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Abstrak :
ABSTRAK
Pendahuluan: Faktor lingkungan seperti alergen dan polusi udara dapat memicu ataupun memperberat gejala asma akut serta menyebabkan persitens gejala asma terutama asma alergi. Telah banyak usaha dilakukan untuk mengurangi kadar alergen dalam udara. Salah satu caranya adalah dengan mempertahankan keseimbangan anion-kation sehingga terjadi denaturasi protein tungau debu rumah yang merupakan alergen utama. Kondisi keseimbangan anion-kation dalam udara ini serupa dengan kondisi alamiah hutan. Lingkungan yang serupa dapat dicapai menggunakan filter udara dengan ioniser sehingga tercapai keseimbangan anion-kation dalam udara. Apakah kondisi ini akan mempengaruhi kondisi inflamasi saluran napas dan fungsi paru pasien asma alergi belum pernah dibuktikan sebelumnya.

Metode penelitian: Penelitian ini dilakukan dengan uji klinis silang (cross-over), terbuka, pada pasien-pasien asma alergi. Data subjek diambil secara mandiri oleh pasien dan pemeriksaan berkala di Poli Asma. PPOK RS Persahabatan sejak Desember 2011 sampai September 2012. Pemeriksaan FeNO menggunakan NIOX mino, uji fungsi paru (spirometri), serta penilaian ACT dilakukan setiap bulan di RS Persahabatan.

Hasil Penelitian: Terdapat 36 pasien yang berhasil mengikuti penelitian sampai selesai, selebihnya mengundurkan diri. Terdapat enam subjek laki-laki dan 30 perempuan, rerata usia 42,72 tahun (18-63). Klasifikasi terbanyak adalah asma persisten ringan (19) diikuti dengan asma persisten sedang dan berat (10 dan 7). Perbandingan selisih nilai ACT akhir dengan nilai awal antara kelompok kontrol dengan perlakuan berbeda bermakna secara statistik (p=0,008) maupun secara klinis (rerata kenaikan 3,31 poin). Tidak didapatkan perbedaan yang bermakna secara statistik dalam nilai FeNO dan uji fungsi paru antara kedua kelompok pengamatan.

Kesimpulan: Pada penelitian ini didapatkan peningkatan nilai asthma control test setelah penggunaan filter udara dengan ioniser namun tidak didapatkan perbedaan inflamasi saluran napas dan nilai faal paru. Penggunaan filter udara anion-kation seimbang dapat direkomendasikan pada pasien asma alergi.

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ABSTRACT
Introduction: Many attempts have been tried to reduce concentration of allergens which may precipitate acute asthma or cause persistence of symptoms especially in allergic asthma patients. One of the techniques used is air filter and ionizer which creates a balance anion-cation ambiance. Studies have showed that its use can reduce airborne allergen concentration. Indoor ionised air has been proven to cause protein denaturation of house dust mite allergen, one of the most prominent indoor allergen. Ionised air has been proved to cause protein denaturation of mite allergens. This condition is similar to the natural condition existing in uncontaminated natural forests. This condition may be achieved by using a commercially available air purifier and ionizer. Whether this condition affects airway inflammation and lung function test in allergic asthma patients is yet to be proven.

Methods: This is a cross-over, unblinded, clinical trial, conducted in allergic asthma patients. Serial spirometry and FeNO measurements are performed monthly. Subjects are also asked to fill ACT for assement of asthma control. Subjects is observed for two months without using air filter in their bedrooms and two months using air filter in their bedrooms with a two weeks interval in between observation.

Results: There were 50 patients enrolled in the beginning of this study but 14 dropped out while 36 completed the study. There were six male subjects and 30 female, averaging 42,72 (min 18, max 63). Most patients were mild persistent (n=30), followed by moderate ande severe persistent asthma (10 and 7, respectively). The difference between baseline and end of two months observation in control and treatment group was statistically and clinically significant (paired t-test, p=0,008, 3 points ACT increase). Although there was a trend of decreased FeNO and increased FEV1/predicted ratio, time series and multivariate analysis in both was not statistically significant.

Conclusion: There was an increase of ACT score after air filter with ionizer usage but the change in FeNO and lung function test was not statistically significant. Air purifier can be recommended in allergic asthma patients to increase asthma control.

