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"Latar Belakang: Tingginya pertumbuhan kasus keganasan ginekologi dan organ panggul menyebabkan penggunaan terapi radiasi meningkat. Akan tetapi, terapi radiasi juga cukup banyak menimbulkan proktitis radiasi sebesar 30%. Tatalaksana menggunakan agen topikal seperti SCFA, sukralfat, steroid, formalin, dan 5-ASA diketahui memiliki hasil yang baik, namun belum banyak studi yang membandingkan terapi mana yang lebih superior. Tujuan: Menilai efektivitas beberapa terapi topikal terhadap perbaikan gejala klinis dan gambaran endoskopi pasien proktitis radiasi. Sumber Data: Pencarian utama dilakukan secara elektronik pada basis data PubMed, Cochrane/CENTRAL, Scopus, dan Science Direct antara September hingga November 2020. Pencarian sekunder dilakukan secara snowballing pada referensi studi yang terkait, dan melalui register uji klinis yang tersertifikasi lainnya seperti Global Index Medicus, Garba Rujukan Digital (GARUDA), ClinicalTrial.gov, dan International Clinical Trials Registry Platform (ICTRP) WHO. Seleksi Studi: Studi uji klinis acak terkontrol dengan intervensi terapi topikal dibandingkan plasebo atau terapi topikal lainnya atau kombinasi terapi medikamentosa, yang menilai luaran berupa respon gejala klinis dan gambaran endoskopi, serta dapat disertai luaran lain, ataupun tidak. Tidak ada batasan terhadap tahun publikasi dan bahasa. Penilaian judul, abstrak, dan studi dilakukan oleh dua orang peninjau independen. Dari total 1786 studi, didapatkan 9 studi memenuhi kriteria eligibilitas.Ekstraksi Data: Ekstraksi data dilakukan oleh dua peninjau independen dan dikonfirmasi pada peninjau ketiga. Konfirmasi data dilakukan dengan menghubungi peneliti dari studi terkait. Tidak didapatkan data tambahan. Hasil: Studi yang melaporkan efektivitas terapi berupa banyaknya jumlah subjek yang mengalami perbaikan atau penurunan skor klinis dan endoskopi dirangkum secara kualitatif. Masing-masing studi saling membahas antar terapi, dan memiliki heterogenitas yang tinggi. Dua studi mengenai formalin dapat dilakukan meta-analisis dengan hasil perbaikan klinis dan endoskopi, namun tidak bermakna terhadap dua studi tersebut (RR 0.97, 95% CI: 0.82-1.15) dan tidak terdapat terapi yang lebih superior dibanding terapi lain dalam meta-analisis tersebut. Empat studi yang membahas formalin 4% memiliki kualitas hasil studi menengah dengan risiko bias rendah. Terdapat 3 dari 9 studi yang membandingkan terapi SCFA dengan plasebo sehingga sulit untuk menyimpulkan terapi mana yang berefek lebih baik, dan memiliki risiko bias tidak jelas, namun dengan jumlah pasien yang sedikitsehingga kualitas studi rendah. Satu studi mengenai efektivitas sukralfat menunjukkan hasil bermakna dengan estimasi risiko rendah (RR 0.57, 95% CI: 0.35-0.92, P = 0.02). Akan tetapi studi mengenai 5-ASA topikal tidak ditemukan dalam inklusi telaah sistematis ini. Secara umum, kualitas hasil studi berdasarkan GRADE dapat dimasukkan ke dalam kategori sedang.Kesimpulan: Penggunaan terapi SCFA enema, formalin topikal, steroid topikal, dan sukralfat enema efektif dalam memperbaiki gejala klinis dan gambaran endoskopi proktitis radiasi. Namun, hingga saat ini belum ada studi klinis berkualitas baik sehingga sulit untuk menilai terapi yang terbaik. Sedangkan dari 2 studi formalin 4% yang dapat dilakukan meta-analisis, menunjukkan bahwa tidak ada terapi yang lebih superior dibandingkan lainnya. Selain itu, tidak ditemukan tidak ditemukan efek samping berat pada penggunaan terapi SCFA enema, formalin topikal, steroid topikal, dan sukralfat enema dalam mengobati proktitis radiasi.

