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Beatrix Angelina Haryono
Stres dan Stresor Kerja Sebelum dan Selama Pandemi COVID-19 Pada Pekerja Pelayanan Publik: Sebuah Studi Mixed Method = Work Stress and Stressor Before and During the COVID-19 Pandemic in Public Service Workers: A Mixed Method
Abstrak :
Latar belakang. Pandemi Covid-19 membawa perubahan yang dilakukan pemerintah untuk menekan penyebaran Covid-19 sehingga diberlakukan aturan Work From Home (WFH) bagi dunia kerja. Saat kasus Covid-19 mulai menurun, perkantoran perlahan mulai kembali ke Work From Office (WFO). Perubahan sebelum dan selama pandemi Covid-19 menimbulkan tekanan yang membuat persepsi tertentu terhadap stres dan stressor kerja setiap saat. Metode. Penelitian dilakukan di Kantor Pelayanan Pajak Tangerang dengan menggunakan metode campuran, metode kuantitatif digunakan untuk mendapatkan gambaran deskriptif stres kerja dan stresor menggunakan kuesioner SV-NBJSQ (Short Version New Brief Job Stres Questionnaire) versi bahasa Indonesia dan metode kualitatif dengan wawancara mendalam semi terstruktur untuk mendapatkan gambaran persepsi pekerja terhadap stres kerja dan stresor di masa sebelum dan selama pandemi Covid-19. Hasil. Prevalensi stres kerja saat WFO masa pandemi Covid-19 sebesar 28%, dengan gejala stres kerja yaitu kurangnya vigor sebesar 18.3 %, kelelahan 12.2%, kecemasan 9.8%, dan stres reaksi fisik 3.7%. Hasil stresor kerja adalah tuntutan emosional 31.7%, konflik peran 28 % , keseimbangan kerja negatif  24.4%, dan kelebihan beban kuantitatif 15.4%. Didapatkan kategori persepsi stres dan stresor kerja di masa sebelum pandemi Covid-19, WFH dan WFO masa pandemi Covid-19 sesuai dengan kata kuncinya. Kesimpulan. Wawancara mendalam dapat menggali jawaban kuesioner tentang gejala stres yang ada dan penyebab stres yang mendasarinya. Terdapat perbedaan dan persamaan persepsi stres dan stresor kerja pada pekerja pelayanan publik saat sebelum dan selama pandemi Covid-19 yang selanjutnya dapat menjadi pertimbangan bagi perusahaan yang akan terus dapat mengalami perubahan akibat pandemi Covid-19 yang masih belum berakhir. ......Background. The Covid-19 pandemic has brought changes  that made by the government to suppress the spread of Covid-19 so that Work From Home (WFH) regulation were held for the world of work. As  Covid-19 cases began to decline, offices slowly began going back to the Work From Office (WFO). Changes before and during the Covid-19 pandemic created a pressure that made certain perceptions of stress and work stressors at all times. Method. The research was carried out at the Tax Service Office in Tangerang using a mixed method where quantitative methods are used to get a descriptive picture of work stress and stressors using the Indonesian version of the SV-NBJSQ ( Short Version New Brief Job Stres Questionnaire) and qualitative methods with semi-structured in-depth interviews to obtain in period before, during the WFH, along with the WFO Covid-19 pandemic to workers in public service offices. Results. The prevalence of work stress during WFO during the Covid-19 pandemic was 28%, with the results of work stress in the form of low vigor of 18.3%, fatigue of 12.2%, anxiety of 9.8%, stress of physical reactions 3.7%. The results of work stressors are emotional demands 31.7%, role conflict 28%, negative work balance 24.4%, and quantitative load 15.4%. The categories of perception stress and work stressors were obtained before the Covid-19 pandemic, WFH and WFO during the Covid-19 pandemic according to the keywords. Conclusion. In-depth interviews could explore the questionnaire answers about existing stress symptoms and the underlying stressors. There are differences and similarities between perceptions of stress and work stressors for public service workers before, and during the Covid-19 pandemic which could then be a factor of consideration for companies that will necessarily continue to experience changes due to the Covid-19 pandemic which currently is still happening.