Abstrak :
Latar belakang: Di negara endemik TB, kanker paru seringkali terlambat didiagnosis akibat sebelumnya didiagnosis sebagai TB paru. Hal ini menjadi perhatian besar karena diagnosis dini kanker paru dapat meningkatkan ketahanan hidup dan kualitas hidup pasien dengan peluang pembedahan yang lebih besar atau pun modalitas kemo-radioterapi yang dapat dipilih. Penelitian inibertujuan untuk mengetahui proporsi pasien kanker paru yang mengalami keterlambatan diagnosis karena sebelumnya didiagnosis sebagai tuberkulosis paru. Metode: Penelitian potong lintang ini dilakukan di RS Persahabatan dengan subjek penelitian adalah semua pasien kanker paru yang telah tegak didiagnosis secara histopatologi dari bulan September 2012 hingga Februari 2013 dengan jumlah total 100 pasien. Keterlambatan diagnosis ditetapkan apabila pasien didiagnosis sebagai TB paru dan mendapat Obat Anti Tuberkulosis (OAT) lebih dari 1 bulan sejak awal gejala ditemukan. Dilakukan anamnesis pada semua pasien dengan foto toraks yang didokumentasikan serta pengambilan data-data dari status pasien. Hasil: Sebanyak 41 dari 100 pasien kanker paru didiagnosis sebagai TB paru dan riwayat mendapat OAT. Dua puluh sembilan dari 41 subjek mendapat OAT lebih dari 1 bulan. Dua puluh sembilan kasus yang terlambat diagnosis tersebut tersebut terdiri dari 21 laki-laki dan 8 perempuan dengan rerata usia 51,5 tahun dan dengan hasil PA yaitu Kanker Paru Karsinoma Bukan Sel Kecil (KPKBSK) sebanyak 28 kasus dan Kanker Paru Karsinoma Sel Kecil (KPKSK) sebanyak 1 kasus serta dengan stage III sebanyak 6 kasus, stage IV sebanyak 22 kasus. Pemeriksaan sputum BTA hanya dilakukan pada 9 kasus. Rerata lama pemberian OAT adalah 4,5±0,4 bulan. Tenaga kesehatan yang memberikan OAT adalah dokter umum sebanyak 12 orang, dokter spesialis paru sebanyak 12 orang dan dokter spesialis penyakit dalam sebanyak 4 orang. Diskusi : Hasil temuan gambaran foto toraks yang menyerupai TB paru di negara endemik TB dapat menyebabkan keterlambatan diagnosis kanker paru karena awalnya didiagnosis sebagai TB paru. Pemberian OAT tanpa evaluasi yang adekuat terlebih lagi tidak mengacu pada International Standard of TB Care (ISTC) akan memicu keterlambatan diagnosis serta progresivitas penyakit pada pasien kanker paru. ......Introduction: In endemic countries, the diagnosis delay of lung cancer is due to initially misdiagnosed as pulmonary tuberculosis. The major concern rise since early diagnosis of lung cancer could improve survival and quality of life by tumor resectability chance and chemo-radiotherapy modality options. This study objective is to find out the proportion of lung cancer diagnosis delay due to misdiagnosed as pulmonary TB initially. Method: The cross sectional study held in Persahabatan Hospital with the subjects were histopatologically proven lung cancer patients between September 2012 to February 2013 involving totally 100 patients. The diagnosis delay were determined whether the patients had diagnosed as pulmonary tuberculosis and received anti tuberculosis treatment (ATT) more than 1 month since current symptoms onset. All patients were interviewed, all chest X-rays were documented and data from medical records were collected. Results: Fourty one of 100 patients were diagnosed as pulmonary TB and 29 of 41 patients received ATT more than 1 months. It consist of 21 men and 8 women with mean age 51.5 years old and the histopatological biopsy are 28 Non Small Cell Lung Cancer (NSCLC) cases, and 1 Small Cell Lung Cancer (SCLC) case with mostly end stage such as 6 cases are stage III and 22 cases are stage IV. Pre-referral sputum Acid Fast Bacilli (AFB) was conducted in only 9 cases with the results were negative. Mean duration of ATT taken was 4.5±0.4 months. The ATT were given by 13 general practitioners, 12 pulmonologists and 4 internists. Discussion: Since similar radiological findings in highly incidence of pulmonary TB, a large number of lung cancer have diagnosis delay due to initially diagnosed as pulmonary tuberculosis. Without proper investigation based on International Standard of TB Care, starting ATT with inadequate evaluation leads to diagnosis delay and lung cancer progression.