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Background: The high incidence of gynecological and pelvic malignancies has led to the usage of radiation therapy. Nonetheless, radiation therapy also causes a significant complication, about 30% of radiation proctitis. Treatments using topical agents such as SCFA, sucralfate, steroids, formalin, and 5-ASA are known to have good results. However, there are only a few studies comparing the superiority of those therapies.

Objectives: To assess the effectiveness of topical therapies in the clinical and endoscopic improvement of radiation proctitis patients.

Data Sources: Primary searching was conducted on electronic databases such as PubMed, Cochrane/CENTRAL, Scopus, and Science Direct between September and November 2020. Secondary searching was done by snowballing method on the relevant study references and through other certified clinical trial registries (Global Index Medicus, Garba Digital Reference (GARUDA), ClinicalTrial.gov, and WHO's International Clinical Trials Registry Platform (ICTRP).

Study Selection: A randomized controlled trial comparing topical therapies versus placebo or other topical therapies or combination with medical therapies that evaluating the clinical response and endoscopic response. There is no restriction regarding the year of publication and language. Each study were assessed by two independent reviewers. From a total of 1,786 studies identified, 9 studies met the eligibility criteria.

Data Extraction: Data extraction was performed by two independent reviewers and confirmed by a third reviewer. Data confirmation was made by contacting the first researchers from related studies. No additional information was obtained.

Results: Studies reporting the effectiveness of therapy in the form of a large number of subjects experiencing improvement or reduction in clinical symptoms and endoscopy were summarized qualitatively. Each study discussed the therapies and the heterogeneity that could not be calculated due to the different outcomes. Two studies on formalin were subject to meta-analysis with clinical and endoscopy improvement. However, they were not significant in the two studies (RR 0.97, 95% CI: 0.82-1.15), and no better treatment compared with others in those studies. Further, four studies discussing 4% formalin had medium study quality results with a low risk of bias. There are 3 out of 9 studies that compared SCFA therapy with placebo so it is difficult to conclude which therapy has a better effect, and has an unclear risk of bias, but with a small number of patients so that the quality of the study is low. One study using sucralfate showed significant results with a low-risk estimate (RR 0.57, 95% CI: 0.35-0.92, P = 0.02). However, the study of topical 5-ASA was not found in the inclusion of this systematic review. The level of evidence for the majority of outcomes was downgraded using GRADE to a moderate level, due to imprecision and study limitation.

Conclusion: The usage of SCFA enema, topical formalin, topical steroid and sucralfate enema are effective in improving the clinical and endoscopic response in radiation proctitis patient. However, until now, there are no good quality studies, making it difficult to prove the best therapy. A meta-analysis from 2 studies using 4% formalin versus irrigation and antibiotics, shows no therapy is superior to another. Otherwise, no serious side effects were found in the usage of these topical therapies"

