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"Latar belakang: Karsinoma nasofaring (KNF) merupakan penyakit genetik multifaktorial, bersifat endemik dan mempunyai perbedaan signifikan dalam distribusi geografi s. Selain faktor virus Epstein Barr (EBV), insiden KNF juga dipengaruhi oleh faktor genetik seperti polimorfi sme gen reseptor sel T lokus β (TCR-β). Penelitian ini bertujuan untuk mengetahui hubungan polimorfi sme gen TCR-β dengan suseptibilitas individu untuk berkembang menjadi KNF pada populasi Indonesia. Metode: Penelitian dilakukan dengan teknik PCR-RFLP menggunakan enzim restriksi Bgl II pada gen TCR-β. Analisis PCR-RFLP gen TCR-β digunakan untuk mendeterminasi alotip gen TCR-β pada penderita KNF dan kontrol dan pada kelompok etnis Cina dan pribumi dalam populasi Indonesia. Hasil: Hasil penelitian menunjukkan bahwa distribusi alotip gen TCR-β pada penderita KNF dan kontrol tidak berbeda bermakna (p > 0,05). Frekuensi alel A meningkat pada penderita KNF. Distribusi alotip gen TCR-β antara etnis Cina dan kelompok pribumi tidak memperlihatkan perbedaan bermakna (p> 0,05). Kesimpulan: Distribusi alel gen TCR-β antara kelompok KNF dengan kelompok kontrol tidak menunjukkan perbedaan. Distribusi alel gen TCR-β antara etnis Cina dan pribumi tidak menunjukkan perbedaan. Polimorfi sme gen TCR-β tidak berhubungan dengan KNF dan etnis pada populasi Indonesia.