Depok: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Tesis Membership  Universitas Indonesia Library
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Ghany Hendra Wijaya
Faktor Penyembuhan Ulkus pada Chronic Limb Threatening Ischemia yang Dilakukan Tindakan Angioplasti Endovaskular di Rumah Sakit Cipto Mangunkusumo = Factors Influencing Ulcer Healing in Chronic Limb Threatening Ischemia Patients After Endovascular Angioplasty at Cipto Mangunkusumo General Hospital
Abstrak :
Latar belakang. Pada CLTI didapatkan iskemik yang progresif sehingga menyebabkan timbulnya nyeri tungkai saat istirahat dan terbentuknya ulkus atau gangren. Intervensi revaskularisasi tungkai bawah merupakan lini pertama tata laksana CLTI, dengan pilihan prosedur berupa pembedahan secara terbuka maupun tindakan endovaskular. Pasien CLTI di RSCM datang dengan kondisi lanjut dan angka reamputasi yang tinggi, sehingga diperlukan penelitian untuk mengetahui faktor yang berhubungan dengan keluaran angioplasti endovaskular yaitu penyembuhan ulkus. Metode. Studi potong lintang dilakukan di RSCM dengan melibatkan pasien CLTI Rutherford 5-6 yang menjalani tindakan angioplasti. Usia, jenis kelamin, riwayat merokok, hipertensi, fibrilasi atrium, gagal jantung, CKD, DM merupakan variabel yang diteliti terhadap penyembuhan ulkus yang merupakan penilaian klinis pascatindakan angioplasty yang dinilai adalah epitelisasi sempurna ulkus dalam kurun waktu 4 bulan pascatindakan. Hasil. Pada 133 subjek penelitian, didapatkan 60,9% pasien mengalami epitelisasi sempurna. Faktor-faktor yang memengaruhi penyembuhan ulkus pada pasien CLTI antara lain, jenis kelamin, riwayat merokok, hipertensi, fibrilasi atrium, gagal jantung, CKD, dan diabetes. Faktor yang paling berhubungan dengan penyembuhan ulkus pascaangioplasti endovaskular berdasarkan uji regresi logistik adalah diabetes. Kesimpulan. Faktor-faktor yang memiliki hubungan bermakna dengan penyembuhan ulkus pada pasien chronic limb threatening ischemia (CLTI) antara lain adalah jenis kelamin, riwayat merokok, hipertensi, fibrilasi atrium, gagal jantung, CKD, dan diabetes. Faktor yang dinilai paling berhubungan adalah diabetes melitus. ......Background. Chronic limb threatening ischemia (CLTI) can cause rest pain in lower extremities and the formation of ulcers or gangrene. Revascularization which can be done using open surgery or endovascular procedures, is the first line treatment in CLTI management. CLTI patients at RSCM usually came with advanced conditions and high re-amputation rates even after revascularization. This study aimed to determine factors associated with the outcome of endovascular angioplasty, especially ulcer healing. Method. A cross-sectional study was conducted at RSCM involving CLTI patients with Rutherford grade 5 and 6 that underwent angioplasty. Age, gender, history of smoking, hypertension, atrial fibrillation, heart failure, chronic kidney disease (CKD), and diabetes mellitus were the independent variables studied in this study. The dependent variable was ulcer healing which is a clinical assessment after angioplasty that was assessed as complete ulcer epithelialization within four months after the procedure. Results. In 133 study subjects, it was found that 60.9% of patients underwent complete epithelialization. Factors that affect ulcer healing in CLTI patients include gender, history of depression, hypertension, atrial fibrillation, heart failure, chronic kidney disease, and diabetes mellitus. The factor with the highest association to ulcer healing after endovascular angioplasty based on logistic regression test is diabetes mellitus. Conclusion. Factors that have a significant relationship with ulcer healing in patients with CLTI include gender, smoking, hypertension, atrial fibrillation, heart failure, CKD, and diabetes. The factor that was considered to have the highest association was diabetes mellitus.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tesis Membership  Universitas Indonesia Library
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Nisrina Fariha
Gangguan Mental Emosional Pada Pramugari/a Penerbangan Komersial di Masa Transisi Pandemi COVID-19 = Mental Emotional Disorder among Commercial Flight Attendant during the Transition Period of COVID-19 Pandemic
Abstrak :
Pendahuluan: Pramugari/a  merupakan salah satu profesi dengan beban kerja cukup besar karena jam kerja yang tidak beraturan, waktu kerja yang panjang serta lingkungan kerja yang tidak biasa. Kondisi pandemi COVID-19 meningkatkan risiko terjadinya gangguan mental emosional pada banyak sektor terutama sektor penerbangan. Meskipun telah memasuki masa transisi pandemi COVID-19, kondisi pekerjaan pramugari/a belum kembali seperti sebelum pandemi terjadi.