"Latar Belakang: Kolitis ulseratif distal merupakan kolitis ulseratif yang paling sering ditemukan. Dibandingkan dengan terapi oral, terapi topikal kurang banyak digunakan pasien. Satu studi melaporkan bahwa terapi oral digunakan pada 35,6% pasien sedangkan terapi topikal hanya digunakan pada 6,7% pasien. Namun demikian, berbagai studi yang menilai terapi topikal tersebut memberikan hasil yang inkonsisten.Tujuan: Mengetahui efektivitas pemberian beberapa terapi topikal dalam tatalaksana kolitis ulseratif distal derajat ringan dan sedang.Sumber Data: Penelusuran studi dilakukan hingga September 2020 pada empat basis data: PubMed/MEDLINE, Cochrane, ProQuest, dan SCOPUS. Pencarian sekunder dilakukan dengan teknik snowballing pada referensi studi yang ditemukan, pencarian melalui ClinicalTrial.Gov, pencarian melalui Garuda, dan Global Index Medicus.Seleksi Studi: Studi randomized controlled trial (RCT). Subyek merupakan pasien kolitis ulseratif distal derajat ringan dan sedang. Studi dengan intervensi yang dilakukan berupa terapi topikal 5-ASA enema, kortikosteroid enema, asam hialuronat enema. Luaran efektivitas yang dinilai berdasarkan respon klinis, remisi klinis, profil keamanan dan efek samping terapi tersebut. Tidak dilakukan pembatasan bahasa maupun waktu.Ekstraksi Data: Ekstraksi data dilakukan oleh kedua peninjau secara independen. Hasil: Respon klinis ditunjukkan pada pemberian 5-ASA enema dibandingkan plasebo enema (RR 2.48, IK 95% 1.81-3.38, p<0.00001). NNT 3 (IK 95% 2-4). Remisi klinis ditunjukkan pada pemberian kortikosteroid enema dibandingkan plasebo enema (RR 1.98, IK 95% 1.59-2.45, p<0.00001). NNT 5 (IK 95% 4-7). Tidak terdapat perbedaan antara pemberian 5-ASA enema bila dibandingkan dengan kortikosteroid enema baik Beclomethasone diproprionate enema (RR 1.04, IK 95% 0.70-1.54, p=0.85) dan Budesonide enema (RR 1.26, IK 95% 0.91-1.73, p=0.16). Asam hialuronat enema merupakan terapi topikal baru yang cukup aman dan efektif namun membutuhkan penelitian lebih lanjut dengan kualitas penelitian yang lebih baik. Terapi topikal memiliki profil keamanan yang baik. Sebagian besar adverse event ringan dan tidak signifikan.Kesimpulan: 5-ASA enema dan kortikosteroid enema efektif dalam mencapai respon dan remisi klinis bila dibandingkan dengan plasebo. Tidak terdapat perbedaan antara 5-ASA enema bila dibandingkan dengan kortikosteroid enema

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Background: Distal ulcerative colitis is the most common ulcerative colitis. Compared with oral therapy, topical therapy is less used by patients. One study reported that oral therapy was used in 35.6% of patients whereas topical therapy was used in only 6.7% of patients. However, studies assessing this topical therapy have yielded inconsistent results. Objective: To determine the effectiveness of topical therapy in the management of mild and moderate distal ulcerative colitis. Data Source: Study searching was done through September 2020 on four databases: PubMed / MEDLINE, Cochrane, ProQuest, and SCOPUS. Secondary searching was done by snowballing method of the study references, searching through ClinicalTrial.Gov, Garuda, and the Global Index Medicus. Study Selection: A randomized controlled trial (RCT). Subjects were mild and moderate distal ulcerative colitis patients. Intervention studies included topical 5-ASA enema therapy, corticosteroid enema, and hyaluronic acid enema. The effectiveness outcome was assessed based on clinical response, clinical remission, safety profile and side effects of the therapy. There are no language or time restrictions. Data Extraction: Data extraction was done by both reviewers independently. Results: Clinical response was shown in 5-ASA enema versus placebo enema (RR 2.48, CI 95% 1.81-3.38, p <0.00001). NNT 3 (CI 95% 2-4). Clinical remission was shown in corticosteroid enema versus placebo enema (RR 1.98, CI 95% 1.59-2.45, p <0.00001). NNT 5 (CI 95% 4-7). There was no difference between 5-ASA enema administration when compared to corticosteroid enema, Beclomethasone diproprionate enema (RR 1.04, 95% CI 0.70-1.54, p = 0.85) and Budesonide enema (RR 1.26, CI 95% 0.91 -1.73, p = 0.16). Hyaluronic acid enema is a new topical therapy that is quite safe and effective in achieving clinical response and remission but requires further research with better research quality. Topical therapies have a good safety profile. Most of the adverse events were mild and insignificant. Conclusion: 5-ASA enemas and corticosteroid enemas were effective in achieving clinical response and remission when compared to placebo. There was no difference between 5-ASA enemas when compared with corticosteroid enemas"

"The rapidly increasing concern of non-ionizing microwave radiations affecting human health adversely has been gaining much of attention. a large volume of research studies have been published in the past decade. most of the previous review literature in this key research area are limited to a certain domain leading to questionable gaps that still need to be filled. this paper, therefore, investigates and analyses all possible gaps, which are left in recent literature related to this issue and aims to provide an inclusive up-to-date overview of evidences and epidemiological studies on different parts of human body, in both adult and children. based on the literature review, it is evident that the rise in the Specific Absorption Rate (SAR) above its maximum value due to the exposure from non-ionizing radiation can cause severe effect on human body such as a cataract formation in the eye, a shortfall in sperm count in men etc. specific Anthropomorphic Mannequin (SAM) model, which is used as a certification technique for cell phone, is found to be overestimating the adult and child head exposure by using same geometric model for child and adult head types. It has also been observed that the electromagnetic radiation has both positive and negative effect on the human life, depending on the context of its application. It is envisaged that human can gain from the positive side and avoid the negative effect. A step by step example of numerical simulation model is illustrated to support future researchers in developing further work in this research area."

