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Abstrak :
ABSTRAK
Untuk mengidentifikasi faktor prediktor seperti PSA, usia, volume prostat, dan densitas PSA (PSAD) sebagai indikasi untuk melakukan biopsi prostat yang dipandu dengan TRUS dalam mengurangi biopsi yang tidak perlu dan meningkatkan tingkat deteksi. Sebanyak 1232 sampel didapatkan dari rekam medis pasie yang dilakukan biopsiprostat dari Januari 2008 sampai Desember 2013 di Rumah Sakit Cipto Mangunkusumo. Diantara 1232 pasien, 33,5% memiliki hasil biopsi yang positif. Nilai median dari usia dan PSA (68 tahun dan 57,45 ng/ml) pada grup dengan biopsi positif lebih tinggi dari grup biopsi negative (65 tahun dan 11,69 ng/ml), p< 0,001. PSAD pada pasien dengan PSA 4-10 ng/ml, 10-20 ng/ml, dan 20 ng/ml (0.20, 0.35, 2.05) pada grup positif lebih tinggi dari grup negative (0.14, 0.24, 0.53), p < 0,001. Hasil pada grup dengan hasil biopsi positif memiliki volume prostat yang lebih rendah (42 ml), dibandingkan pada grup biopsi yang negative (55,4 ml), p < 0,001. Pada kurva ROC, PSAD memiliki sensitivitas dan spesifisitas yang paling tinggi (81.4% dan 82.0%) dengan cut-off point 0,43, p < 0,001. Insidensi PCa meningkat dengan nilai PSA yang lebih tinggi, usia yang lebih tua, dan volume prostat yang lebih kecil. Penggunaan PSAD 0,17 ng/ml sebagai cut-off point pada pasien dengan tingkat PSA antara 4-10 ng/ml direkomendasikan untuk meningkatkan deteksi PCa pada laki-laki di Indonesia

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ABSTRACT
To identify the predictor factors such as PSA, age, prostate volume (PV), and PSA Density (PSAD) as indications to perform TRUS guided prostate biopsy in reducing unnecessary biopsies and improving detection rate. 1232 samples were obtained from the medical records of patients underwent prostate biopsy from January 2008 to December 2013 in Cipto Mangunkusumo Hospital Jakarta. Statistical analysis was performed with Mann-Whitney test and unpaired t test for the quantitative variables. Chi-square test was used for qualitative variables. This study also conducted Receiver Operating Characteristic (ROC) curve to determine the cut-off point and the optimum specificity and sensitivity for each variable. Among 1232 patients, 33.5% had positive biopsy result. The median age and PSA (68 years and 57.45 ng/ml) in positive biopsy group was higher than negative group (65 years and 11.69 ng/ml), p < 0.001. PSAD in patients with PSA 4-10 ng/ml, 10-20 ng/ml, and 20 ng/ml (0.20, 0.35, 2.05) in positive group was higher than negative group (0.14, 0.24, 0.53), p < 0.001. Positive biopsy result has lower PV (42 ml) compared to negative biopsy (55.4 ml), p < 0.001. In ROC curve, PSAD had the highest sensitivity and specificity (81.4% and 82.0%) with cut-off point 0.43, p <0.001. The Incidence of PCa increased with higher PSA level, older age and lower PV. Utilization of PSAD 0.17 ng/ml/ml as cut-off point in patients with PSA level between 4 -10 ng/ml is recommended to improve PCa detection in Indonesian men.