Abstract
Background: Nasopharyngeal carcinoma (NPC) is a multifactorial genetic disease, characteristically endemic and shows considerable differences in its geographical distribution. Besides infection with EBV, genetic factors such as polymorphisms of TCR-β gene contribute to the incidence of NPC. This study investigates the association of TCR-β gene polymorphisms with individual susceptibility to develop NPC in Indonesian ethnic groups. Methods: The study was carried out by the PCR-RFLP method using Bgl II restriction enzyme to digest TCR-β gene. The PCR-RFLP analysis of TCR-β gene was used to determine allotypes of TCR-β gene in NPC patients and control among ethnic Chinese and indigenous groups in the population of Indonesia. Results: The results indicate that the distribution of TCR-β gene allotypes between NPC patients and controls are not signifi cantly different (p > 0.05); however, the frequency of A allele tends to increase in NPC patients. The distribution of TCR-β gene allotypes between Chinese ethnic group was not signifi cantly different from indigenous groups (p > 0.05). Conclusion: The distribution of TCR-β gene allele between NPC group and control groups showed no difference. The distribution of TCR-β gene between ethnic Chinese and indigenous groups showed no difference. Polymorphisms of TCR-β gene are not associated with NPC and ethnic groups in Indonesian population. "
[Fakultas Kedokteran Universitas Indonesia, Fakultas Kedokteran Universitas Indonesia], 2011
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Artikel Jurnal  Universitas Indonesia Library
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"Purpose
The association between the preoperative absolute neutrophil count (NC), lymphocyte count (LC), and monocyte count (MC) in the peripheral blood and the prognosis of gastric cancer (GC) patients has not been investigated widely.
Methods
We enrolled 445 patients who underwent surgery for GC between January, 2005 and April, 2013 to analyze the correlations among NC, LC, and MC and their prognoses.
Results
Based on cut-off values calculated by ROC analysis, patients were sub grouped as having: NC ≥ 4477 (NCHigh), NC < 4477 (NCLow); and as LC ≥ 1447 (LCHigh), LC < 1447 (LCLow); and as MC ≥ 658,5 (MCHigh), MC < 658,5 (MCLow). Each group was assigned as follows; NCHigh group = 1, NCLow group = 0, LCHigh group = 0, LCLow group = 1, MCHigh group = 1, MCLow group = 0, and the sum of each score was defined as the lymphocyte-monocyte-neutrophil score (LMN score). The overall 5-year survival rates were 89%, 74%, 57,8%, and 53,3% for LMN scores of 0, 1, 2, and 3, respectively (P = 0,0004). Multivariate analysis indicated that the LMN score was an independent prognostic indicator.
Conclusions
The combination of preoperative NC, LC, and MC appears to be a useful indicator of GC prognosis."
Tokyo: Springer, 2019
617 SUT 49:10 (2019)
Artikel Jurnal  Universitas Indonesia Library
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Agustinus Gatot Dwiyono
"Latar Belakang: Kanker Nasofaring (KNF) merupakan keganasan yang sering di Indonesia. Molekul terkait imun yang banyak diteliti adalah Programmed Death-1 (PD-1)/Programmed Death-Ligand 1 (PD-L1). Penelitian ini bertujuan untuk mengetahui profil PD-L1 dari spesimen KNF di Indonesia.
Metode: Spesimen biopsi massa nasofaring diambil untuk pemeriksaan konsentrasi protein PD-L1 dengan metode Enzyme-Linked Immunosorbent Assay (ELISA). Pada spesimen yang terbukti secara histologis KNF dilakukan pemeriksaan Imunohistokimia (IHK) untuk mengetahui ekspresi PD-L1.
Hasil: Lima puluh empat spesimen biopsi nasofaring diperoleh. Tiga puluh lima dari 54 spesimen dikonfirmasi secara histologis KNF yang tidak berdiferensiasi dengan usia rerata 51 tahun. Selebihnya, 19 spesimen lainnya secara histologis bukan KNF dengan usia rerata 37 tahun. Pada pemeriksaan ELISA, median konsentrasi PD-L1 dari spesimen KNF adalah 2100,73 ± 3689,52 pg/mg protein, dan spesimen bukan KNF adalah 1010,88 ± 1082,37 pg/mg protein. Pada pemeriksaan IHK 30 sampel KNF untuk pemeriksaan ekspresi PD-L1, semuanya mengekspresikan PD-L1 positif, dengan rincian; skor 1 sebanyak 7%, skor 2 sebanyak 30%, dan skor 3 sebanyak 63%.
Kesimpulan: Protein PD-L1 dari spesimen KNF dengan pemeriksaan ELISA signifikan meningkat dibandingkan dengan bukan KNF. Semua spesimen KNF dengan pemeriksaan IHK mengeskspresikan PD-L1 positif dengan mayoritas skor 3.

Background: Nasopharyngeal Carcinoma (NPC) is a common malignancy in Indonesia. Immune-related molecules that have been studied are Programmed Death-1 (PD-1)/Programmed Death-Ligand 1 (PD-L1). This study aims to determine the profile of PD-L1 from NPC specimens in Indonesia.
Method: A nasopharyngeal biopsy specimen was taken to examine the concentration of PD-L1 protein by the Enzyme-Linked Immunosorbent Assay (ELISA). Immunohistochemistry (IHC) examinations were conducted to determine the PD-L1 expression.
Results: Fifty-four nasopharyngeal biopsy specimens were obtained. Thirty-five of 54 specimens were confirmed histologically for undifferentiated NPC with an average age of 51 years. The rest, 19 other specimens are histologically non NPC with an average age of 37 years. On ELISA examination, the median PD-L1 concentration of the NPC specimen was 2100.73 ± 3689.52 pg/mg protein, and the non-KNF specimen was 1010.88 ± 1082.37 pg/mg protein. At the IHC examination of 30 NPC samples for PD-L1 expression examination, all of them expressed PD-L1 positive, with details; score 1 is 7%, score 2 is 30%, and score 3 is 63%.
Conclusion: PD-L1 protein from NPC specimens by ELISA examination was significantly increased compared to non-NPC. All NPC specimens with IHC examination expressed PD-L1 positive with a majority score of 3.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
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UI - Tesis Membership  Universitas Indonesia Library
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"Pragnosis buruk pada penderita KNF dapat disebabkan oleh resistensi terhadap efek induksi apoptosis radioterapi dan / atau kemoterapi. Apoptosis bergantung pada aktifasi tepat kaspase 3 yang menghasilkan pembelahan protein-protein kunci seperti PARP-1. Untuk meneliti apakah disrupsi jalur apoptosis menghasilkan sel-sel tumor yang resisten terhadap terapi, dalam penelitian ini dipelajari apakah ketiadaan aktifasi kaspase 3 dalam biopsi tumor para penderita KNF berkaitan dengan hasil pengobatan klinik yang buruk. Selain itu dalam studi terakhir ini akan diteliti apakah tiadanya aktifasi kaspase 3 berkaitan dengan hilangnya ekspresi pro-kaspase 3 dan XIAP."
MPIAPI 14:1 (2005)
Artikel Jurnal  Universitas Indonesia Library
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Tri Handayani
"Latar belakang: Kualitas suara ditentukan oleh karakteristik elastisitas pita suara, resonansi dan struktur di saluran vokal. Produksi suara merupakan salah satu komponen yang berperan penting dalam komunikasi verbal, interaksi sosial serta merupakan identitas dan kepribadian tiap individu yang berkontribusi pada kesejahteraan dan kualitas hidup seseorang. Pasien karsinoma nasofaring pasca radiasi tanpa adanya residu dapat mengalami fibrosis pada velofaring dan memicu gangguan penutupan velofaring selama bicara sehingga menimbulkan hipernasal.

