tindakan ESWL dengan menggunakan kombinasi gelombang kejut 60 gk.menit dan 120 gk/menit. Dari total 60 pasien, rata-rata usia adalah 45.61 14.54 tahun. Sebanyak 30 pasien 50 menderita batu ginjal non-kalik inferior, 26 pasien 43.4 menderita batu kalik inferior, dan 4 pasien 6.7 menderita batu ureter. Dari 60 pasien, 52 pasien 86.7 menderita batu dengan ukuran 10 ndash; 20 mm, empat pasien 6.7 dengan ukuran < 10 mm, dan empat pasien 6.7 dengan ukuran > 20 mm. Kejadian bebas batu 2 minggu post ESWL terjadi pada 46 pasien 76.7 , lalu 15 orang 25 mengeluhkan nyeri intensitas ringan VAS 1-3 , 5 orang 8.3 intensitas sedang 8.3 , dan 40 orang bebas nyeri 66.7 . Penggunaan DJ stent terjadi pada 7 pasien 11.7 dan hematuria terjadi pada 1 pasien 1.7 . Penelitian ini menunjukkan bahwa tata laksana batu saluran kemih menggunakan ESWL dengan kombinasi 60 gelombang kejut/menit dan 120 gelombang kejut/menit memiliki tingkat kejadian bebas batu yang lebih tinggi dan efek samping yang lebih rendah dibandingkan penelitian-penelitian serupa dengan menggunakan satu frekuensi gelombang kejut saja.

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ESWL has emerged as the main treatment option for kidney stone located in pyelum and superior calyces or middle calyses with size of le 20 mm, and in proximal ureter stone with size of 17 years old. Pasien underwent ESWL procedure with combination of 60 shockwave minutes and 120 shockwave minute. From total 60 patients, the mean age was 45.61 14.54 years old. 30 patients 50 diagnosed with non inferior calyces stone, 26 patients 43.4 with inferior calyses stone, and 4 patients 6.7 have ureteral stones. From 60 patients, 52 86.7 patients had stone with size of 10 20 mm, 4 6.7 patients had stone sized 10 mm. Stone free after 2 weeks happened in 46 patients 76.7 . 15 patients complained low intensity pain, 5 patients 8.3 complained mid intensity pain, and 40 patients 66.7 were pain free. The use of DJ stent happened in 7 patients 11.7 . This study showed that ESWL procedure with combination of 60 shockwave minutes and 120 shockwave minutes have a higher stone free rate and lower complication compared with single shockwave prcedure"

"ABSTRAKThe physiotherapy statistics from the Saraburi Hospital in Thailand show that patients with chronic lower back pain from muscle tearing have a higher tendency toward chronic pain, requiring continuous treatment. Most physiotherapists use radial shockwave therapy (RSWT) or radial pulse therapy to treat patients with chronic muscle tears. The aim of this study was to determine the immediate efficacy of RSWT on patients with lower back pain caused by chronic muscle strain. The purpose of this work is to assess the effectiveness of RSWT in the treatment of chronic back muscle pain. The type of this research is quasi-experimental research study. The location is this study is Physical Therapy Clinic at the Saraburi Hospital in Thailand. The study participants had pain intensities of greater than 5 out of 10. The experimental group (30 patients) received RSWT to the lower back for 10-15 minutes once a week for 6 weeks. The control group (30 patients) received ultrasound (US) treatments to the lower back using the semi-static technique with gel, but without turning the machine on, for 15 minutes once a week for 6 weeks. Both groups were taught to avoid bending and carrying heavy loads, as well as the correct way to lift heavy objects. None of the patients received medications, injections, massages, or acupuncture. The pain levels in both groups at work and at rest were measured using a visual analog scale. The treatment results were evaluated and compared at the 1st, 4th, and 6th treatments. The patient satisfaction was assessed at the 6 treatments as follows: 1 = most, 2 = high, 3 = moderate, 4 = low, and 5 = minimum. The effects on daily life and career performance were measured before the study and at the end as follows: 1 = most, 2 = high, 3 = moderate, 4 = low, 5 = minimum, and 6 = no effect. A statistical analysis was performed on the demographic data as well as on the pain level comparisons. The results of the RSWT and US treatments were measured while the patients were resting and working at 1, 4, and 6 months. Twelve and 18 of the patients were cured, respectively. In the US groups, 6 patients were statistically significantly better at the , , and treatments (but no cures). The post-treatment satisfaction was not significantly different between the RSWT and US groups. Consequently, the use of RSWT to treat chronic muscle strain can reduce pain immediately, and it can cure pain completely in some cases. Therefore, it should be used to treat more patients with chronic muscle strain. It should also be considered for use in chronic pain cases in which the patient does not respond to other conservative treatments."