Abstrak :
Latar belakang: Laju penurunan VEP1 dan VEP1/KVP pada pasien PPOK dari beberapa data yang ada menunjukkan penurunan yang lebih tajam dibandingkan normal, namun untuk penelitian yang dilakukan selama 1 tahun belum pernah diperbarui di RSUP Persahabatan. Penelitian ini mencoba untuk mengetahui laju penurunan nilai VEP1, VEP1/KVP pada pasien PPOK setelah 1 tahun pengobatan. Metode: Penelitian kohort retrospektif ini dilakukan untuk mengukur laju penurunan nilai VEP1, VEP1/KVP pasien PPOK di klinik Asma PPOK RSUP Persahabatan setelah pengobatan selama 1 tahun. Hasil: Laju penurunan nilai VEP1 setelah 1 tahun pengobatan adalah sebesar 121,53 120ml/tahun sedangkan laju penurunan nilai VEP1/KVP setelah 1 tahun pengobatan adalah sebesar 2,75 0,47 p10 80,6, derajat GOLD 2 64,5 , mengkonsumsi LABACs 64,5 dan usia terdiagnosis ≥60 tahun 64,5 . Laju penurunan VEP1 lebih banyak terjadi pada kelompok D 110ml/tahun sedangkan laju penurunan VEP1/KVP lebih banyak terjadi pada kelompok B 3,29. Kesimpulan: Pada penelitian ini diketahui sebagian besar pasien mengalami laju penurunan VEP1 dan VEP1/KVP yang bermakna secara statistik dan sebagian kecil yang mengalami kenaikan meskipun tidak bermakna secara statistik. Tidak didapatkan hubungan yang berbeda bermakna baik antara jenis kelamin, usia, keluhan respirasi, riwayat merokok, IB, jenis rokok, komorbid, tingkat pendidikan, usia terdiagnosis, IMT, kelompok A-B dan C-D, kelompok A-C dan B-D, riwayat eksaserbasi, CAT, derajat obstruksi dan pemberian terapi LABACs dengan laju penurunan nilai VEP1 dan VEP1/KVP. Kata kunci: Penurunan fungsi paru, PPOK. ...... Background: The rate of decline in FEV1 and FEV1/FVC in COPD patients from some of the available data shows more decline than normal, but for a 1 year study has not been updated in Persahabatan Hospital. This study attempted to determine the rate of FEV1 and FEV1/FVC decline in COPD patients after 1 year treatment. Methods: This retrospective cohort study was conducted to measure the rate of FEV1 and FEV1/FVC decline in COPD patients at Asthma COPD Clinic Persahabatan Hospital after 1 year treatment. Results: The rate of decline in FEV1 after 1 year treatment was 121.53 120ml/year while the rate of decline in FEV1/FVC after 1 year treatment was 2.75 0.47 p 10 80.6 , GOLD 2 64.5 , with LABACs treatment 64.5 and diagnosed ge;60 years 64.5 . The rate of decline in FEV1 was more prevalent in group D 110ml/year while the rate of decline in FEV1/FVC was more prevalent in group B 3.29. Conclusions: In this study most patients have a statistically significant rate of decline in FEV1 and FEV1/FVC, however a small proportion of patients experienced increases in FEV1 and FEV1/FVC although it does not reach statistical treshhold. No significant differences are found between sex, age, respiratory complaints, smoking history, BI, type of cigarette, comorbid, educational level, diagnosed age, BMI, AB and CD group, AC and BD group, history of exacerbations, CAT, obstruction and treatment of LABACs with rate of decline in VEP1 and VEP1 / KVP.

Abstrak :
ABSTRAK
Pendahuluan: Polusi udara akibat kepadatan kendaraan merupakan bahaya serius bagi kesehatan sehingga orang yang terpajan polutan terus menerus mengalami peningkatan risiko terjadinya penurunan faal paru. Polisi lalulintas merupakan subjek yang terus menerus terpajan dengan emisi gas buang kendaraan sebagai risiko dari pekerjaannya.Gas buang kendaraan terdiri dari nitrogen oksida, karbon monoksida, bahan partikel dan lainnya yang dapat menyebabkan kerusakan bronkiolus terminal dan menurunnya kompains serta kapasitas vital paru. Penelitian ini bertujuan menilai status faal paru polisi lalulintas Jakarta Pusat dan apakah terdapat hubungan antara pajanan terhadap polusi gas buang kendaraan dengan penurunan faal paru. Disamping itu juga dilakukan analisis hubungan antara penurunan faal paru dengan berbagai faktor yang mempengaruhinya.

Metode: Penelitian potong lintang ini melibatkan 170 polisi lalulintas di polres Jakarta Pusat, usia 20-55 tahun, masa kerja minimal 2 tahun. Data kesehatan secara keseluruhan diamati menggunakan Kuesioner Proyek Pneumomobile Indonesia dan pemeriksaan fisis dan status kesehatan paru secara khusus diamati menggunakan foto toraks dan spirometri. Kadar CO-ekshalasi juga dianalisis. Analisis statistik dikerjakan menggunakan SPSS versi 17.

Hasil: Dalam penelitian ini didapatkan sampel total adalah 130 subjek tetapi 9 subjek dropout karena tidak menyelesaikan pemeriksaan secara lengkap dan benar. Data subjek yang dilakukan analisis adalah sebanyak 121 dengan karakteristik 33,9% memiliki usia antara 41-50 tahun dengan rerata usia 37,0 tahun (SD 8,8); 57,9% memiliki berat badan lebih; 55,4% merupakan perokok aktif; 64,5% menggunakan alat pelindung diri secara buruk; 47,9% memiliki masa kerja >10 tahun; 100% bekerja 56 jam seminggu.Rerata kadar CO-ekshalasi adalah 8,7 (SD 5,0). 9,9% subjects memiliki foto toraks normal,hanya 16,7% yang merupakan kelainan paru dan 83,3% merupakan kelainan nonparu. 19% subjek memiliki kelainan faal paru yaitu 60,9% kelainan restriksi ringan dan 39,1% kelainan obstruksi ringan dan sedang. Tidak terdapat hubungan bermakna secara statistik antara variabel independen usia, status nutrisi, riwayat merokok, penggunaan alat pelindung diri, durasi kerja terhadap variabel dependen pemeriksaan spirometri.Hanya variabel masa kerja subjek yang semakin lama memiliki hubungan bermakna secara statistik terhadap penurunan hasil pemeriksaan spirometri dengan p=0,0014.

Kesimpulan: Penelitian ini menunjukkan lamanya masa kerja polisi lalulintas berhubungan bermakna secara statistik dengan penurunan faal paru.