Abstrak :
Kanker prostat adalah penyakit progresif yang menghasilkan moribiditas dan mortalitas yng tinggi. Penelitian ini berutujuan untuk menilai ketepatan dari Indonesian Prostate Cancer Risk Calculator IPCRC dalam memprediksi risiko kanker prostate. Data penelitian didapatkan secara retrospektif selama periode Agustus 2014 hingga Desember 2015 dari rekam medis pasien terduga kanker prostat. Pemeriksaan colok dubur, Prostate specific antigen PSA, dan volume prostat digunakan sebagai parameter prediktif dalam IPCRC. Biopsi prostat digunakan sebagai standar baku. Akurasi IPCRC divalidasi dengan menggunakan analisis ROC. Penelitian ini memiliki 127 subjek penelitian dengan median usia pasien BPH dan pasien kanker prostat adalah 66 52-85 dan 69.5 50-100 tahun. Pemeriksaan colok dubur yang tidak normal ditemukan pada 2 pasien 2. Median dari PSA dari pasien BPH dan kanker prostat dalah 10.2 1.6-203.1 dan 74.06 6.94-1412. Volume prostate pasien BPH memiliki median sebesar 47.9 13.774-108 dibandingkan 50.25 19.2-107 pada pasien kanker prostate. Area tersebesar dibawah kurva probabilitas kanker prostat adalah 0.907 95 CI 0.84-0.97. Jika probabilitas kanker prostate lebih dari 15 pada IPCRC, sensitivitas IPCRC mencapai 88.5 dan spesifitas IPCRC mencapai 81.8, dimana bila ditemukan probabilitas kanker prostate lebih dari 20 dengan menggunakan IPCRC, sensitivitasnya mencapai 80.8 dengan spesifitas sebesar 89.9. Dan bila probabilitas kanker prostate lebih dari 25 dalam IPCRC, sensitivitas sebesar 65.4 dan spesifisitas sebesar 89.9. Sehingga, dapat disimpulkan IPCRC merupakn perangkat yang akurat dalam prediksi kanker prosate pada populasi ini. Validasi lebih lanjut masih dibutuhkan pada populasi lain. ......Prostate cancer is a progressive disease resulting in morbidity and mortality. The aim of this study is to assess the accuracy of Indonesian Prostate Cancer Risk Calculator IPCRC in predicting prostate cancer risk. Data were obtained retrospectively during August 2014 to December 2015 from medical records of suspected prostate cancer patients. Digital rectal examination, Prostate Specific Antigen PSA, and prostate volume PV were used as predictive parameters in IPCRC. Prostate biopsy was used as the diagnostic gold standard. The accuracy of IPCRC was validated using the ROC analysis. Our study included 127 subjects. Median age of BPH patients and prostate cancer patients were 66 52-85 and 69.5 50-100. The digital rectal examination was found abnormal in 2 patients 2. Median of PSA of BPH patients and prostate cancer patients were 10.2 1.6-203.1 and 74.06 6.94-1412 respectively. The prostate volume of BPH patients 47.9 13.74-108 median compared to prostate cancer patients 50.25 19.2-107 median. The largest area under the curve of the probability of prostate cancer using IPCRC is 0.907 95 CI 0.84-0.97. If the probability of prostate cancer more than 15 using IPCRC, the sensitivity is 88.5 and specificity is 81.8, besides, if the probability of prostate cancer more than 20 using IPCRC, the sensitivity is 80.8 and specificity is 89.9 and if the probability of prostate cancer more than 25 using IPCRC, the sensitivity is 65.4 and specificity is 89.9 IPCRC is accurate for predicting prostate cancer in our population. Further validation is needed in other population.

Abstrak :
Latar belakang: Adenokarsinoma prostat adalah keganasan tersering kedua yang dialami pria di Indonesia. Skor Gleason digunakan untuk mengklasifikasi tingkat diferensiasi dari tumor sedangkan menghitung kadar PSA digunakan sebagai salah satu cara untuk mendiagnosis kanker prostat. Tujuan: Riset ini bertujuan untuk mengetahui korelasi antara skor Gleason dengan kadar PSA pada pasien adenokarsinoma prostat di departemen Patologi Anatomik RSCM. Metode Penelitian: Data dikumpulkan dari 77 sampel yang didapat dari form pemeriksaan hasil diagnosis pasien adenokarsinoma prostat tahun 2011 sampai 2014 di arsip Department Patologi Anatomik RSCM. Data diolah menggunakan analisis uji korelasi Kendall Tau-b di program SPSS 20. Hasil: Sebagian besar pasien datang dengan skor Gleason yang sudah tinggi skor Gleason >7. Nilai PSA terkecil yang didapat dari arsip departemen Patologi Anatomik sebesar 2,73 ng/ml, nilai tertinggi mencapai 7100 ng/ml. Nilai rata-rata PSA meningkat dengan meningkatnya skor Gleason. Rata-rata nilai PSA dari skor Gleason 6, 7, 8, 9, dan 10 adalah 46,641 ng/ml, 63,935 ng/ml, 231,762 ng/ml, 542,146 ng/ml, and 1044,348 ng/ml p = 0,003, r = 0,254. Kesimpulan: Terdapat korelasi yang lemah antara skor Gleason dengan nilai PSA pada pasien adenokarsinoma prostat di Department Patologi Anatomik RSCM. Nilai PSA meningkat seiring meningkatnya skor Gleason.