"Radiografer secara umum mempunyai tugas dan tanggung jawab untuk melakukan pemeriksaan pasien secara radiografi meliputi pemeriksaan untuk radiodiagnostik termasuk kedokteran nuklir dan ultrasonografi (USG) dan melakukan tindakan proteksi radiasi dalam mengoperasikan peralatan radiologi. Penelitian ini bertujuan memprakirakan risiko pajanan radiasi sinar-X pada pekerja radiasi di Departemen Radiologi RSUPN Cipto Mangunkusumo. Dalam perhitungan prakiraan risiko pajanan radiasi sinar-X, dosis pajanan radiasi sianr-X radiografer diperoleh dari hasil pengukuran film badge. Data pola aktifitas (lama kerja, frekuensi pajanan dan masa kerja) diperoleh berdasarkan hasil wawancara pada 35 radiografer di Departemen Radiologi RSUPN Cipto Mangunkusumo. Berdasarkan perhitungan yang dilakukan, nilai rata-rata Excess Cancer Risk (ECR) lifetime (4,8E-2) dan realtime (1,9E-2). Karena secara teoretis karsinogenisitas tidak mempunyai nilai ambang atau non threshold, maka prakiraan risiko dinyatakan unacceptable (dosis tidak dapat diterima) bila ECR < E4. Kisaran angka E-4 diperoleh dari nilai default karsinogenistas yang digunakan oleh US-EPA (1990). Berdasarkan perhitungan ECR lifetime dan ECR realtime diperoleh gambaran prakiraan risiko efek karsinogenik yang terjadi pada radiografer di Departemen Radiologi RSUPN CM, dinyatakan aceptable pada risiko kanker baik pada ECR lifetime maupun realtime.

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Radiographer in general have a duty and responsibility to audit includes examined patients for radiodiagnostic including nuclear medicine and ultrasonography (USG), and radiation protection in radiology and operating equipment. This study aims to estimated the risk of X-ray radiation exposure to radiographer in the Department of Radiology RSUPN Cipto Mangunkusumo using Environmental Health Risk Analysis (ARKL). In calculating the estimated risk forecasts ARKL, risk of X-ray radiation exposure dose radiographer obtained from measurements of the film badge. Data patterns of activity (duration of work, frequency of exposure and years of work) obtained based on the results of a survey of 35 radiographers in the Department of Radiology RSUPN Cipto Mangunkusumo.

Based on the calculations performed, the average value of Excess Cancer lifetime Risk (ELCR) is 4,8E-2 and the value of Excess Real-time Cancer Risk (ERRC) the average is 1,9E-2. Because theoretically carcinogenicity has non-threshold value, then the forecast is declared unacceptable when ECR < E-4. Range of numbers obtained from the E-4, carcinogenicity default values used by the US-EPA (1990). Based on the calculation of the ELCR and ERCR forecasts illustrate the risk of carcinogenic effects that occur in the radiographers in the Department of Radiology RSUPN CM, acceptable on cancer risk both in the ELCR and ERRC."