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ABSTRACT
Introduction: Air pollution due to road traffic is a serious health hazard and thus the persons who are continuously pollutant exposed, may be at an increased risk. In this respect, traffic policemen are at a risk, since they are continuously exposed to emissions from vehicles, due to the nature of their job. Automobile exhaust consists of oxides of nitrogen, carbon monoxide, particulate matter, and others, which cause injury to the terminal bronchioles and a decrease in the pulmonary compliance and vital capacity. The present study was aimed at assessing the pulmonary function status in traffic policemen in Central Jakarta whether prolonged exposure to vehicular exhausts had any detrimental effect on their lung functions. The relationship between decrements of lung function and various influencing factors also analyzed.

Methods: Across-sectional study was conducted in 170 traffic policemen in Central Jakarta, age 20-55 years, working periods at least 2 years. The data of overall health status was observed using Indonesia Pneumomobile Project Questioner and physical examinations and lung health status was observed using thorax X-ray and spirometry. Level of CO-exhalation was also analyzed. The statistical analysis was carried out with SPSS PC software version 17.

Results: Total samples included in this study were 130 subjects, 9 subjects were dropped out because uncompleted study’s tests. Analyzed subjects were 121 whose characteristics were 33,9% were in age classifications 41-50 years and mean age was 37,0 (SD 8,8); 57,9% overweight; 55,4% active smokers; 64,5% bad masker application; 47,9% in working periods >10 years; 100% had 56 working hours in a week. Mean CO-exhalation level was 8,7 (SD 5,0). 9,9% subjects had abnormal thorax X-ray that16,7% were lung abnormality and 83,3% were nonlung abnormality. 19% subjects recorded lung function decreased included 60,9% mild restriction and 39,1% mild and moderate obstruction. There were no statistical significant between age, nutrition’s classifications, smoking history, protective mask applications, working duration as independent variables and spirometry parameters as dependent variables. Longer working periods were the only dependent variable had statistical significant with decreasing spirometry results with p=0,0014.

Conclusion: This study showed that working periods had statistical significant with lung function decrement.

Abstrak :
Tujuan penelitian potong lintang ini adalah menggambarkan tingkat keterkontrolan asma, kualitas hidup, dan kepatuhan pengobatan serta melihat hubungan antara keterkontrolan asma dengan kualitas hidup dan kepatuhan pengobatan. Sebanyak 132 pasien asma poli rawat jalan RSUP Persahabatan menyatakan kesediaan dan mengikuti penelitian ini dengan lengkap. Data diambil melalui wawancara dan pengamatan cara pakai obat. Sebesar 64 pasien (48,5%) menderita asma yang tidak terkontrol dan 68 pasien (51,5%) termasuk dalam asma yang terkontrol. Gambaran kualitas hidup menunjukkan nilai rerata domain gejala sebesar 4,83 (±1,49), domain keterbatasan aktivitas sebesar 5,99 (±0,86), domain fungsi emosi sebesar 5,13 (±1,63), dan domain pajanan lingkungan sebesar 3,89 (±1,88). Gambaran kepatuhan pengobatan pada penelitian ini sebesar 45,5% pasien minum obat sesuai anjuran dokter, 38,6% pasien rutin kontrol ke petugas kesehatan, dan 45,5% menggunakan obat inhalasi dengan benar. Domain pajanan lingkungan berdampak lebih besar terhadap gangguan kualitas hidup dibandingkan dengan domain lainnya. Terdapat hubungan antara keterkontrolan asma dengan kualitas hidup (r=0,307, p<0,05) dan hubungan antara keterkontrolan asma dengan kepatuhan pengobatan (penggunaan dosis obat, rutin kontrol, dan penggunaan obat inhalasi) (p<0.05). ...... The aim of this cross-sectional study was to describe the level of asthma control, quality of life, medication compliance, and assess correlation between the level of asthma control, quality of life, and compliance with treatment. A hundred and thirty two patients with asthma in outpatient ward of RSUP Persahabatan hospital have provided consent and completed study. Data collection were conducted from interviews and observation how to use the drug. Sixty four patients (48.5%) had uncontrolled asthma and 68 patients (51.5 %) included in the controlled asthma. The mini asthma quality of life questionaire showed the mean symptom domains score of 4.83 (±1.49), activity limitations domain score of 5.99 (± 0.86), emotional function domain score of 5.13 (±1.63 ), and the environmental stimuli domain of 3.89 (±1.88). Medication compliance revealed that 45,5% used medication dose as recommended by physician, 38,6% visited the physician for routine follow up, and 45,5% used the inhaled medication correctly. Environmental stimuli had more impact in quality of life compared to symptoms, activity limitation and emotional function. There is a relationship between the domain of quality of life with asthma control level (r=0,307, p<0,05) and there is a relationship between medication dose as recommended by physician, visiting the physician for routine follow up and using the inhaled medication correctly with asthma control level (p <0.05).