Tujuan: Mengetahui karakteristik dan proporsi skor nasalance pada pasien KNF pasca radiasi dengan atau tanpa gangguan persepsi bicara.

Metode: Penelitian ini merupakan studi survei deskriptif dengan teknik cross sectional dan kemudian dilanjutkan pengambilan data retrospektif pasien karsinoma nasofaring pasca radiasi di RSUPN Dr. Cipto Mangunkusumo periode Juli – Agustus 2023. Parameter yang dinilai adalah skor nasalance dengan menggunakan nasometer.

Hasil: Skor nasalance pasien karsinoma nasofaring pasca radiasi pada uji gajah 1 didapatkan median 14 (7-22), rerata uji hantu 1 39,8% + 4,5, dan rerata uji sengau 62,2 + 6,9, dengan titik potong skor nasalance pada uji gajah 1 antara persepsi bicara normal dengan gangguan persepsi bicara hipernasal adalah 15.5% dan pada uji hantu 1 adalah 42.5%. Jenis kelamin dan dosis radiasi pada otot konstriktor faring memiliki kecenderungan hubungan yang bermakna terhadap gangguan persepsi bicara pada pasien karsinoma nasofaring pasca radiasi.

Kesimpulan: Diperlukan studi prospektif pada pasien karsinoma nasofaring dengan penilaian sebelum dan sesudah radiasi serta evaluasi follow-up untuk menilai efek radiasi yang mencakup semua aspek fungsional suara dan ucapan yang relevan.


Background: Voice quality is determined by the elasticity of the vocal cords, resonance, and structures in the vocal tract. Voice production is a component that plays an important role in verbal communication and social interaction. It is the identity and personality of each individual that contribute to their welfare and quality of life. Post-radiation nasopharyngeal carcinoma patients without any residue can experience fibrosis in the velopharynx and trigger disruption of the velopharyngeal closure during speech, causing hypernasality.

Objective: To determine the characteristics and proportions of the nasalance score in post-radiation NPC patients with or without impaired speech perception.

Methods: This research is a descriptive study using cross-sectional techniques, followed by retrospective data collection of post-radiation nasopharyngeal carcinoma patients at CMGH Dr. Cipto Mangunkusumo for the period July–August 2023. The parameter assessed is the nasalance score using a nasometer.

Results: The nasalance score in the Gajah 1 test obtained a median of 14 (7-22), for the mean value of Hantu 1 test was 39.8% + 4.5, and for the mean value of Sengau test was 62.2 + 6.9, with a nasalance score cut point in Gajah 1 test between normal speech perception and hypernasal was 15.5% and in Hantu 1 test was 42.5%. Gender and radiation dose to the pharyngeal constrictor muscle tend to have a significant relationship with impaired speech perception in post-radiation nasopharyngeal carcinoma patients.