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Background: Prostatic adenocarcinoma is the second most frequent malignancies occur in men in Indonesia. Gleason score is used to classify the grading of the tumor and PSA is used as one of diagnostic tools for prostate cancer. Aim: To identify the correlation between Gleason score and PSA level in patients with prostate adenocarcinoma at Department of Anatomical Pathology Cipto Mangunkusumo Hospital. Method The data was obtained from 77 samples taken from request forms from patients with prostatic adenocarcinoma from 2011 to 2014 in the archive of Department of Anatomical Pathology and analyzed using Kendall Tau b rsquo s Rank Correlation in SPSS 20. Result: Most patient came with high Gleason Score Gleason score 7 . The minimum PSA level obtained from the arcieve in Department of Anatomical Pathology is 2.73 ng ml and the highest value reached up to 7100 ng ml. The average PSA level increased with the Gleason score. Gleason score 6, 7, 8, 9, and 10 has the average PSA level of 46.641 ng ml, 63.935 ng ml, 231.762 ng ml, 542.146 ng ml, and 1044.348 ng ml respectively p 0.003, r 0.254. Conclusion: There is statistically weak significant correlation between Gleason score and PSA level in patients with prostatic adenocarcinoma in Department of Anatomical Pathology Cipto Mangunkusumo Hospital. PSA increased as the Gleason score increase.

Abstrak :
Pendahuluan: Kanker prostat adalah keganasan terbanyak pada pria, penyebab kematian kedua terbesar akibat keganasan. Colok dubur adalah pemeriksaan dasar dan deteksi dini untuk mendiagnosis kanker prostat. Saat ini pemeriksaan Prostate-Specific Antigen (PSA) dianggap sebagai tumor marker yang paling bermanfaat untuk mendeteksi kanker prostat. The American Cancer Society dan American Urologic Association merekomendasikan penyaringan kanker prostat setiap tahun dengan pemeriksaan colok dubur dan PSA. Tujuan: Tujuan penelitian ini adalah untuk mengetahui hubungan antara pemeriksaan colok dubur dan nilai PSA pada pasien kanker prostat di RSUP DR Sardjito Yogyakarta periode Januari 2011 sampai Desember 2011. Metode Penelitian: Penelitian ini adalah kasus kontrol. Data dikumpulkan secara retrospektif dari catatan medis RSUP DR Sardjito pada pasien dengan colok dubur yang abnormal atau colok dubur normal dengan nilai PSA ≥ 10 ng/dl selama periode Januari 2011 sampai Desember 2011. Hasil pemeriksaan colok dubur dan nilai PSA didapatkan pada saat kunjungan pertama pasien ke rumah sakit. Analisis data nominal menggunakan Chi Square dengan SPSS 18. Hasil: Terdapat 87 pasien yang berhasil dikumpulkan selama periode Januari 2011 sampai Desember 2011 yang memiliki hasil pemeriksaan colok dubur abnormal atau colok dubur normal dengan nilai PSA ≥ 10 ng/dl. Pasien memiliki usia rata-rata 70 tahun, nilai median PSA 10,9 ng/dl. Pada pasien ini ditemukan colok dubur abnormal 43 (49,4%), colok dubur normal 44 (50,6%), PSA ≥ 10 ng/dl 69 (79,3%) dan PSA < 10 ng/dl 18 (20,7%). Pemeriksaan colok dubur dan PSA dinilai signifikan secara statistik untuk mendeteksi kanker prostat, hasil secara berurutan 67,2% vs 32,8% (p < 0,001) and 71,9% vs 28,1% (p = 0,002. Semua pasien dengan colok dubur abnormal dan PSA ≥ 10 ng/dl terdiagnosis kanker prostat (p < 0,001). Simpulan: Pemeriksaan colok dubur dan Prostate Specific Antigen (PSA) adalah prediktor terbaik untuk kanker prostat. ...... Introduction: Prostate cancer is the most frequent form of cancer in males, being also second cause of death by cancer. Digital Rectal Examination (DRE) is the basic examination and early diagnosis for prostate cancer. The Prostate-Specific Antigen (PSA) assay is currently considered the most useful tumor marker for detecting prostate cancer. Both the American Cancer Society and American Urologic Association recommended annual cancer screening with both Digital Rectal Examination (DRE) and PSA. Objective: The objective of this study is to understand the correlation between DRE and PSA level in prostate cancer at Sardjito General Hospital Yogyakarta during januari 2011 until december 2011. Research Method: This is a case control study. The data were retrospectively collected from medical record in sardjito general hospital who had abnormal DRE or normal DRE with PSA ≥ 10 ng/dl during januari 2011 until December 2011. The DRE and PSA value were examined in the first time they came to the hospital. A chi-square was performed to analyzed the nominal data with SPSS 18. Result: There are 87 patients were collected during januari 2011 until December 2011 who had abnormal DRE or normal DRE with PSA ≥ 10 ng/dl. The median age was 70 years, median PSA level was 10,9 ng/dl. Of these patient, we found abnormal DRE in 43 (49,4%), normal DRE in 44 (50,6%), PSA ≥ 10 ng/dl was 69 (79,3%) and PSA < 10 ng/dl was 18 (20,7%). Digital Rectal Examination and PSA was statistically significant to detected prostate cancer, 67,2% vs 32,8% (p < 0,001) and 71,9% vs 28,1% (p = 0,002), respectively. All patient who had abnormal DRE and PSA ≥ 10 ng/dl were diagnosed with prostate cancer (p < 0,001). Conclusion: Digital Rectal Examination (DRE) and Prostate Specific Antigen (PSA) are the best predictor for prostate cancer.