"Latar belakang: Resistensi insulin dan berbagai komplikasi organ yang ditemukan pada kasus diabetes telah berkembang sejak tahapan prediabetes, diantaranya gangguan fungsi ginjal. Suplementasi vitamin D menjadi terapi yang menjanjikan untuk mencegah perkembangan gangguan ginjal. Oleh karena itu, dilakukan studi untuk menganalisis pengaruh suplementasi vitamin D baik dosis tinggi dan dosis rendah pada model tikus prediabetes dalam mencegah perburukan fungsi ginjal. Metode: Digunakan metode penelitian praklinis eksperimental pada tikus Wistar jantan. Tikus diberikan diet tinggi lemak dan glukosa kemudian dibagi menjadi empat kelompok acak yakni 1 kelompok kontrol dan 3 kelompok prediabetes (Tidak mendapat suplementasi vitamin D, mendapat vitamin D dosis rendah 100 IU/kgBB/hari atau dosis tinggi 1000 IU/kgBB/hari). Setelah 12 minggu, diambil serumnya untuk mengevaluasi kadar urea, kreatinin, dan albumin. Hasil: Studi ini menunjukkan bahwa kadar urea (p = 0,275) dan kreatinin (p = 0,067) tidak memiliki perbedaan signifikan pada setiap kelompok intervensi. Kelompok prediabetes dengan suplementasi vitamin D 1000 IU/kgBB/hari memiliki kadar urea serum lebih rendah dibandingkan 100 IU/kgBB/hari. Namur, suplementasi vitamin D 100 IU/kgBB/hari lebih menurunkan serum kreatinin dibanding 1000IU/kgBB/hari. Terdapat perbedaan signifikan pada kadar albumin (p = 0,003). Suplementasi vitamin D 100IU/kgBB/hari dan 1000IU/kgBB/hari ditemukan meningkatkan albumin serum. Kesimpulan: Pemberian suplementasi Vitamin D, baik dosis rendah maupun dosis tinggi tidak memberikan perbedaan signifikan pada urea dan kreatinin serum dibandingkan tikus yang tidak mendapat suplementasi namun didapati perbedaan signifikan pada kadar albumin serum tikus. Akan tetapi, perbedaan signifikan ini ditemukan pada albumin serum tikus sehat dibandingkan dengan tikus prediabetes. Suplementasi vitamin D meningkatkan kadar albumin serum secara signifikan.

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Introduction: Insulin resistance and organs complication related to diabetes have developed since prediabetic stage. One of this complications is impaired kidney function. Vitamin D supplementation become a promising therapy to prevent worsening of kidney function. Therefore, this study was conducted to assess and compare the effect of high dose and low dose vitamin D supplementation on markers of kidney function. Methods: This study is experimental preclinical study on animal model using serum sample of male Wistar rat. The rats received high fat and glucose diet and divided into a group of normal control and three groups of prediabetic (without vitamin D supplementation, with low dose (100IU/kgBW/day) and high dose (1000IU/kgBW/day) vitamin D supplementation). After 12 weeks, blood samples were collected to evaluate level of serum urea, creatinine, and albumin. Result : This study showed that serum urea (p=0,275) and creatinine (p=0,067) were not different statistically between groups. Group of prediabetic with 1000 IU vitamin D supplementation had lower serum urea compared to prediabetic group with 100 IU supplementation. On the contrary, vitamin D 100 IU/kgBW/day supplementation produced better result than 1000 IU/kgBW/day to lower serum creatinine. There was significant difference in serum albumin between all groups (p=0,003). Vitamin D supplementation of 100IU/kgBW/day and 1000IU/kgBW/day increased serum albumin levels more than normal groups. Conclusion: Low dose and high dose Vitamin D supplementation did not give significant difference to serum urea and creatinine level compared to nontherapy group. However, serum albumin was increased with supplementation of vitamin D 100 IU/kgBW/day and 1000 IU/kgBW/day in prediabetic rat than normal rat."