Objektif: Tujuan penelitian ini adalah untuk mengetahui prevalensi serta hubungan antara faktor individu serta pekerjaan di masa transisi pandemi COVID-19 dengan risiko terjadinya gangguan mental emosional pada pramugari/a penerbangan komersial di Indonesia.

Metode: Penelitian ini merupakan penelitian potong lintang yang dilakukan di Balai Kesehatan Penerbangan Jakarta dari tanggal 9 September – 3 Oktober 2022. Pengumpulan data menggunakan kuesioner mandiri, Fear of COVID-19 Scale, dan Self Reporting Questionnaire-20 kemudian dianalisis dengan menggunakan SPSS versi 25.

Hasil: Penelitian diikuti oleh 163 responden, terdiri dari 89,6% pramugari dan 10,4% pramugara. Diantara faktor individu dan pekerjaan, ada beberapa yang memiliki hubungan signifikan dengan risiko gangguan mental emosional seperti usia muda p <0,001, tidak memiliki anak p 0,047, kebiasaan olahraga yang kurang (95% CI 0,97-9,18); p 0,048, masa kerja < 5 tahun (95% CI 1,35-8,78); p 0,007 serta persepsi ketidakamanan pekerjaan (95% CI 1,47-8,55); p 0,003. Berdasarkan hasil analisis multivariat, masa kerja dan persepsi ketidakamanan pekerjaan merupakan faktor paling dominan yang dapat meningkatkan risiko terjadinya gangguan mental emosional sebesar 3,66 (95% CI 1,39 – 9,66); p 0,009 dan 3,31 (95% CI 1,30 – 8,43); p 0,012 kali.

Kesimpulan: Prevalensi risiko gangguan mental emosional pada pramugari penerbangan sipil Indonesia di masa transisi pandemi COVID-19 cukup tinggi. Dari semua faktor yang dianalisis pada penelitian ini, terlihat masa kerja dan persepsi ketidakamanan pekerjaan dominan meningkatkan risiko terjadinya gangguan mental emosional. Diperlukan penelitian lanjutan untuk menilai faktor-faktor risiko lainnya yang dapat berkontribusi dengan terjadinya gangguan mental emosional. ......Background: Flight attendant is a profession with a heavy workload due to irregular working hours, long working hours and an working mostly at high altitude. The condition of the COVID-19 pandemic increases the risk of mental emotional disorders in many sectors especially the aviation sector, one of which is due to job insecurity. Even though we have entered the transition period of the COVID-19 pandemic, the stability of flight attendants has not returned to what it was before the pandemic outbreak.

Objective: To determine the prevalence of mental emotional disorders among Indonesian commercial flight attendants during the transition period of the COVID-19 pandemic and its relationship with job insecurity.

Methods: This cross-sectional study was conducted at the Directorate General of Civil Aviation Medical Jakarta from September 9th to October 3rd 2022. The data was collected using independent questionnaire such as Fear of COVID-19 Scale and Self Reporting Questionnaire-20, which was then analyzed using SPSS version 25.