Abstrak :
Tujuan: Untuk mengetahui apakah pemberian furosemide per oral dosis tunggal pada penderita pembesaran prostat jinak yang akan dilakukan pemeriksaan uroflowmetri dapat mempengaruhi lama tunggu penderita di klinik dan basil pemeriksaan uroflowmetri. Bahan dan Cara: Penelitian merupakan penelitian prospektif, open label, cross over study terhadap 40 (rerata umur 62.42 ± 7.40 tahun) penderita pembesaran prostat jinak yang memenuhi kriteria penelitian. Penderita dibagi menjadi dua kelompok, 20 penderita menerima furosemide 20 mg pada kunjungan 1 dan tanpa furosemide pada kunjungan 2 (kelompok 1); 20 penderita lainnya tidak diberikan furosemide pada kunjungan 1 dan menerima furosemide 20 mg pada kunjungan 2 (kelompok 2). Lama menunggu penderita di klinik (sejak penderita berkemih sampai memenuhi syarat untuk pemeriksaan) dan basil uroflowmetri yang terdiri dari volume buli, voided volume, maximum flow rate, average flow rate, voiding time, residu urin pasca berkemih dicatat dan dianalisa dengan Student Mast atau Mann-Whitney U-test. Hasil: Karakteristik subyek penelitian pada kedua kelompok yang terdiri dari umur, kadar hemoglobin, serum kreatinine dan nilai PSA tidak berbeda bermakna secara statistik (p>0.05). Terdapat perbedaan yang sangat bermakna (p<0.01) pada lama tunggu penderita di Klinik Urologi; pada kelompok 1 dari 72.55 bertambah menjadi 120.00 menit sedangkan pada kelompok 2 dari 178.05 berkurang menjadi 89.75 menit. Pada pemberian obat, secara keseluruhan terjadi pengurangan lama menunggu yang sangat bermakna (p<0.01), dari 149.02 menit tanpa furosemide menjadi 81.15 menit dengan pemberian furosemide peroral. Pada analisa basil uroflowmetri yang terdiri dari volume bull, voided volume, maximum flow rate, average flow rate, voiding time, residu urin pasca berkemih pada kedua kelompok maupun secara keseluruhan dengan dan tanpa pemberian obat, tidak didapatkan perbedaan yang berrnakna secara statistik (p.0.05). Kesimpulan: Pemberian furosemide peroral dosis tunggal sangat mengurangi lama menunggu untuk pemeriksaan uroflowmetri penderita pembesaran prostat jinak di klinik tanpa mempengaruhi hasil pemeriksaan uroflowmetri yang terdiri dari volume bull, voided volume, maximum flow rate, average flow rate, voiding time dan residu urin pasca berkemih.

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Objective: To identify whether a single dose of oral furosemide given to benign prostate hyperplasia patients scheduled for uroflowmetry had an impact on clinic waiting time and flow rate parameters. Materials and Methods: This was a prospective, open label, cross over study conducted among 40 benign prostate hyperplasia patients (mean age 62.42 ± 7.40 years) who fulfilled the inclusion criteria.. They were separate on two groups, where the 1 s1 group receive 20 mg furosemide at the 15` visit but no furosemide at rd visit and the 2"d group without furosemide at the 1S1 visit and receive 20 mg furosemide at god visit. Clinic waiting time and flow rate parameters (bladder volume, voided volume, maximum flow rate, average flow rate, voiding time and post void residual urine-measuring by ultrasound) were captured in a database. Student t-test or Mann-Whitney U-test analysis were carried out to evaluate the characteristic different between the two groups. Results: Patients characteristics (age, hemoglobin content, creatinine and PSA serum) between the two groups were not statistically different (p>0.05). There was significant different on clinic waiting time in both groups; 72.55 versus 120.00 minutes, p<0.01 at 15` group and 178.05 versus 89.75 minutes, p<0.0I at 2nd group. An oral 20 mg of furosemide was significant reduction on clinic waiting time in all patients (81.15 versus 149.02 minutes, p<0.01). From evaluation of flow rate parameters (bladder volume, voided volume, maximum flow rate, average flow rate, voiding time and post void residual urine), there were not statistically different in each group and in all patiens whether with or without receive 20 mg furosemide (p>0.05). Conclusions: The impact of a single dose 20 mg of oral furosemide was significant reduced clinic waiting time without significant changes in flow rate parameters at benign prostate hyperplasia patients who scheduled for uroflowmetry.