"Latar Belakang: Periostin memainkan peran sebagai mediator proses inflamasi termasuk inflamasi dan fibrosis ginjal. Namun, data signifikansi periostin pada acute kidney injury terbatas. Kami meneliti korelasi kadar periostin urin dengan fungsi ginjal pada pasien keganasan yang mendapat terapi cisplatin dosis tinggi. Metode: Penelitian kohort prospektif ini dilakukan di n ruang rawat HOM lantai 8 gedung A, di RSCM dari November 2019 hingga jumlah sampel minimal terpenuhi dengan cara consecutive sampling. Data dianalisis menggunakan SPSS versi 23.0 sesuai tujuan penelitian. Hasil: Dari 37 responden diketahui 70,3% laki-laki, 29,7% berusia 41-50 tahun, 59,5% menderita KNF, serta 64,9% memiliki Skor Karnofsky 80. Kadar ureum dan kreatinin darah responden meningkat dari pra kemoterapi hingga 1 minggu paska kemoterapi I. Begitu juga dengan nilai eGFR yang makin menurun. Perubahan kadar periostin menurun selama kemoterapi I dan II, naik kembali 1 minggu paska kemoterapi III dengan nilai p>0,05. Pada uji korelasi kadar periostin urin dengan variabel fungsi ginjal lainnya tidak didapatkan domain yang signifikan bermakna (p>0,05) dengan nilai koefisien korelasi lemah (r = 0,017-0,254) dan beberapa domain memiliki arah korelasi negatif.Simpulan: Tidak didapatkan korelasi bermakna kadar periostin urin dengan kadar ureum darah, kreatinin darah serta laju filtrasi glomerulus pasien keganasan dengan terapi cisplatin dosis tinggi.

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Background: Periostin plays role as mediator of inflammatory processes including inflammation and kidney fibrosis. However, data on the significance of periostin in acute kidney injury are limited. We investigated the correlation of urine periostin levels with kidney function in malignant patients receiving high-dose cisplatin therapy. Methods: This prospective cohort study was conducted in the 8th floor HOM care room in building A, in the RSCM from November 2019 until the minimum sample size was fulfilled by consecutive sampling. Data were analyzed using SPSS version 23.0 according to the purpose of study. Results: Of the 37 respondents known to be 70.3% male, 29.7% aged 41-50 years, 59.5% suffer from NPC, and 64.9% have Karnofsky score of 80. Urea levels and blood creatinine of respondents increased from pre-chemotherapy to 1 week after chemotherapy I. Likewise, the eGFR value decreases. Changes in periostin levels decreased during chemotherapy I and II, rising again 1 week after chemotherapy III with a p value> 0.05. In the correlation test of urinary periostin levels with other kidney function variables, no significant domain was found (p> 0.05) with a weak correlation coefficient (r = 0.017-0.254) and some domains had a negative correlation direction.

Conclusion: No significant correlation was found in urine periostin levels with blood urea levels, blood creatinine and glomerular filtration rates of malignant patients with high-dose cisplatin therapy."