Conclusion: A prospective study is needed in nasopharyngeal carcinoma patients with pre- and post-radiation assessment and follow-up evaluation to assess radiation's effects, including all relevant functional aspects of voice and speech."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tugas Akhir  Universitas Indonesia Library
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Sihaloho, Florensa
"Tujuan
Untuk mendapatkan data metastasis KGB retrofaring pada penderita KNF dengan
pemeriksaan CT nasofaring di Rumah Sakit Kanker “Dharmais”.
Metode
Penelitian studi deskriptif analitik dari data sekunder CT nasofaring penderita
KNF yang belum mendapatkan terapi radiasi dan kemoterapi. Penilaian metastasis
KGB retrofaring dengan diameter aksial minimal ≥ 5 mm yang berada di level
atlas dekat arteri karotis interna. Penilaian massa tumor menurut TNM AJCC edisi
ke-7 tahun 2010. Dilakukan uji statistik untuk mengetahui adanya hubungan
metastasis KGB retrofaring dengan massa tumor, tipe histopatologi, invasi lateral,
dan massa tumor melewati midline.
Hasil dan diskusi
Sebanyak 85 penderita KNF dengan subyek terbanyak laki-laki, umur rerata 43,2
tahun, metastasis KGB retrofaring sebanyak 81 subyek, dan metastasis KGB
servikal level II merupakan metastasis KGB terbanyak.
Kesimpulan
Metastasis KGB retrofaring adalah metastasis KGB terbanyak kedua setelah KGB
servikal level II. Kedua metastasis KGB ini merupakan drinase pertama metastasis
KGB pada KNF.