Abstrak :
[Tujuan: Untuk mengetahui pengaruh kepribadian tipe A terhadap kejadian kanker prostat Metode: Penelitian ini merupakan penelitian case control dengan subjek pasien kanker prostat dan kontrol. Dilakukan penelitian menggunakan kuisioner menggunakan Howard Glazer Personality Questionnaire (HGPQ) and Social Readjustment Rating Scale (SRRS). SRRS dibagi dalam kejadian 2 tahun, 5 tahun, dan 10 tahun. Data dievaluasi dengan analisa stastistik Chi Quadrat dan Mann Whitney U Hasil: Tidak terdapat hasil yang signifikan dalam hasil SRRS 2 tahun (P= 0,94), 5 tahun (p = 0,73) dan 10 tahun (p=0,47) antara pasien kanker prostat dan kontrol. Terdapat hasil yang signifikan dalam hasil HGPQ antara pasien kanker buli dan kontrol (p=0,007) Kesimpulan: Kepribadian tipe A sebagai kepribadian pemicu stres memberikan korelasi positif terhadap kejadian kanker prostat., Objective:To investigate the effect of type A personality as a stress personality type on prostate cancer incidence. Method:This was case control study with prostate cancer patient and control as subject of the study. Subject were asked some questionnaires about their personality using Social Readjustment Rating Scale (SRRS) and Howard Glazer Personality Questionnaire (HGPQ). Events in SRSS scale devided in 2 years ago, 5 years ago and 10 years ago. Data was evaluate with chi Quadrat and Mann Whitney U. Result:There were no significant difference in SRRS score between prostate cancer patien and control in 2 years events (p=0,94), 5 years events (p= 0,73) and 10 years (p=0,47). There were significant difference in HGPQ score between bladder cancer and control (p=0,007). Conclusion:Type A personality as a stress personality have a positive correlation in incidence of prostate cancer]

Abstrak :
Pendahuluan. Kadmium memiliki peranan penting karena banyak digunakan di berbagai macam industri. Kadmium dapat masuk dan terakumulasi dalam tubuh termasuk di prostat. Kadmium sangat toksik dan bisa menyebabkan kanker. Tujuan dari laporan kasus berbasis bukti ini adalah untuk mendapatkan jawaban yang tepat terkait hubungan antara pajanan kadmium di tempat kerja dan kanker prostat pada pekerja. Metode. Pencarian literatur dilakukan melalui database PubMed, Scopus dan Cochrane Library. Kata kunci yang digunakan adalah cadmium, cancer, prostate, work* dan occupation*. Pemilihan artikel menggunakan kriteria inklusi dan eksklusi yang telah ditetapkan. Kemudian dilakukan penilaian kritis menggunakan kriteria yang relevan untuk studi etiologi atau systematic review berdasarkan Oxford Center for Evidence-Based Medicine. Hasil. Terpilih dua artikel yang relevan dan valid dengan desain studi systematic review dan meta-analisis. Penelitian dari Ju-Kun, dkk menunjukkan rasio kematian terstandarisasi (standardized mortality ratio) antara pajanan Cd dan risiko terjadinya kanker prostat adalah 1.66 (95% CI 1.10–2.50) pada populasi pekerja yang terpajan Cd. Berdasarkan penelitian Chen, dkk menunjukkan bahwa pekerja dengan pajanan kadmium memiliki risiko terjadinya kanker prostat yang lebih tinggi dibandingkan populasi umum, namun secara statistik tidak signifikan yakni dengan nilai OR pada studi case-control 1.17 (95%CI [0.85-1.62]), dan standardized mortality ratio (*100) pada studi kohort adalah 98 (95%CI [75-126]). Kesimpulan. Hasil studi yang ada tidak menunjukkan bukti yang cukup untuk memastikan bahwa pajanan kadmium bisa menyebabkan kanker prostat pada pekerja. ......Introduction. Cadmium has an important role because widely used in various industries. Cadmium penetrates and can be accumulated in human body including prostate. Cadmium is highly toxic and can cause human carcinogens. The aim of this evidence-based case report is to get an appropriate answer about the association between occupational cadmium exposure and prostate cancer in worker. Method. The literature searching was conducted through PubMed, Scopus and Cochrane Library. The keywords used were cadmium, cancer, prostate, work* and occupation*. The selection of articles was performed using the defined inclusion and exclusion criterias. Then, they were critically appraised using relevant criteria by the Oxford Center for Evidence-Based Medicine for etiological study or systematic review. Result. Two relevant and valid articles with systematic review and meta-analysis study design were included. Studies by Ju-Kun, et al. showed that the combined standardized mortality ratio of the association between Cd exposure and risk of prostate cancer was 1.66 (95% CI 1.10–2.50) in populations exposed to occupational Cd. While a study by Chen, et al. showed that workers with cadmium exposure have more risk for prostate cancer than general population but was not significant statistically with the weighted OR in case-control studies was 1.17 (95%CI [0.85-1.62]), and the weighted standardized mortality ratio (*100) in cohort studies was 98 (95%CI [75-126]). Conclusion. The current evidences do not show sufficient evidence to ensure that cadmium exposure can cause prostate cancer in worker.