Abstrak :
[ABSTRAK
Pendahuluan. Kanker paru jenis karsinoma bukan sel kecil (KPKBSK) terdiri dari nonskuamosa dan skuamosa. Kanker paru jenis karsinoma bukan sel kecil nonskuamosa adalah adenokarsinoma dan karsinoma sel besar. Saat ini terapi kanker paru sangat berkembang dari agen kemoterapi sampai terapi target terutama EGFR-TKI. Penelitian ini bertujuan untuk menilai angka tahan hidup pasien KPKSBK nonskuamosa yang mendapat kemoterapi lini pertama dibandingkan terapi EGFR-TKI di RSUP Persahabatan. Metode. Penelitian ini adalah penelitian retrospektif antara tahun 2010 sampai 2013 dari rekam medis pasien KPKBSK non skumosa yang mendapatkan kemoterapi lini pertama dan EGFR-TKI. Pasien dikemoterapi dengan platinum baseddan EGFR-TKI diterapi gefitinib 1x250 mg/hari atau erlotinib 1x150 mg/hari. Angka tahan hidup dinilai dari mulai tegak diagnosis sampai pasien meninggal atau saat penelitian dihentikan. Hasil. Dari 96 sampel KPKBSK non skuamosa terdiri dari 48 pasien yang mendapat kemoterapi lini pertama dan 48 pasien yang diterapi EGFR-TKI. Berdasarkan karakteristik pasien, usia terbanyak adalah 40-60 tahun (kemoterapi 32 (66,7%) dan EGFR-TKI 31 (64,6%) dengan jenis kelamin laki-laki yang mendominasi (kemoterapi 25(52,1%), EGFR-TKI 27 (56,2%). Pasien merokok yang mendapat kemoterapi lini pertama 41,7% dan EGFR-TKI 56,3% dengan IB terbanyak untuk kemoterapi (IB ringan 27,1%) dan untuk EGFR-TKI (IB sedang 22,9%). Jenis histologi adenokarsinoma 95,8% dengan dominasi stage IV 89,6% (kemoterapi 91,7% dan EGFR-TKI 87,5%) disertai tampilan status 2 59,4%. Angka tahan hidup pasien (ATH) 6 bulan 74%, ATH 1 tahun 22,90% dan ATH 2 tahun 6,20%. Masa tengah tahan hidup (MTTH) pasien yang mendapat EGFR-TKI lebih lama sedikit dibandingkan yang mendapat kemoterapi lini pertama (263 hari versus 260 hari. Kesimpulan. Masa tahan hidup 1 tahun pasien KPKBSK non skuamosa yang diterapi EGFR-TKI sedikit lebih lama dibandingkan kemoterapi lini pertama (263 hari vs 260 hari). Sedangkan ATH 1 tahun pasien kemoterapi lini pertama lebih besar dibandingkan EGFR-TKI (25% vs 20,8%). Faktor yang paling mempengaruhi angka tahan hidup adalah stage dengan nilai p<0,05.

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ABSTRACT
Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital. Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days). Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital. Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days). Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital. Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days). Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital. Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days). Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05., Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital. Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days). Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.]

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Latar belakang dan tujuan:Data mengenai pasien PPOK pada ras melanesia belum ada.Tujuan penelitian ini untuk mengetahui Mengetahui faktor risiko dan nilai uji jalan 6 menit pada pasien PPOK ras Melanesia di Kota Jayapura, Papua.Metode: Penelitian ini merupakan penelitian potong lintang yang dilakukan di RSUD Dok II Jayapura.Pengambilan sampel dilakukan pada bulan September 2017.Hasil: Pada penelitian ini yang memenuhi kriteria inklusi sebesar 40 pasien PPOK.Faktor risiko pasien PPOK ras Melanesia yang merokok adalah 27 subjek 67,5 , pajanan biomass 18 subjek 45 , ISPA berulang 12 subjek 30 dan IMT kurang 6 subjek 15 , normal 33 subjek 82,5 , lebih 1 subjek 2,5 .Terdapat hubungan bermakna antara kelompok PPOK dengan ISPA berulang p=0,003 , OR 11,67 dengan IK 95 2,2-61,2 .Terdapat hubungan bermakna antara kriteria spirometri berdasarkan GOLD dengan rokok p=0,016 , pajanan biomass p=0,013 , OR 11,76 dengan IK 95 1,31-105,50 , ISPA berulang p=0,041, OR 0,16 dengan IK 95 0,03-0,785 dan IMT p=0,002 .Jarak tempuh uji jalan 6 menit terbanyak pada kelompok 200-300 m dengan 36 subjek 90 .VEP 1prediksi terbanyak adalah 50-80 dengan 30 subjek 75 dengan rerata 58,33 10,083 dan rerata VEP 1 ml adalah 1375 445,88.Pemeriksaan foto toraks pasien PPOK ras melanesia adalah normal sebanyak 38 subjek 95 dan emfisematous 2 subjek 5 .Skor CAT pasien PPOK ras melanesia di RSUD Dok II Jayapura < 10 sebanyak 36 subjek 90 dan > 10 sebanyak 4 subjek 10 dengan hubungan bermakna antara skor CAT dengan kelompok PPOK p=0,042 .Indeks brinkman IB pasien PPOK ras melanesia di RSUD Dok II Jayapura adalah ringan sebanyak 7 subjek 7 , sedang 12 subjek 44 dan berat 8 subjek 30 serta hubungan bermakna antara IB dengan hasil spirometri berdasarkan GOLD p= 0,005 .Faktor komorbid yang didapatkan pada pasien PPOK ras melanesia di RSUD Dok II Jayapura adalah gagal jantung sebanyak 2 subjek 5 . Nilai rerata uji jalan 6 menit m adalah 277,88 32,83 dan VO2 maks ml/Kg/mnt adalah 22,08 1,047 serta tidak terdapat hubungan bermakna antara kelompok PPOK ras melanesia di RSUD Dok II Jayapura dengan uji jalan 6 menit dan prediksi VO2 maks.Kesimpulan: ISPA berulang, pajanan biomass,rokok, IMT merupakan faktor yang berpengaruh pada PPOK ras melanesia. Uji jalan 6 menit pasien PPOK ras melanesia lebih rendah dibandingkan non melanesia.Kata kunci :Faktor risiko, PPOK, ras melanesia, uji jalan 6 menit.