Objectives
To get the data retropharyngeal lymph node metastatic in NPC patients with
nasopharyngeal CT examination in Dharmais Cancer Hospital.
Methods
Analytic descriptive study using secondary data from nasopharyngeal CT
examination of NPC patients who had not received radiation therapy and
chemotherapy. Assessment of retropharyngeal lymph node metastatic with
minimal axial diameter ≥ 5 mm at the level of the atlas near the internal carotid
artery. Tumor mass assessed according to the AJCC TNM 7th edition in 2010.
Performed statistical tests to determine the relationship retropharyneal lymph
node metastatic with tumor mass, histopathologic type, lateral invasion, and
tumor mass through the midline.
Result and discussion
A total of 85 patients with NPC most male subjects, mean age 43.2 years, 81
patients with retropharyngeal lymph node metastatic, and level II cervical lymph
node metastatic is the highest.
Conclusion
Retropharyngeal lymph node metastatic is the second highest after level II
cervical lymph node metastatic. Both of these lymph node metastatic is the first
drainage lymph node metastastic in NPC.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013
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UI - Tesis Membership  Universitas Indonesia Library
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M. Adham
"Abstrak
Nasopharyngeal carcinoma (NPC) is the most frequent head and neck malignancy in Indonesia. Misdiagnosis of NPC is common because of unspecific symptoms as unilateral ear complaint. This case reminds doctors of the early symptoms of NPC and of other factors which lead to misdiagnosis and addresses also patients and their families. Reported is a 44 years old man with unilateral ear disorder that had been treated by otorhinolaryngologists, an ophthalmologist, a neurologist, and dentist first, but diagnosed with nasopharyngeal carcinoma stage IVA (T4N1M0) one year later. NPC has unspecific early symptoms such as unilateral ear disorder. Primarily doctors, but also patients and their families should be aware of unilateral ear complaint."
Jakarta: Faculty of Medicine Universitas Indonesia, 2014
610 UI- MJI 23:1 (2014) (2)
Artikel Jurnal  Universitas Indonesia Library
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Prasetyo Widhi Buwono
"Latar Belakang : Infeksi sering didapatkan pada pasien kenker nasofaring yang menjalani kemoterapi. Infeksi disebabkan oleh rusaknya barier fisik karena efek kemoterapi atau efek kemoterapi yang akan menurunkan imunitas tubuh,Infeksi pasca kemoterapi akan menunda kemoterapi berikutnya, akibatnya respon kemoterapi menjadi tidak optimal.
Tujuan : Mendapatkan data status imunitas selular primer dan sekunder, pasca kemoterapi neoajuvan 3 siklus, data kekerapan infeksi dan perbandingan kekerapan infeksi pada pasien KNF stadium lanjut yang mendapatkan kemoterapi neoadjuvan 3 siklus pada pasien kanker nasofaring stadium lanjut, antara yang imunitas selular menurun dan yang tidak menurun.
Metode : Penelitian one group before and after observasional, 1 kelompok tanpa kontrol selama 3 bulan di gedung A lantai 8 RSCM, juli ndash; september 2015.Penurunan rerata jumlah lekosit, netrofil, CD4 , CD8, kejadian infeksi dianalisis bivariat dengan uji T berpasangan atau uji Mann Whitney.Penelitian ini juga melihat kekerapan kejadian infejsi post kemoterapi neoadjuvan.Penelitian ini menggunakan tingkat kemaknaan 0,005, interval kepercayaan 95.
Hasil : Tidak ada penurunan status imunitas selular primer, lekosit p=0,356 dan netrofil p=0,289.Terdapat penurunan status imunitas selular sekunder, CD 4 P=0,002, CD 8 P=0,001, dengan ratio CD 4 /CD 8 tidak berubah rerata CD 4 sudah rendah sejak sebelum kemoterapi.Mukositis oral dan pneumonia merupakan infeksi yang kerap didapatkan. CD4 yang rendah pada kelompok sebelum kemoterapi meningkatkan potensi infeksi selama dan sesudah kemoterapi neoadjuvan.Penurunan imunitas seluler sekunder nilai rerata jumlah CD4 berhubungan dengan peningkatan kejadian infeksi pasca siklus ke 2 p=0,016.
Kesimpulan : Tidak terdapat penurunan imunitas selular primer dan didapatkan penurunan imunitas selular sekunder pada pasien karsinoma nasofaring stadium lanjut yang menjalani kemoterapi neoadjuvan 3 siklus.Pada pasien dengan penurunan imunitas selular sekunder terdapat peningkatan kejadian infeksi mukositis oral dan pneumonia CD 4 yang rendah merupakan prediktor kejadian infeksi. Penurunan imunitas selular sekunder hanya akan meningkatkan kejadian infeksi pasca siklus ke 2 kemoterapi neoadjuvan.