Abstrak :
Tujuan: Mengevaluasi secara prospektif keamanan dan efektifitas penyuntikan lidokain 1% periprostat pada biopsi prostat transrektal dengan bimbingan USG transrektal. Materi dan Metoda: sari 60 pasien yang dibiopsi prostat, dipilih secara random masing-masing 30 orang disuntikan lidokain 1% atau plasebo secara double-blind. Disuntikan 5 cc lidokain 1% atau Na CI 0,9% menggunakan jarum 22 dengan bantuan probe USG transrektal ke kumpulan syaraf dikedua sisi prostat. Nyeri yang dirasakan waktu biopsi dinilai dengan menggunakan skala nyeri "Visual Analogue Scale" (VAS) dan komplikasi yang terjadi setelah biopsi pada kedua grup. Skala nyeri dianalisa statistik menggunakan Student -T Test. Hasil: Skala nyeri waktu biopsi antara yang disuntikan lidokain 1% dibandingkan NaCl 0,9% berbeda secara bermakna dengan VAS (2,1 ± 1,3 dan 5,7 ± 1,7 p<0,05). Komplikasi setelah biopsi seperti nyeri, hematuri, hematochezia dan demam pada kedua perlakuan tidak memberikan perbedaan yang bermakna. Kesimpulan: Penyuntikan lidokain 1% periprostat merupakan metode mudah, aman dan efektif untuk mengurangi nyeri pada biopsi prostat.

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Purpose : We prospectively evaluated the safety and efficacy of periprostatic 1 % lidocaine injection during transrectal prostate biopsy with transrectal ultrasound guided. Materials and Methods: A total of 60 consecutive patients undergoing prostate biopsy were randomized into 1% lidocaine and placebo groups using 0,9% sodium chloride of 30 each in double-blind fashion. A 2,5 ml dose of 1% lidocaine or 0,9% sodium chloride was injected via 22 gauge needle inserted through and guided by the transrectal ultrasound probe at the prostatic neurovasculer bundle on each side. Pain during biopsy was assessed using a 0 to 10 point linear visual analog pain scale and other complications (pain after biopsy, hematuria, hematochezia and fever) were recorded to determine whether there was a difference between those two groups. Statistical analysis of pain score was performed by using Student T-Test. Results : Pain scores were significantly lower in the periprostatic 1% lidocaine injection group compared to the placebo group (2.1 ± 1.3 versus 5.7 ±1.7 , p < 0.05 ). There was no significant difference in pain after biopsy, hematuria, hematochezia and fever rate among these two groups. Conclusions : Per iprostatic 1% lidocaine injection is a simple, safe and efficacious method of providing satisfactory anesthesia to reduce pain in men undergoing transrectal prostate biopsy.

Abstrak :
[ABSTRAK
Latar belakang : Dalam pembuktian kasus persetubuhan, anamnesis dan pemeriksaan fisik memiliki nilai bukti yang rendah. Dokter Forensik hanya dapat membuktikan persetubuhan dengan ditemukannya cairan mani atau sel sperma pada pemeriksaan penunjang. Baru-baru ini dikembangkan rapid test SD Bioline Semen Inspection yang sensitif dan spesifik untuk menemukan prostate-spesific antigen (PSA) yang merupakan salah satu dari kandungan cairan mani. Diharapkan metode ini dapat menjadi alternatif dalam pembuktian kasus persetubuhan. Tujuan : Untuk mengetahui nilai diagnostik alat SD Bioline Semen Inspection dalam mendeteksi adanya PSA pada usapan vagina, dan gambaran perbandingan nilai diagnostiknya pada subyek yang bersetubuh antara 1-3 hari dan 4-7 hari sebelum dilakukan pemeriksaan. Metode :uji diagnostik dengam metode potong lintang, membandingkan antara rapid test SD Bioline Semen Inspection dengan Automatic Immuno Assay (AIA). Hasil : Nilai diagnostik alat SD Bioline Semen Inspection pada penelitian ini menunjukkan sensitivitas 44,44%, spesifisitas 100%, nilai duga positif 100%, nilai duga negatif 86,11%, prevalensi 22,5% dan akurasi 87,5%. Pada subyek yang bersetubuh antara 1-3 hari sebelum pemeriksaan menunjukkan nilai diagnostik sensitivitas 50%, spesifisitas 100%, nilai duga positif 100%, nilai duga negatif 89,29%, prevalensi 9,35% dan akurasi 90,32%. Pada subyek yang bersetubuh antara 4-7 hari sebelum pemeriksaan menunjukkan nilai diagnostik sensitivitas 33,33%, spesifisitas 100%, nilai duga positif 100%, nilai duga negatif 75%, prevalensi 33,33% dan akurasi 77,78%. Kesimpulan : SD Bioline Semen Inspection dapat digunakan dalam pelayanan kedokteran Forensik untuk membuktikan adanya PSA, namun perlu dilakukan uji konfirmasi dengan modalitas lain jika didapatkan hasil negatif.