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ABSTRACT
Background and purpose:Data on patients with COPD on melanesian races is not present. The aim of this study was to determine the risk factors and 6-minute road test scores in patients with COPD Melanesia in Jayapura City, Papua.Method:This research is cross sectional study conducted in RSUD Dok II Jayapura. Sampling was conducted in September 2017.Result:In this study the inclusion criteria were 40 patients with COPD. Risk factors for COPD patients smoking Melanesia were 27 subjects 67.5 , biomass exposure 18 subjects 45 , recurrent lower inspiratory infection of 12 subjects 30 and BMI less 6 subjects 15 , normal 33 subjects 82.5 , more 1 subject 2.5 . There was a significant relationship between group of COPD with recurrent lower inspiratory infection p = 0,003, OR 11,67 with CI 95 2,2-61,2 . There was significant relation between spirometry criteria based on GOLD with cigarette p = 0,016 , biomass exposure p = 0.013, OR 11.76 with 95 IK 1.31-105.50 , recurrent lower inspiratory infection p = 0.041, OR 0.16 with CI 0.03-0.785 and IMT p = 0.002 . The distance of the 6-minute walking test was highest in the 200-300 m group with 36 subjects 90 .The FEV 1 predicted was 50-80 with 30 subjects 75 with mean of 58.33 10,083 and FEV 1 ml is 1375 445.88. The examination of chest X-rays of patients with COC melanesia is normal for as many as 38 subjects 95 and emfisematous 2 subjects 5 .The CAT scores of melanesian COPD patients in RSUD Dok II Jayapura 10 for 4 subjects 10 with significant association between CAT score and group COPD p = 0,042 . Brinkman index IB of COPD patient melanesia in RSUD Dok II Jayapura was mild s 7 subjects 7 , 12 subjects 44 and weight 8 subjects 30 and significant relationship between IB and spirometry based on GOLD p = 0,005 . The comorbid factor obtained in patients with COPD melanesia in RSUD Dok II Jayapura is a heart failure of 2 subjects 5 . The mean value of the 6-minute walking test m was 277.88 32.83 and the max VO2 ml / Kg / mnt was 22.08 1.047 and there was no significant association between the melanesian rape COPD group in RSUD Dok II Jayapura by testing 6 min walking test and prediction VO2 max.Conclusions: Recurrent acute lower respiratory infection, biomass exposure, cigarette, BMI is a contributing factor in COPD melanesia. The 6-minute road test of COPD patients of melanesia is lower than non melanesia.

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Latar belakang: Profesi pengemudi taksi merupakan profesi yang unik, lingkungan kerja luas, jam kerja panjang, sistem pcnggajian yang fluktuatif, dan risiko kecelakaan di jalan raya. Pada PT X 60% kccelakaan dikarenakan mengantuk. Salah satu penyebab kondisi mengantuk adalah adanya kemungkinan obstructive sleep apnea (OSA). Bcbcrapa faktor risiko kemungkinan OSA seperti kegemukan dan hipertensi dijumpai pada pengemudi PT X. Metode: Penelitian ini menggunakan desain cross sectional pada pengemudi taksi X Mampang Jakana Selatan, pada bulan November»Desember 2008. Pengumpulan dilakukan dengan pengisian Kuesioner Berlin, dan pemeriksaan fisik (tekanan darah, bcrat, badan, tinggi badan, dan lingkar leher) pada 280 orang pengemudi. Hasil: Jumlah responden sebanyak 280 orang, didapatkan 70 orang (25%) kemungkinan OSA. Kemungkinan OSA pada pengemudi dipcngaruhi olch bcbcrapa faktor yaitu: IMT 325 (acyusred OR 4.29, p <0.001, 95% Cl 2.04 - 9.05) riwayat keluarga mendengkur (aafiusled OR 2,34, p <0.00l, 95% Cl 1.45 - 3.78), lingkar leher 3 40 cm (afyusred OR 3.37, p 0.002, 95% Cl 1.58 - 7.19), umur 3 36 tahun (argusted OR 2.47, p 0.027, 95% CI I.ll - 5.48) dan jadwal keija tinggi (ac§usted OR 3.07, p 0.0l6, 95% Cl L23 - 7.66). Kesimpulan: Didapat prevalensi kemungkinan OSA pada pengemudi Taksi X sebesar 25%. Kemungkinan OSA pada pcngcmudi Taksi X dipengaruhi oleh faktor indeks massa tubuh 325, riwayat keluarga mendengkur, Iingkar leher 540 cm, umur 336 tahun serta jadwal kerjatinggi. ......Background: Taxi Driver is an unique profession because of the wide environment, the long hours working duration, the fluctuation wages, and the accidental risks. About 60% taxi's accidents in Company X were caused by sleepy conditions. Sleepy conditions may be caused by obstructive sleep apnea (OSA). Some factors that increase the prevalence of suspected OSA, like obesity and hypertension were founded among the taxi drivers in this company. Method: This study was conducted with cross sectional design. The data was collected from November until December 2008 in Mampang, Jakarta Selatan. Data collection used Berlin's Questionnaire and Physical examinations (blood pressure, weight, height, neck circumference) to 280 drivers. Result: This research showed that there are 25%, it?s mean 70 respondents from 280 respondents have OSA prevalence. Prevalence of OSA among taxi?s drivers is caused by several factors. The factors are Body Mass index (BMI) 3 25 (adjusted OR 4.29, p < 0.00l, 95% Cl 2.04 - 9.05), snoring historical in family (adjusted OR 2.34, p < 0.001 , 95% CI 1.45 - 3.78), neck circumference 3 40 cm (adjusted OR 3.37, p 0.002, 95% CI 1.58 - 7.l9), age 2 36 years old (adjusted OR 2.47, p 0.027, 95% Cl 1.ll - 5.48) and high work schedule (adjusted OR 3.07, p 0.0l6, 95% Cl 1.23 - 7.66). Conclusion: This research has founded that there are 25%, it?s mean 70 respondents from 280 respondents have suspected OSA. Prevalence of suspected OSA among taxi?s drivers is caused by BMI 2 25, snoring historical in family, neck circumference 5 40 cm, age 3 36 years old and high work schedule.