Results: The subjects were 163 people in total, consisting of 89,6% female flight attendants and 10,4% male flight attendants The prevalence of mental emotional disorders in Indonesian commercial flight attendants during the transition period of COVID-19 pandemic was found to be 15.3%. The trends showed that there is a significant relationship between perceptions of job insecurity and mental-emotional disorders p=0.036, and there are other characteristics that are significantly related to mental-emotional disorders such as young age p=<0.001, not having children p=0.047, and working period <5 years (95% CI 1.35-8.78); p=0.007.

Conclusion: The prevalence risk of mental emotional disorders in Indonesian commercial flight attendants during the transition period of COVID-19 pandemic is quite high. The existence of job insecurity is one of the dominant factors associated with the occurrence of mental emotional disorders during the transition period of COVID-19 pandemic and also young age seems to be a contributing factor. However, further research is still needed to assess other risk factors that can contribute to the occurrence of mental emotional disorders.

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tesis Membership  Universitas Indonesia Library
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Caesar Nurhadiono Raharjo
Pengaruh Faktor Pekerjaan terhadap Kelelahan pada Pekerja PLTP: Suatu Analisis menggunakan Pemodelan Persamaan Struktural = Effect of Occupational Factors on Fatigue in Geothermal Workers: An Analysis Using Structural Equation Modelling
Abstrak :
Penelitian ini bertujuan untuk menguji pengaruh faktor pekerjaan seperti jadwal kerja dan jabatan terhadap dimensi kelelahan pekerja di Perusahaan Panas Bumi “X” dengan menggunakan Swedish Occupational Fatigue Inventory (SOFI) versi Indonesia. Variabel laten dalam penelitian ini adalah dimensi kelelahan yaitu kehilangan energi, pengerahan tenaga fisik, ketidaknyamanan fisik, perasaan mengantuk dan kehilangan motivasi. Variabel yang diamati meliputi jenis jadwal kerja, posisi kerja, dan semua item SOFI. Tekknik pengambilan sampel menggunakan total sampling dan didapatkan sebanyak 132 pekerja di Perusahaan Panas Bumi “X” yang bersedia menjadi responden penelitian. Untuk pengujian hipotesis penelitian menggunakan analisis pemodelan persamaan struktural (structural equation modeling [SEM]) dengan menguji model pengukuran dan model struktural. Hasil penelitian menunjukkan bahwa dimensi kelelahan yang umum dialami pekerja adalah kekurangan energi meskipun secara statistik tidak terbukti adanya pengaruh antara jadwal kerja dan jabatan terhadap dimensi kelelahan (p>0,05). Penelitian ini menjelaskan mengapa faktor pekerjaan tidak berpengaruh terhadap dimensi kelelahan pada populasi yang diteliti. Hal ini dimungkinkan karena fleksibilitas waktu kerja, sistem kerja yang sangat baik serta sistem keselamatan dan kesehatan kerja yang diterapkan oleh perusahaan (perlu studi dan/atau metode lain). ......This study aims to examine the effects of occupational factors such as work schedule and work position on the fatigue dimensions among workers at Geothermal Company “X” using the Indonesian version of the Swedish Occupational Fatigue Inventory (SOFI). The latent variables in this study were the dimensions of fatigue, namely lack of energy, physical exertion, physical discomfort, sleepiness and lack of motivation. The observed variables include the type of work schedule, work positions, and all SOFI items. Total sampling was used on 132 workers at Geothermal Company "X" who agreed to be research participants. For a research hypothesis test, statistical analysis using structural equation modelling (SEM) by testing the measurement and structural model. The results showed that the common fatigue dimension experienced by workers was lack of energy although statistically it was not proven that there was an influence between work schedule and position on the fatigue dimension (p>0.05). This study explains why occupational factors at Geothermal Company "X" have no effect on fatigue dimensions in the studied population. This is possibly due to working time flexibility, excellent work system as well as the occupational health and safety system implemented by the company (another study and/or method are required).