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ABSTRACT
Background : History and physical examination alone could not prove a sexual intercourse. Thus, forensic doctors also need to find evidence of seminal fluid or sperm in determining sexual intercourse. Recently, there is an advancement in diagnostic tool in examining prostate specific antigen (PSA) in seminal fluid, which is a SD Bioline Semen Inspection. As a rapid test, this diagnostic tool is expected to be used in daily practice as an alternative method in determining sexual intercourse. Objective : To determine diagnostic value of SD Bioline Semen Inspection in detecting Prostate Specific Antigen ( PSA) from vaginal swabs; To have an overview of diagnostic value of SD Bioline Semen Inspection in detecting Prostate Specific Antigen ( PSA) between 1-3 days and 4-7 days of intercourse prior to the examination. Methods: This study is a cross-sectional research to compare SD Bioline Semen Inspection tool to Automatic Immuno Assay (AIA) Results: This study showed SD Bioline Semen Inspection tool has 44.44% sensitivity, 100% specificity, 100% positive predictive value, 86,11% negative predictive value, prevalence is 22.5% and 87.5% accuracy. On the subject who have history of intercourse between 1-3 days prior to the examination, it showed 50% sensitivity, 100% specificity, 100 % positive predictive value, 89,29% negative predictive value, prevalence is 9.35% and 90.32% accuracy. On the subject who have history of intercourse between 4-7 days prior to the examination, it showed 33.33% sensitivity, 100% specificity, 100% positive predictive value, 75% negative predictive value , prevalence is 33.33%, and 77.78% accuracy. Conclusion: The SD Bioline semen Inspection can be used in forensic medical services to prove the existence of PSA, but if the results are negative it still needs confirmation from other diagnostic modalities.;Background : History and physical examination alone could not prove a sexual intercourse. Thus, forensic doctors also need to find evidence of seminal fluid or sperm in determining sexual intercourse. Recently, there is an advancement in diagnostic tool in examining prostate specific antigen (PSA) in seminal fluid, which is a SD Bioline Semen Inspection. As a rapid test, this diagnostic tool is expected to be used in daily practice as an alternative method in determining sexual intercourse. Objective : To determine diagnostic value of SD Bioline Semen Inspection in detecting Prostate Specific Antigen ( PSA) from vaginal swabs; To have an overview of diagnostic value of SD Bioline Semen Inspection in detecting Prostate Specific Antigen ( PSA) between 1-3 days and 4-7 days of intercourse prior to the examination. Methods: This study is a cross-sectional research to compare SD Bioline Semen Inspection tool to Automatic Immuno Assay (AIA) Results: This study showed SD Bioline Semen Inspection tool has 44.44% sensitivity, 100% specificity, 100% positive predictive value, 86,11% negative predictive value, prevalence is 22.5% and 87.5% accuracy. On the subject who have history of intercourse between 1-3 days prior to the examination, it showed 50% sensitivity, 100% specificity, 100 % positive predictive value, 89,29% negative predictive value, prevalence is 9.35% and 90.32% accuracy. On the subject who have history of intercourse between 4-7 days prior to the examination, it showed 33.33% sensitivity, 100% specificity, 100% positive predictive value, 75% negative predictive value , prevalence is 33.33%, and 77.78% accuracy. Conclusion: The SD Bioline semen Inspection can be used in forensic medical services to prove the existence of PSA, but if the results are negative it still needs confirmation from other diagnostic modalities., Background : History and physical examination alone could not prove a sexual intercourse. Thus, forensic doctors also need to find evidence of seminal fluid or sperm in determining sexual intercourse. Recently, there is an advancement in diagnostic tool in examining prostate specific antigen (PSA) in seminal fluid, which is a SD Bioline Semen Inspection. As a rapid test, this diagnostic tool is expected to be used in daily practice as an alternative method in determining sexual intercourse. Objective : To determine diagnostic value of SD Bioline Semen Inspection in detecting Prostate Specific Antigen ( PSA) from vaginal swabs; To have an overview of diagnostic value of SD Bioline Semen Inspection in detecting Prostate Specific Antigen ( PSA) between 1-3 days and 4-7 days of intercourse prior to the examination. Methods: This study is a cross-sectional research to compare SD Bioline Semen Inspection tool to Automatic Immuno Assay (AIA) Results: This study showed SD Bioline Semen Inspection tool has 44.44% sensitivity, 100% specificity, 100% positive predictive value, 86,11% negative predictive value, prevalence is 22.5% and 87.5% accuracy. On the subject who have history of intercourse between 1-3 days prior to the examination, it showed 50% sensitivity, 100% specificity, 100 % positive predictive value, 89,29% negative predictive value, prevalence is 9.35% and 90.32% accuracy. On the subject who have history of intercourse between 4-7 days prior to the examination, it showed 33.33% sensitivity, 100% specificity, 100% positive predictive value, 75% negative predictive value , prevalence is 33.33%, and 77.78% accuracy. Conclusion: The SD Bioline semen Inspection can be used in forensic medical services to prove the existence of PSA, but if the results are negative it still needs confirmation from other diagnostic modalities.]