"Energi merupakan unsur yang selalu berhadapan dengan manusia dalam kehidupan sehari-hari, yang terdiri dari beberapa jenis, seperti energi potensial, energi mekanik, energi kinetik dan lainya. Kalor juga merupakan energi yang sangat dibutuhkan kemampuan untuk memanfaatkan energi ini. Kalor juga memiliki sifat dapat berpindah dari suatu tempat ke tempat lainya, salah satunya adalah radiasi. Radiasi kalor merupakan sumber energi yang sangat baik untuk dimanfaatkan karena sifatnya yang mampu berpindah tanpa adanya perantara. Namun radiasi juga dapat membahayakan jika fluks kalor yang dipaparkan sangat besar yang mampu memicu penyalaan api pada objek yang terpapar.untuk menghindari hal tersebut maka perlu diantisipasi dengan salah satu cara melakukan pemetaan radiasi kalor pada suatu area tersebut. Pemetaan yang dilakukan terdiri dari beberapa faktor seperti jarak, offset, elevasi dan sudut pandang. Tentu saja jika sumber panas berada pada area fluida menyebabkan adanya pengaruh konveksi pada fluks kalor yang terukur. Kalor yang dihasilkan akan mengubah karakteristik udara disekitar objek yang dipaparkan dan akan membentuk sebuah lapisan batas yang memiliki ketebalan sesuai dengan karakteristik aliran kalor.

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Energy is always connected with human life in every day, which is like potential energy, mechanical energy, kinetic energy and others. Heat is also a kind of energy, that rsquo s needed skill and capabilites to use this energy. Heat also has properties that can devolve to others place, one of that is radiation. Heat radiation is a very good energy to be exploited because of the nature characteristics of radiation is being able to move without a medium. However, radiation can also be dangerous if the heat flux is very large which can be triggered ignition fire of the object. To keep those things it is necessary to anticipate, one of them is to make a mapping of radiation in the area. Mapping consists of several factors such as distance, offset, elevation and view factor. Of course, if there is heat in the fluid region it will cause influence of convection in measurable heat flux. The heat produced of the heater will change the properties of air around exposed object and will form a layer that has a thickness according to the heat flow."

"ABSTRACT

Recently, there -is a rapidly grow in the field of optical fiber communications, particularly in the technology of fiber waveguide which is used as transmitting media or communication lines. 'Due mayor problem in optical waveguide systems is the coupling loss in connectors or couplers for the purpose of gaining maximum coupling efficiency. This research is dedicated to obtain an efficient wavegui de devi ce by studyi ng the applicability of cone-shaped fiber end-face as fiber star coupler without any complement element. Light power from one end-face of fiber was directly coupled to another cone-shaped fiber end-face. The first step of this study was the process of cone-shaping for graded-index fibers. The result was used as coupling elements in an experimental star coupler. The evaluation of the result is carried out based on the concept of radiation pattern of electromagnetic field in cone-shaped end-face of fibers- It. is concluded that the experimental star coupler is predicted to be useful with some improvement in choosing fiber-core diameter. matching the size of the coupled fibers and aligning the suitable axes of the outgoing fibers.;Recently, there -is a rapidly grow in the field of optical fiber communications, particularly in the technology of fiber waveguide which is used as transmitting media or communication lines. 'Due mayor problem in optical waveguide systems is the coupling loss in connectors or couplers for the purpose of gaining maximum coupling efficiency. This research is dedicated to obtain an efficient wavegui de devi ce by studyi ng the applicability of cone-shaped fiber end-face as fiber star coupler without any complement element. Light power from one end-face of fiber was directly coupled to another cone-shaped fiber end-face. The first step of this study was the process of cone-shaping for graded-index fibers. The result was used as coupling elements in an experimental star coupler. The evaluation of the result is carried out based on the concept of radiation pattern of electromagnetic field in cone-shaped end-face of fibers- It. is concluded that the experimental star coupler is predicted to be useful with some improvement in choosing fiber-core diameter. matching the size of the coupled fibers and aligning the suitable axes of the outgoing fibers."

"The dualistic theory is utilized as the framework for our analysis of the emerging spatial pattern of development in Nigeria’s Federal Capital Territory. The analysis is carried out using the principal axis method of factoring out data set. Furthermore, the scores of the extracted orthogonal factors are mapped and interpreted in spatial terms. The space economy of our study is observed to conform with the dualistic theory in two major ways. It is suggested that the development of an asymmetrical relationship between the two structural components of the observed spatial dualism must be prevented by adopting appropriate regional development policies."