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Tesis Membership  Universitas Indonesia Library
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Nia Agustiana
Korelasi Work Engagement dengan kejadian presenteeism pada pekerja manufaktur alat berat = Correlation of Work Engagement with the incident of presenteeism in heavy equipment manufacturing workers
Abstrak :
Latar Belakang: Presenteeism merupakan suatu fenomena yang menjadi perhatian dunia kesehatan kerja karena dapat mempengaruhi produktivitas pekerja secara negatif. Beberapa faktor diketahui berhubungan dengan presenteeism terutama terkait faktor pekerjaan. Dalam model Job Demand-Resource, Work engagement diyakini merupakan salah satu faktor yang memiliki hubungan dengan kejadian presenteeism, dimana pekerja dengan work engagement yang baik cenderung memiliki tingkat presenteeism yang rendah. Penelitian terkait hubungan diantara work engagement dan presenteeism pada pekerja manufaktur alat berat, khususnya di Indonesia belum pernah dilakukan. Hal ini yang melatarbelakangi dilakukannya penelitian ini. Metode: Penelitian ini merupakan penelitian cross sectional, dengan total responden berjumlah 109 orang, yang merupakan pekerja pada perusahaan manufaktur alat berat di Jakarta, Indonesia. Keseluruhan data pada penelitian ini merupakan data primer yang diambil menggunakan kuesioner. Penilaian untuk presenteeism menggunakan kuesioner dengan metode Quality dan Quantity (QQ method). Sementara Work engagement dinilai dengan menggunakan kuesioner Utrecht Work Engagement Scale 9 (UWES-9) versi Bahasa Indonesia. Hasil: Sebaran skor presenteeism responden cukup rendah dengan nilai median 10 (minimum 0 dan maksimum 76). Sebagian besar responden memiliki skor Work engagement yang tinggi dengan nilai median 5,55 (minimum 3,33 dan maksimum 6,00). Hubungan yang signifikan antara work engagement dan presenteeism (p-value <0,001) dengan koefisien korelasi (r) -0,381. Pada analisis multivariat ditemukan juga bahwa jenis pekerjaan (p value = 0,013) dan Pola kerja (p value = 0,001) responden memiliki hubungan signifikan dengan kejadian Presenteeiam. Kesimpulan: Terdapat hubungan yang signifikan dan korelasi negatif antara work engagement dengan kejadian presenteeism pada pekerja manufaktur alat berat. ...... Background: Presenteeism is a phenomenon that has become a concern in occupational health because it can negatively affect worker productivity. Several factors are known to be related to presenteeism, especially those associated with work. In the Job Demand- Resource model, work engagement is believed to be one factor that is related to the incidence of presenteeism, where workers with good work engagement tend to have lower levels of presenteeism. Research on the relationship between work engagement and presenteeism in heavy equipment manufacturing workers, especially in Indonesia, has never been done, and becomes the reason for conducting this study. Methods: This research is a cross sectional study, with a total of 109 respondents, who are workers at a heavy equipment manufacturing company in Jakarta, Indonesia. All data in this study are primary data taken using a questionnaire. Assessment for presenteeism uses a questionnaire with the Quality and Quantity (QQ method). Meanwhile, work engagement was assessed using the Indonesian version of the Utrecht Work Engagement Scale 9 (UWES-9) questionnaire. Results: The distribution of respondents' presenteeism scores was quite low with a median value of 10 (minimum 0 and maximum 76). Most respondents had high Work engagement scores with a median value of 5.55 (minimum 3.33 and maximum 6.00). There is a significant relationship between work engagement and presenteeism (p-value <0.001) with a correlation coefficient (r) of -0.381. In multivariate analysis, it was also found that respondents' type of work (p value = 0.013) and work patterns (p value = 0.001) had a significant relationship with the incidence of presenteeism. Conclusion: There is a significant and negative correlation between work engagement and the incidence of presenteeism in heavy equipment manufacturing workers.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tesis Membership  Universitas Indonesia Library