Abstrak :
Pada tahun 2018, kanker prostat merupakan penyakit ganas kedua terbanyak pada pria secara global setelah kanker paru-paru. IDC-P merupakan varian agresif dari kanker prostat yang sering sering disalahinterpretasikan dengan proliferasi intraduktal seperti HGPIN yang dapat mempengaruhi perawatan pasien laki-laki pengidap kanker prostat. Teknik analisis spektroskopi Raman merupakan teknik molekuler berprospek untuk menganalisa jaringan biologis yang telah banyak digunakan dalam mencoba untuk mengidentifikasi berbagai macam jenis kanker. Sayangnya, spektroskopi Raman menghasilkan sinyal yang lemah dan mudah dipengaruhi oleh noise dan latar belakang floresens. Penelitian ini bertujuan untuk mengembangkan pipeline yang mencakup tahapan prapengolahan dan klasifikasi terhadap spektra Raman dari spesies IDC-P dan HGPIN untuk mendapatkan hasil metrik evaluasi yang optimal. Tujuan ini dicapai dengan menemukan nilai parameter optimal pada tahapan prapengolahan (smoothing, baseline correction, normalisasi), dan klasifikasi untuk menghasilkan hasil klasifikasi yang terbaik. Dihasilkan sebuah pipeline yang mencakup tahapan prapengolahan dan klasifikasi dengan kemampuan untuk meng- hasilkan hasil evaluasi metrik yang tinggi untuk metrik evaluasi F1 Test, accuracy, dan AUC-ROC masing-masing bernilai : 98.8%, 97.9%, dan 98.8%. Berdasarkan hasil anali- sis ANOVA, ditemukan bahwa perbedaan pada parameter window length dan polynomial order pada tahapan Savitzky-Golay smoothing tidak memiliki signifikansi terhadap hasil evaluasi metrik (p > 0.05). Sebaliknya, metode baseline correction beserta nilai polynomial degree yang berbeda cenderung memberikan signifikansi ke hasil evaluasi metrik (p < 0.05). ......In 2018, prostate cancer was the second most common malignant disease in men globally, following lung cancer. IDC-P is an aggressive variant of prostate cancer often misinterpreted as intraductal proliferation like HGPIN, which can impact the treatment of male patients with prostate cancer. Raman spectroscopy analysis is a promising molecular technique for analyzing biological tissues and has been extensively used in attempts to identify various types of cancer. Unfortunately, Raman spectroscopy produces weak signals that are easily influenced by noise and fluorescent backgrounds. This research aims to develop a pipeline that includes preprocessing and classification stages for Raman spectra of IDC-P and HGPIN species to achieve optimal evaluation metric results. This goal is achieved by finding the optimal parameter values in preprocessing stages (smoothing, baseline correction, normalization) and classification to produce the best classification results. A pipeline was created that includes preprocessing and classification stages capable of producing high evaluation metric results for the F1 Test, accuracy, and AUC-ROC metrics, respectively valued at 98.8%, 97.9%, and 98.8%. Based on ANOVA analysis, it was found that differences in the ’window length’ and ’polynomial order’ parameters in the Savitzky-Golay smoothing stage do not significantly affect the evaluation metric results (p > 0.05). Conversely, the baseline correction method and different ’polynomial degree’ values tend to significantly impact the evaluation metric results (p < 0.05).