Background: The infections especially in a the oropharynx often get on cancer patients nasopharyngeal .One of the causes of infection include breakdowns physical mucous barier because the tumor growth or because the effects of chemotherapy and radiation .Chemotherapy and radiation will result in side effects namely the inflammation and ulceration mouth and the oropharynx mucous called mukositis oral.selama endure chemotherapy, besides mukositis oral, infections of the also often found .Chemotherapy resulted in an emphasis on cell production immune response that result in the lekopenia with rob possibilities infection become larger.
The purpose: To asess of immunity cellular status on advanced stage nasaofaringeal patient to get 3 cycle neoadjuvan chemotherapy and assess the incident lung infection and tumor area after undergoing 3 cycle neoadjuvan chemotherapy.
The methode: Research one group before and after observational use 1 group without control. The research was done during the three months in the building a floor 8 Ciptomangunkusumo Hospital juli september 2015. The Data on the background respondents will be analyzed by a sort of descriptive set by using analysis univariat.hubungan between chemotherapy neoadjuvan and an immune response cellular will be analyzed bivariat by test wilcoxon sign rank test. In this research also be seen the proportion of the infection before pre and post chemotherapy neoadjuvan .This research using level evidence 0.05 to the interval trust 95.
Results: From 17 subject of research , 12 subjects 70,6 is laki laki , women made up subjects 29,4 .Median age patient is 46,7 , 10 patients 58,8 less than median age , 7 patients 42,2 more of age median.stadium 4a obtained on 4 patients 23,5 patients , while stadium 4 b obtained on 13 patients 76,5 .Seen from the infection after chemotherapy neoadjuvan 9 subjects 52,8 never would have experienced infection , 8 subjects 47,2 experienced infection. Looks the relationship between chemotherapy neoadjuvan 3 cycle in immunity cellular p 0,007 on cds 4 and p 0,005 on cds 8 , the immunity cellular decline in the infection look after chemotherapy neoadjuvan cycle to 2 p 0,016 on cds 4 while after cycle to 3 not seen the relationship between chemotherapy neoadjuvan 3 cycle in the infection .Count of leukosit and lymphocytes cannot be used to predict a decrease in an immune response cellular after undergoing 3 cycle neoadjuvan chemotherapy.
Conclusions: Immune response decreased on advanced stage nasopharynx carcinoma patient are undergoing 3 cycle neoadjuvan chemotherapy neoadjuvan 3 . The Decreased of cellular immune response has played of increased infection in the lung and tumor area post 2 cycle neoadjuvan chemotherapy.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2016
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UI - Tesis Membership  Universitas Indonesia Library
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Novita Salim
"Pasien kanker dan infeksi rentan mengalami malnutrisi. Malnutrisi berat merupakan faktor risiko dari sindrom refeeding, suatu pergeseran cairan dan elektrolit yang berat akibat nutrisi yang diberikan pada pasien malnutrisi dan menimbulkan gangguan metabolik. Deplesi mineral intrasel (hipofosfatemia, hipomagnesemia, hipokalemia), gangguan cairan tubuh (refeeding edema), defisiensi tiamin, aritmia, gagal nafas, dan gagal jantung kongestif merupakan tanda dan gejala sindrom refeeding yang dapat meningkatkan morbiditas dan mortalitas. Dilaporkan empat pasien malnutrisi berat dengan tuberkulosis (TBC) paru dan karsinoma nasofaring (KNF) yang mengalami sindrom refeeding saat dirawat di rumah sakit. Terapi medik gizi dengan pemberian energi awal kurang dari 20 kkal/kgBB/hari lalu ditingkatkan bertahap, kadar elektrolit darah yang rendah dilakukan koreksi melalui oral atau intra vena, juga diberikan suplementasi tiamin dan mikronutrien lain. Pemantauan ketat klinis, tanda vital, keseimbangan cairan, dan kadar elektrolit darah dilakukan minimal 24 jam selama nutrisi diberikan. Pada akhir perawatan, terdapat perbaikan gejala dan tanda sindrom refeeding, serta kadar elektrolit darah. Lama perawatan pasien di rumah sakit 11-27 hari. Terapi medik gizi yang benar dan sesuai dapat mengurangi keparahan sindrom refeeding, memperbaiki klinis dan kadar elektrolit darah pasien.

Patients with cancer or infection disease are vulnerable to malnutrition. Severe malnutrition is a risk factor for refeeding syndrome, profound shifts of fluid and electrolytes that is developed from refeeding and causes metabolic disturbances. Intracellullar mineral depletion (hypophosphatemia, hypomagnesemia, hypokalemia), body water imbalance (refeeding edema), thiamine deficiency, arrhythmia, respiratory failure and congestive heart failure are the signs and symptoms of refeeding syndrome which can increase morbidity and mortality. We report four severe malnutrition patients with pulmonary tuberculosis and nasopharyngeal carcinoma who developed refeeding syndrome while being treated for their underlying illness in hospital. Medical nutrition therapy started with energy less than 20 kcal/kg/day and increased slowly, low blood electrolytes levels were supplemented with oral or intravenous electrolytes. Patients were also given thiamine and another micronutrient supplementation. Patients were monitored closely for clinical conditions, vital signs, water balances and blood electrolytes levels minimum every 24 hours. Before discharge, improvement was seen in signs and symptoms of refeeding syndrome, and blood electrolytes levels. Hospital length of stay was 11 to 27 days. Appropriate medical nutrition therapy can reduce refeeding syndrome severity, give clinical and blood electrolytes levels improvement."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
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UI - Tugas Akhir  Universitas Indonesia Library
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