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Putu Lokita Pradnyana Putra
Efek Aplikasi Asam Traneksamat Topikal Terhadap Perdarahan Dan Kebutuhan Transfusi Darah Pascaoperasi Katup Jantung = Topical Application Effect of Tranexamic Acid in Postoperative Bleeding and Blood Products Transfusion After Heart Valve Surgery
Abstrak :
Latar belakang : Perdarahan merupakan salah satu komplikasi tersering pascaoperasi katup jantung. Asam traneksamat merupakan golongan antifibrinolitik umum yang digunakan untuk menurunkan jumlah perdarahan pascaoperasi katup jantung. Secara teori, rute pemberian topikal mempunyai efek samping yang lebih sedikit dibandingkan secara sistemik. Penelitian ini bertujuan untuk mengetahui pengaruh aplikasi asam traneksamat topikal terhadap jumlah perdarahan dan kebutuhan transfusi darah pascaoperasi katup jantung.  Metode : Penelitian ini bersifat uji klinis acak terkendali tersamar ganda. Pasien dibagi menjadi kedua kelompok dengan jumlah yang sama, kelompok plasebo (n = 22) dan kelompok perlakuan dengan asam traneksamat (n = 22). Pada kelompok perlakuan, sebanyak 5 gram asam traneksamat dilarutkan dalam 50 mL NaCL 0,9% dan diberikan pada saat mesin jantung paru dihentikan dan saat penutupan sternum. Uji normalitas data dianalisa menggunakan uji Saphiro Wilk, sementara untuk hasil keluaran klinis dan kebutuhan transfusi pascaoperasi menggunakan uji T independen dan Uji Mann Whitney.  Hasil: Dari penelitian ini didapatkan jumlah perdarahan inisial pascaoperasi kelompok perlakuan lebih banyak jika dibandingkan dengan kelompok plasebo, namun secara statistik tidak bermakna. (kelompok perlakuan 52,5 (5-230) vs kelompok plasebo (37,5 (10-160), p = 0,301). Secara keseluruhan, pada kelompok perlakuan, total jumlah perdarahan 48 jam pascaoperasi lebih sedikit dibandingkan kelompok plasebo (p = 0,438). Kebutuhan transfusi PRC pascaoperasi kelompok perlakuan lebih sedikit dibandingkan dengan kelompok plasebo, namun secara statistik tidak bermakna (kelompok perlakuan 481,82 ± 372,51 vs kelompok plasebo 543,27 ± 421,11, p = 0,611). Kelompok plasebo merupakan kelompok dengan jumlah kebutuhan transfusi FFP dan trombosit terbanyak (TC p = 0 ,750; FFP p = 0,434). Kebutuhan transfusi kriopresipitat pada kelompok perlakuan lebih banyak dibandingkan dengan kelompok plasebo (median kelompok perlakuan 0 (0-327) vs median kelompok plasebo 0 (0-192), p = 0,962).  Simpulan: Pada penelitian ini, aplikasi asam traneksamat topikal tidak memberikan efek yang bermakna dibandingkan plasebo dalam menurunkan jumlah perdarahan dan kebutuhan transfusi pascaoperasi katup jantung.  ......Background: Postoperative bleeding is one of the significant complications in heart valve surgery. Tranexamic acid is a well-known antifibrinolytic drug to reduce postoperative blood loss. Theoretically, the topical application of tranexamic acid provides a better effect than systemic application. This study aims to examine the effect of the topical tranexamic acid application on postoperative bleeding and blood product transfusion after heart valve surgery. Method: This study was a double-blinded, placebo-controlled, randomized clinical trial. Samples were divided equally into two main groups, the placebo group (n = 22) and the tranexamic acid group (n = 22). Five grams of tranexamic acid were diluted in 50 mL of 0.9% NaCL and was administered after CPB and before sternum closure. The Saphiro-Wilk test was used for analyzing data normality, while clinical outcome and transfusion requirements data were evaluated by the Independent T-test and Mann-Whitney test.  