"Telah dikembangkan alat yang dapat digunakan untuk membantu menetukan sudut pada pembuatan lead brick (plain brick). Sudut yang dimaksud adalah sudut luar dan dalam pada lead brick (plain brick) male and female yang harus memenuhi standart ISO 7212-1986 dengan toleransi sudut male 90o o+15 dan female 90o o-15. Ketepatan pengerjaan sudut ini menjadi sangat penting untuk menjaga keseimbangan supaya susunan lead brick tidak miring atau rubuh. Oleh karena itu setiap pengerjaannya menggunakan rotary table karena memudahkan dalam setting benda kerja dan kepresisian pengukuran bisa dijaga. Namun dikarenakan banyaknya operator yang belum bisa menggunakan alat ini sebagai alat bantu untuk mencapai toleransi sudut yang disyaratkan, maka diperlukan adanya metode pengukuran yang tepat pada proses machining lead brick menggunakan alat bantu rotary table sehingga dapat digunakan sebagai acuan untuk mencapai tingkat ketelitian sudut 0,03o pada pembuatan sudut luar dan dalam (male and female) lead brick (plain brick)."

"Tujuan: Membandingkan distribusi dosis respon akhir RE dan efek samping akut RE teknik konvensional dan teknik konformal pada kasus kanker serviks lokal lanjut Metode Dilakukan studi kohort retrospektif terhadap pasien kanker serviks II B dan III B yang mendapat RE pra brakiterapi di Dept Radioterapi RSCM. Hasil: Didapat 51 pasien menjalani RE teknik konvensional 25 dengan Cobalt 60 26 dengan Linac dan 29 pasien menjalani teknik konformal Sesuai ketentuan ICRU 50 dan 62 prescribed dose dan cakupan volume target teknik konvensional Cobalt lebih kecil p 0 001 dan 1 kasus dari 25 pasien mendapatkan PTV 95 Prescribed dose dan cakupan volume target teknik konvensional Linac lebih besar p 0 001 dibanding teknik konformal Rerata conformity index teknik konvensional sebesar 2 dan teknik konformal 1 02 p 0 001 Dosis dan volume pada buli rektosigmoid dan bowel teknik konvensional lebih besar p 0 001 Respon komplit akhir RE teknik konvensional adalah 42 dan teknik konformal adalah 58 p 0 001 Faktor independen respon akhir RE yaitu stadium FIGO dini dan ukuran tumor sebelum RE kecil le 4cm Pada semua kasus tidak didapatkan efek samping akut lokal yang berat RTOG grade 3 4 Proporsi efek samping ringan RTOG grade 1 2 pada gastrointestinal vesikourinaria dan kulit lebih banyak pada teknik konvensional secara berurutan 72 Vs 28 p 0 002 78 Vs 22 p 0 003 dan 78 Vs 22 p 0 01. Kesimpulan: RE teknik konformal lebih unggul dibanding teknik konvensional dalam distribusi prescribed dose dan cakupan volume target atau organ kritis yang berdampak pada respon tumor akhir RE dan efek samping.

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Purpose: To compare the dose distribution acute tumor response and acute side effects between conventional and conformal techniques EBRT in locally advanced uterine cervical cancerMethods and materials Retrospective cohort study was done in stage II B and III B uterine cervical cancer underwent EBRT before brachytherapy in Dept Radioterapi RSUPN Cipto Mangunkusumo.

Results: Fifety one patients underwent conventional technique EBRT and 29 patients of conformal technique EBRT The average of target prescribed dose and volume coverage of 2 techniques EBRTwas in accordance with criteria of ICRU 50 and 62 smaller p 0 001 only 1 case of Cobalt conventional technique EBRT showed PTV 95 Conformity index of conventional technique EBRT was 2 and conformal technique EBRT was 1 02 p 0 001 Dose and volume of vesicourinary rectosigmoid and distal large bowel of conventional technique EBRT was greater p 0 001 Complete response of conventional technique was 42 and conformal technique was 58 p 0 001 Independent factors were early FIGO stage and tumor size before EBRT le 4cm There were no severe acute side effects RTOG grade 3 4 in both groups Acute side effects RTOG grade 1 2 of conventional techniques was more than conformal gastrointestinal vesikourinaria and skin respectively 72 vs 28 p 0 002 78 vs 22 p 0 003 and 78 vs 22 p 0 01.

Conclusion: Conformal technique EBRT was superior to conventional technique EBRT in prescribed dose distribution target volume coverage and organ at risk dose that impact on acute tumor response and side effects "