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Latar Belakang : Paduan kemoterapi berbasis platinum dengan generasi ketiga khususnya karboplatin-vinorelbin sudah sering digunakan sebagai kemoterapi paliatif pada pasien KPKBSK stage lanjut di Indonesia khususnya Rumah Sakit Umum Pusat RSUP Persahabatan namun sampai saat ini belum terdapat data mengenai efikasi dan toksisiti paduan kemoterapi ini di RSUP Persahabatan.Metode : Desain penelitian ini adalah survey observasional retrospektif pada pasien KPKBSK stage lanjut IIIB dan IV yang menjalani kemoterapi lini I di RSUP Persahabatan dengan paduan kemoterapi karboplatin-vinorelbin sejak 1 Januari 2015 sampai 30 Maret 2017.Hasil : Total subjek dalam penelitian ini adalah 38 pasien yang mendapatkan paduan kemoterapi Karboplatin AUC-5 pada hari ke-1 dan vinorelbin 30 mg/m2 pada hari ke1 dan ke-8. Paduan kemoterapi karboplatin-vinorelbin mempunyai efikasi yang baik dengan Objective overall response rate ORR 12,5 dan clinical benefit rate CBR 87,5 . Overall survival OS pada penelitian ini adalah 34,2 dengan masa tengah tahan hidup 387 hari 12,9 bulan dan progression free survival 323 hari 10,7 bulan. Toksisiti hematologi dan nonhematologi yang paling sering terjadi adalah anemia derajat 1 38,4 dan keluhan mual, muntah derajat 2 57,9 . Pada penelitian ini terdapat 2 kasus perdarahan saluran cerna derajat 2 namun pasien masih dapat melanjutkan kemoterapi. Kami juga mendapatkan komplikasi tindakan kemoterapi berupa phlebitis ringan pada 24 pasien 65,7 dan phlebitis sedang pada 1pasien 2,6 .Kesimpulan: Paduan karboplatin-vinorelbin sebagai kemoterapi lini I memiliki efikasi yang baik serta efek toksisiti yang masih dapat ditoleransi sehingga aman diberikan pada pasien KPKBSK stage lanjut. Kata kunci: efikasi, toksisiti, hematologi, nonhematologi, objective overall response rate, clinical benefit rate, overall survival, MTTH, TTP, PFS

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ABSTRAK
Background Combination of platinum base and third generation drugs Carboplatin and vinorelbine chemotherapy are frequently used as paliative chemotherapy for Non small cell lung cancer NSCLC patients in Indonesia especially in Persahabatan Hospital. But there are still no data about the activity and tolerability of this regiment in Persahabatan Hospital. This study is conducted to evaluate the efficacy and toxicity of this regiment as first line chemotherapy for advanced NSCLC patients in Persahabatan Hospital.Method This study is an observational survey retrospective study for advanced NSCLC patientswho receive carboplatin vinorelbine regiment as fisrt line chemotherapy since 1st January 2015 to 30th March 2017.Result We observea total of 38 patients who receive carboplatin 5 AUC on day 1 and vinorelbine 30mg m2 on day 1 and 8. This regiment has a good efficacy with overall response rate ORR 12,5 and clinical benefit rate CBR 87,5 . The overall survival OS is 34,2 with median of survival time 387 days 12,9 moths and PFS 323 days 10,7 moths . We found grade 1 anemia 38,4 and grade 2 nausea vomiting 57,9 as hematological and non hematological toxicity that frequently occur in this study. We found 2 cases of grade 2 gastrointestinal bleeding but the patients are still able to continue the chemotherapy after doing some correction for the haemoglobin Hb . We also found mild phlebitis in 24 patients 65,7 and 1 moderate phlebitis in 1 patient 2,6 as procedural complication of this chemotherapyConclusion Combination ofcarboplatin and vinorelbine as first line chemotherapy has a good efficacy and tolerability for advanced NSCLC patients. Key word efficacy, toxicity, haematological, non hematological, overall objective response rate ORR , clinical benefit rate CBR , overall survival OS , median time of survival, time to progression TTP and progression free survival PFS .