Result: The initial amount of postoperative bleeding in the tranexamic acid group is greater in comparison of placebo group, however it shows no statistical significance (tranexamic acid 52.5 (5-230) vs. placebo (37.5 (10-160), p = 0.301). Overall, the total of postoperative bleeding within the first 48-hour in the tranexamic acid group is fewer than the placebo group (p = 0.438). PRC transfusion required in the tranexamic acid group is fewer than the placebo group but shows no significance (tranexamic acid 481.82 ± 372.51 vs. placebo 543.27 ± 421.11, p = 0.611). It was found that the placebo group requires the most FFP and thrombocyte transfusion count (TC p = 0 .750; FFP p = 0.434). The need for cryoprecipitate transfusion in the tranexamic acid group is greater than the placebo group (tranexamic acid median 0 (0-327) vs. placebo median 0 (0-192), p = 0.962).  Conclusion: In this study, the topical tranexamic acid application does not provide significant results compared to placebo group in reducing both postoperative bleeding and blood product transfusion after heart valve surgery.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tugas Akhir  Universitas Indonesia Library
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Abdurrahman Hadi
Akurasi kadar Alfa Fetoprotein dan Human Chorionic Gonadotropin serum dalam Penegakkan Diagnosis Tumor Sel Germinal Nonseminoma Mediastinum = Accuracy of Alpha-Fetoprotein and Human Chorionic Gonadotropin Serum in Establishing the Diagnosis of Nonseminomatous Germ Cell Tumors in the Mediastinum
Abstrak :
Latar Belakang: Tumor sel germinal mediastinum merupakan kelompok neoplasma gonad yang sensitif terhadap kemoterapi, namun agresif dan memiliki prognosis buruk. Penegakkan diagnosis dini yang tepat adalah hal yang penting dan salah satunya adalah dengan penilaian penanda tumor alpha fetoprotein (AFP) dan beta human chorionic gonadotropin (ßHCG). Metode: penelitian ini dilakukan dengan desain uji diagnostik dengan pendekatan potong lintang terhadap pasien tumor sel germinal nonseminoma mediastinum di RSUP Persahabatan sejak Januari 2015 hingga Desember 2022 dengan mengukur kadar Alfa Fetoprotein dan Human Chorionic Gonadotropin serum dan dilakukan pemeriksaan histopatologi. Analisis data dilakukan untuk menguji sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif, akurasi diagnostik, dan analisis kurva receiver operating characteristic (ROC). Hasil: Dari total 362 subjek yang memenuhi kriteria inklusi, dari kedua penanda tumor AFP dan ßHCG didapatkansensitivitas 90,77% (IK 95% 80,98% - 96,54%), spesifisitas 97,98% (IK 95% 95,65% - 99,26%), nilai duga positif 90,77% (IK 95% 81,61% - 95,61%), nilai duga negatif 97,98% (IK 95% 95,77% - 99,05%), rasio kekerapan positif 45,4 (IK 95% 20,27 – 99,58), rasio kekerapan negatif 0,09 (IK 95% 0,04 – 0,2), serta nilai akurasi diagnostik sebesar 96,69% (IK 95% 94,28% - 98,28%). Kesimpulan: Pemeriksaan kadar Alfa fetoprotein dan ßhuman chorionic gonadotropin memiliki akurasi 96,69%, sensitivitas 90,77% spesifisitas 97,98%, nilai duga positif 90,77%, nilai duga negatif = 97,98% dalam penegakkan diagnosis tumor sel germinal nonseminoma mediastinum ......Background: Mediastinal germ cell tumors are a group of gonadal neoplasms that are sensitive to chemotherapy, but very aggressive and have poor prognosis. Early and correct diagnosis is important, one of them is by measuring tumor markers in serum: alpha-fetoprotein (AFP) and beta human chorionic gonadotropin (βHCG). Method: This study was conducted with a diagnostic test with a cross sectional approach design on patients with mediastinal germ cell tumors at RSUP Persahabatan from January 2015 to December 2022, and also assessment of tumor markers alpha-fetoprotein (AFP) and beta human chorionic gonadotropin (βHCG) serum and histopathology examination. Data analysis was carried out to find the sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and receiver operating characteristic (ROC) Results: Of a total of 362 eligible subjects, the sensitivity was 90.77% (95% CI 80.98% - 96.54%), the specificity was 97.98% (95% CI 95.65% - 99.26%), the positive predictive value was 90.77% (95% CI 81.61% - 95.61%), the negative predictive value was 97.98% (95% CI 95.77% - 99.05%), the positive likelihood ratio was 45.4 (95% CI 20.27 - 99.58), the negative likelihood ratio was 0.09 (95% CI 0.04 - 0.2), and the diagnostic accuracy was 96.69% (95% CI 94.28% - 98.28%). Conclusion: the sensitivity was 90.77%, the specificity was 97.98%, the positive predictive value was 90.77%, the negative predictive value was 97.98%, and the diagnostic accuracy was 96.69%.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tesis Membership  Universitas Indonesia Library