"Latar Belakang: Periostin memainkan peran sebagai mediator proses inflamasi termasuk inflamasi dan fibrosis ginjal. Namun, data signifikansi periostin pada acute kidney injury terbatas. Kami meneliti korelasi kadar periostin urin dengan fungsi ginjal pada pasien keganasan yang mendapat terapi cisplatin dosis tinggi. Metode: Penelitian kohort prospektif ini dilakukan di n ruang rawat HOM lantai 8 gedung A, di RSCM dari November 2019 hingga jumlah sampel minimal terpenuhi dengan cara consecutive sampling. Data dianalisis menggunakan SPSS versi 23.0 sesuai tujuan penelitian. Hasil: Dari 37 responden diketahui 70,3% laki-laki, 29,7% berusia 41-50 tahun, 59,5% menderita KNF, serta 64,9% memiliki Skor Karnofsky 80. Kadar ureum dan kreatinin darah responden meningkat dari pra kemoterapi hingga 1 minggu paska kemoterapi I. Begitu juga dengan nilai eGFR yang makin menurun. Perubahan kadar periostin menurun selama kemoterapi I dan II, naik kembali 1 minggu paska kemoterapi III dengan nilai p>0,05. Pada uji korelasi kadar periostin urin dengan variabel fungsi ginjal lainnya tidak didapatkan domain yang signifikan bermakna (p>0,05) dengan nilai koefisien korelasi lemah (r = 0,017-0,254) dan beberapa domain memiliki arah korelasi negatif. Simpulan: Tidak didapatkan korelasi bermakna kadar periostin urin dengan kadar ureum darah, kreatinin darah serta laju filtrasi glomerulus pasien keganasan dengan terapi cisplatin dosis tinggi.

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Background: Periostin plays role as mediator of inflammatory processes including inflammation and kidney fibrosis. However, data on the significance of periostin in acute kidney injury are limited. We investigated the correlation of urine periostin levels with kidney function in malignant patients receiving high-dose cisplatin therapy.

Methods: This prospective cohort study was conducted in the 8th floor HOM care room in building A, in the RSCM from November 2019 until the minimum sample size was fulfilled by consecutive sampling. Data were analyzed using SPSS version 23.0 according to the purpose of study.

Results: Of the 37 respondents known to be 70.3% male, 29.7% aged 41-50 years, 59.5% suffer from NPC, and 64.9% have Karnofsky score of 80. Urea levels and blood creatinine of respondents increased from pre-chemotherapy to 1 week after chemotherapy I. Likewise, the eGFR value decreases. Changes in periostin levels decreased during chemotherapy I and II, rising again 1 week after chemotherapy III with a p value> 0.05. In the correlation test of urinary periostin levels with other kidney function variables, no significant domain was found (p> 0.05) with a weak correlation coefficient (r = 0.017-0.254) and some domains had a negative correlation direction.

Conclusion: No significant correlation was found in urine periostin levels with blood urea levels, blood creatinine and glomerular filtration rates of malignant patients with high-dose cisplatin therapy."

"Pada tahun 2011 sampai tahun 2013 terdapat 48 barang dan jasa di RSUP Sanglah yang disediakan dengan cara KSO dan belum pernah dilakukan evaluasi. Salah satunya ESWL yang merupakan alat yang tinggi utilisasinya. Tujuan dari penelitian ini adalah untuk membandingkan biaya antara tindakan ESWL dengan KSO dan tanpa KSO. Penelitian ini menggunakan metode cross sectional dengan pendekatan kuantitatif dan kualitatif. Hasil penelitian ini menunjukan bahwa biaya total tindakan ESWL lebih tinggi 1,4x dibandingkan tanpa KSO, tetapi dengan KSO ESWL mampu menjamin ketersediaan pelayanan setiap saat. Disarankan agar rumah sakit melakukan evaluasi tarif dan perjanjian dengan penyedia alat ESWL.

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In the year 2011 until 2013 there were 48 equipment and services in Sanglah General Hospital were provided through joint operation with private institution and has never been evaluated, which one of its equipment is ESWL with a quite high utilization. This study used a cross-sectional design and involved qualitative approach. The study revealed that total cost of ESWL with joint operation was 1.4x higher than the cost without joint operation (own purchase) and hospital has to cover part of the cost. However, joint operation has its advantage in securing provision of service. It?s necessary for hospital to re-evaluate its agreement on rates with ESWL providers."