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Latar Belakang : Pasien kanker paru umumnya datang pada stage yang sudah lanjut. Keterlambatan bisa diakibatkan oleh pasien itu sendiri, dokter dan sistem kesehatan. Sejak diberlakukan Jaminan Kesehatan Nasional, RSUP Persahabatan sebagai rujukan penyakit paru mengalami peningkatan jumlah pasien kanker paru. Diagnosis kanker paru ditargetkan tegak dalam dua minggu. Namun, selama ini ini belum ada data berapa lama diagnosis kanker paru dapat ditegakan dan berapa biaya yang dikeluarkan serta faktor-faktor apa saja yang mempengaruhinya.Metode : Penelitian ini merupakan studi observasional. Sebanyak 110 subjek terdapat pada penelitian ini. Kami mengevaluasi berapa waktu dan biaya yang dibutuhkan sejak subjek datang ke RSUP Persahabatan sampai diagnosis histopatologi kanker paru didapat. Kami juga mengevaluasi beberapa faktor yang menentukan lama dan besarnya biaya penegakan diagnosis kanker paru.Hasil : Sebanyak 110 subjek terdapat dalam penelitian ini. Delapan puluh empat 76,36 subjek laki-laki dan 26 23,64 perempuan. Nilai tengah umur subjek adalah 57 tahun dengan kisaran 26 sampai 86 tahun. Sebanyak 53 48,2 mendapatkan diagnosis dalam waktu le; dan 57 51,8 subjek mendapatkan diagnosis lebih dari 2 minggu. Nilai tengah penegakan diagnosis adalah 15 hari dengan kisaran 1 ndash;68 hari. Pasien dengan stage lanjut, tampilan status yang jelek dan dirawat dengan pembiayaan umum memiliki waktu tunggu yang lebih singkat. Biaya penegakan diagnosis kanker paru di RSUP Persahabatan memiliki nilai tengah Rp. 13.025.381,- dengan kisaran Rp. 1.083.000,- hingga Rp156.285.000,-. Subjek dengan stage lanjut, tampilan status yang buruk, memiliki penyulit dan dirawat di kelas non JKN memiliki biaya yang lebih besar.Kesimpulan : Nilai tengah waktu penegakan diagnosis kanker paru pada penelitian ini adalah 15 hari dengan kisaran 1-86 hari. Waktu tunggu berhubungan dengan stage pada saat datang, tampilan status, kelas perawatan. Biaya penegakan diagnosis kanker paru di RSUP Persahabatan memiliki nilai tengah Rp. 13.025.381,- dengan kisaran Rp. 1.083.000,- hingga Rp156.285.000,-. Biaya penegakan diagnosis berhubungan dengan stage pada saat datang, tampilan status, penyulit dan kelas perawatan.Kata Kunci : Kanker paru, diagnosis, keterlambatan diagnosis

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ABSTRAK
Background and aim Most lung cancer patients had been diagnosed in advanced stage. Most reasons for the delay of the diagnosis, might be from patients and or health system. Currently, in Indonesia has National Health Insurance System Jaminan Kesehatan Nasional . That situation made an increasing numbers of patients who come to referral hospital. In Persahabatan Hospital the National Referral for Respiratory Diseases, the maximum time interval for lung cancer diagnosis was set not more than two weeks, however several cases were delayed. We had been conducting a study to evaluate time diagnostic time and cost for diagnose lung cancer.Method We performed bservational study in Persahabatan Hospital Jakarta. One hundred an ten new patients was recruited in this study. We evaluated how long the time was and how much was needed from the first visit until the initial diagnosis by histopatology obtained. We also evaluated the factors that have correlated with time and cost of diagnosis.Results One hundred and ten patients were enrolled in this study. Eighty four 76,36 were male and 26 23,64 were female. The median age was 57 years old with range 26 to 86 years old. Data had shown that 53 48,2 patient were diagnosed under target time 2 weeks but 57 51,8 had diagnostic time more than 2 weeks. The median time of diagnostic was 15 days with range 1 ndash 68 days. Diagnostic delay was correlated with early stage of the diseases, good performance status, financial resource. The median cost of diagnosis was Rp. 13.025.381, with range Rp. 1.083.000, to Rp156.285.000, . Subject who came with late stage, poor performance status, had complication of lung cancer and hospitalized in private area had higher cost of diagnostic. Conclusion Median diagnostic time of lung cancer in RSUP Persahabatan is 15 days range from 1 to 86 days. Diagnostic time correlates with stage at admission, performance status at admission and source of financial. The median cost of diagnosis is Rp. 13.025.381, with range Rp. 1.083.000, to Rp156.285.000, . Cost of diagnosis correlates with stage at admission, performance status at admission, source of financial and complication related with lung cancer.