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Rendy Agustian
Efek Aplikasi Asam Traneksamat Topikal Terhadap Perdarahan dan Kebutuhan Transfusi Darah Pascabedah Pintas Arteri Koroner = Effect of Topical Application of Tranexamic Acid in Postoperative Bleeding and Blood Transfusion after Coronary Artery Bypass Graft
Abstrak :
Latar belakang dan tujuan: Penggunaan asam traneksamat intravena pada bedah jantung bertujuan untuk mengurangi komplikasi perdarahan pascabedah. Asam traneksamat secara topikal (intraperikardial) bekerja secara lokal dan meminimalisasi efek samping sistemik. Penelitian ini bertujuan untuk mengetahui apakah penggunaan asam traneksamat topikal lebih efektif terhadap jumlah perdarahan dan kebutuhan transfusi darah pascabedah dibandingkan dengan plasebo pada bedah pintas arteri koroner . Metode: Randomisasi 44 sampel menjadi kelompok asam traneksamat topikal (n = 22) dan kelompok plasebo (n = 22). Variabel dengan sebaran normal menggunakan statistik independent t-test, sedangkan data dengan sebaran tidak normal menggunakan statistik nonparametrik Mann-Whitney test.  Hasil: Perdarahan inisial (asam traneksamat 47,50 (10-105) mL vs plasebo 75 (10-160) mL menunjukkan  p = 0,012), perdarahan 6 jam pascabedah (asam traneksamat 135,50 (80-285) mL vs plasebo 190 (35-480) mL menunjukkan p = 0,021, kebutuhan transfusi trombosit (asam traneksamat 0(0-136) mL vs plasebo 0(0-993) menunjukkan p = 0,027), dan kebutuhan transfusi kriopresipitat (asam traneksamat 0(0-0) mL vs plasebo 0 (0-347) menunjukkan p = 0,034). Simpulan: Asam traneksamat topikal efektif mengurangi perdarahan, dan kebutuhan transfusi darah pascabedah pintas arteri koroner. ......Background and purpose: Administration of intravenous tranexamic acid in cardiac surgery aimed to reduce postoperative bleeding complications. Tranexamic acid topically (intrapericardially) works locally and minimizes systemic side effects. This study aims to determine whether topical tranexamic acid is more effective on the amount of bleeding and the need for postoperative blood transfusion compared with placebo in patients undergoing CABG on-pump surgery. This study aims to determine whether topical tranexamic acid is more effective in reducing postoperative bleeding and decreasing postoperative blood transfusion  compared to placebo in patients underwent on-pump CABG.  Methods: 44 samples are randomized into the tranexamid acid group (n = 22) and the placebo group (n = 22). Variables with normal distribution were carried out with independent t-test statistical analysis, whereas data with abnormal distribution were analyzed using nonparametric statistics Mann-Whitney test. Result: Postoperative bleeding and transfusion in the tranexamic acid group compared to the placebo group showed differences as follows: initial bleeding (tranexamic acid 47.50 (10-105) mL vs. placebo 75 (10-160) mL, p = 0.012), 6 hours postoperative bleeding (tranexamic acid 135.50 (80-285) mL vs. placebo 190 (35-480) mL, p = 0.021), Postoperative bleeding requiring platelet transfusion (tranexamic acid 0(0-136) mL vs. placebo 0(0-993), p = 0.027), and postoperative bleeding requiring cryoprecipitate transfusion (tranexamic acid 0(0-0) mL vs. placebo 0 (0-347), p = 0.034). Conclusion: Topical tranexamic effectively reduces postoperative bleeding and minimize postoperative blood transfusion in CABG.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tugas Akhir  Universitas Indonesia Library