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"Background : The treatment of lung tuberculosis in patient with diabetes mellitus comorbidity is still a major problem because of high incidence rate, unfavourable outcome and failure. In indonesia, there is no specific study about outcome, characteristics and profile patient with this unfavourable outcome.Objectives : To identify the treatment outcome, patient characteristic and patient profile for unfavourable outcome.Methods : This is a retrospective cohort study, analyzing medical record of lung tuberculosis patient with diabetes mellitus comorbidity that treated in Cipto Mangunkusumo Hospital from January 2013 to December 2018. Unfavourable outcome as defined by Tb-DOTS national program consist of subject with failure to treat, death, loss to follow up and transferred out without known of final results. Result : A total of 141 subject enrolled in this study, with median age of subject was 57 years (range 28 to 79 years) and majority subject is male (56.03%), Tb relapse found in 24.11% subject. Outcome of Tb treatment based on National Program was treatment complete in 51.77%, Cure in 1.42%, loss to follow up in 31.91%, transferred out in 14%, and died in 7% subjects. Unfavourable outcome found in 46.81% subject, with majority found in male subject, married, working subject, actively smoking, subject with previous Tb treatment, non-adherence, previously known diabetes, underweight or normoweight subject, reduce eGFR below 60 ml/min/1.73m2, subject with insulin therapy on intensive phase, and poorly controlled diabetes.Conclusion : Unfavourable outcome found in 46,81% subject, will loss to follow up was the highest composition (31.91%)."

"Tujuan: Untuk mengetahui efektifitas, kenyamanan, dan toksisitas dari alat testicular shield buatan sendiri pada preservasi fertilitas pasien di Instalasi Radioterapi pada Rumah Sakit pusat rujukan nasional di Indonesia.Metode: Penelitian deskriptif analitik, dilakukan perhitungan dosis pada TPS dan Film Dosimetry, Pemeriksaan laboratorium hormon FSH, LH, dan Testosteron pre dan post radiasi serta penilaian toksisitas kulit daerah skrotum paska radiasi dan kenyamanan penggunaan pada pasien kanker abdominopelvis yang menjalani terapi radiasi.Hasil: Total terdapat 6 pasien yang menyelesaikan proses perencanaan radiasi dengan 5 pasien berhasil menyelesaikan tatalaksana radiasi. Didapatkan Dosis rerata testis 0,8 Gy dan rerata dosis testis dibandingkan dosis preskripsi sebesar 1,8% dengan pengurangan dosis sekitar 80%. Terdapat peningkatan hormon FSH (63,5%), LH (32,2%), dan penurunan Testosteron (3,7%). Panggunaan testicular shield dapat mencegah terjadinya hipogonadisme primer akibat radiasi. Rerata skor kenyamanan 9,4 dengan tanpa ditemukan peningkatan toksisitas kulit paska radiasi.Kesimpulan: Alat testicular shield yang dibuat pada studi ini terbukti memiliki efektitas yang baik untuk mengurangi dosis yang diterima testis dengan tidak menimbulkan rasa tidak nyaman saat digunakan dan tanpa penginkatan toksisitas kulit skrotum.Kata Kunci: Pasien kanker abdominopelvis, Preservasi Fertilitas Pria. Terapi Radiasi, Testicular Shield, FSH, LH, Testosteron, Kenyamanan, Toksisitas kulit.

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Purpose: To determine the effectiveness, comfort and toxicity of In-house testicular shield devices in preserving patient fertility in radiotherapy installations at national referral hospital centers in Indonesia.

Method: Descriptive analytical research, dose calculations were carried out on TPS and Film Dosimetry, laboratory examination of FSH, LH and Testosterone hormones pre and post radiation as well as assessment of skin toxicity in the skin scrotal area post radiation and comfort of use in abdominopelvic cancer patients undergoing radiation therapy.

Results: A total of 6 patients completed the radiation planning process with 5 patients successfully completing radiation treatment. The average testicular dose was 0.8 Gy and the average testicular dose compared to the prescribed dose was 1.8% with dose reduction to testis approximately 80%, After Radiotheraphy there was an increase in the hormones FSH (63,5%), LH (32,2%), and a decrease in Testosterone (3.7%). The use of a testicular shield can prevent primary hypogonadism due to radiation. The mean comfort score was 9.4 without escalation in skin toxicity.

Conclusion: The testicular shield device created in this study was scientifically proven to have good effectiveness reducing dose received by testis with excellent comfort and without escalation in scrotal skin toxicity."

"ABSTRACTThyroid nodule is a health problem which commonly found in daily practice, therefore clinical guidance is needed. This guideline was compiled by a multidisciplinary team and expected to be a guideline in diagnosing thyroid nodules on daily clinical practice."