AbstractBackground: Hormonal therapy is one treatment option for prostate cancer. There are two main categories of hormone therapy: surgical therapy and non-surgical therapy. Orchiectomy is the surgical method of hormone therapy; medication supplementation is the non-surgical method. Many kinds of indicators are used to track the advancement of patients with prostate cancer receiving hormone therapy. tPSA levels are one of the markers that are regularly evaluated.Methods: In this retrospective study, PSA levels in patients with prostate adenocarcinoma cancer were evaluated before and after bilateral orchiectomy. Use the search terms "prostate cancer" and "orchiectomy" to find research subject data in the UGM Academic Hospital's medical records installation between 2020 and 2023. The study's findings will be shown in a graphic and statistical analysis while protecting the subjects' anonymity.Results: Most of the participants (n=18, 60.0%) have pre-orchiectomy tPSA level of more than 30 ng/mL, while only almost a quarter (n=7, 23.3%) of participants have post-orchiectomy tPSA level of more than 30 ng/mL. The two research groups (p<0.0001) before and after the orchiectomy procedure, significantly differ between the two research groups based on Wilcoxon paired sample test analysis.Conclusion: TPSA levels are considerably decreased by bilateral orchiectomy.

Background: Masturbation is normal sexual behavior. However, masturbation in childhood is rarely discussed in the research. Childhood masturbation or gratification disorder, is characterized by self-stimulation of genitalia in prepubescent children. However, childhood masturbation often stops if the child is distracted, and spontaneous recovery within two years in most cases Generally, no drug therapy is required for childhood masturbation unless it is very frequent or excessive and it affects the daily functionality of the child. Regarding the treatment of childhood masturbation, we highlight the fact that evidence-based therapy for childhood masturbation is lacking due to unclear standard guidelines on it. We need a path of therapy that can help doctors in the management of childhood masturbation. Case: Here we reported two cases of excessive childhood masturbation from a 3-year-old and a 10-month-old female patient who were brought by their mother to the outpatient clinic pediatric, Academic Hospital, Universitas Gadjah Mada, Indonesia, with a complaint of stretching by flexing the legs and rubbing on her genital part Risperidone as one of the drug therapies for this case and present a good outcome. Additionally, this article also provides literature reviews on childhood masturbation treatment that may guide clinicians in its evaluation and management. Conclusion: We conclude that behavioral treatment is the common strategy for childhood masturbation. The treatment, as well as behavioral and drug therapeutic strategies, should be considered to achieve an effective outcome.

Background: Cancer is a major burden of disease worldwide, including in Indonesia. As an effort to control the burden of cancer, WHO established National Cancer Control Programs (NCCP) where cancer registration is one of the key points. Dharmais Cancer Center Hospital, appointed as the national cancer center, has the responsibility to conduct a cancer registry in Indonesia. The good quality data of cancer registry according to international standards is beneficial to describe the cancer burden in the country. In Dharmais Cancer Center Hospital, microscopic verification is one of the variables that has not been qualified. Therefore, it is important to evaluate the completeness of cancer data variables toward data cancer quality on hospital-based cancer registry of Dharmais Cancer Center Hospital. To assess the quality of cancer data based on microscopic verification, to evaluate the completeness of hospital-based cancer registry variables and the quality of data based on microscopic verification between complete and incomplete variable groups. Materials and Methods: This quantitative research is an observational study (non-experimental) with cross- sectional study design. It utilizes secondary data from hospital-based cancer registry of Dharmais Cancer Center Hospital for incidence year 2013-2017. Results: Data quality of microscopic verification that assessed on a complete data group is 87,8% and for overall cancer cases is 62%. Among social variables, identity numbers are the most incomplete variable, which is 39%. While among tumor data variables, stage is also the most incomplete variable with 82% data. There are differences between the quality of data based on microscopic verification with the completeness of data, especially among social data variables and tumor data variables. Conclusion: The quality data based on microscopic verification that is assessed on a complete variable group is better than microscopic verification on overall cancer cases. The incomplete variables among social variables are identity number, date of birth, address, and district/province. Whereas on tumor variables, the incomplete variables are stage, treatment, metastasis, and laterality. The completeness of cancer data has an important role on data quality based on microscopic verification mainly on social and tumor variables. Improvement and strengthening particularly on management and technical aspects of cancer registration are indispensable.

Background:Remuneration is an important strategy to improve the competence of hospital services. Remuneration aims to motivate employees which can be achieved if the remuneration system is implemented fairly, but the gap between the ratio of the number of doctors and the average points to rates causes’ physician dissatisfaction toward the remuneration system. Objective:Analyze satisfaction level and measure remuneration satisfaction factors on Pediatricians and Obstetrics and Gynecologists at ABC Hospital Jakarta. Method:This study used quantitative methods with multiple linear regression analysis measured by the Equity Scale and Remuneration Satisfaction Scale. Interviews were used to obtain comprehensive analysis results from respondents who were in the lower and upper limits of the questionnaire results. The interview also involved the management of ABC Hospital Jakarta.Result and discussion:Total 44 respondents consisting of 30 Pediatricians and 14 Obstetricians and Gynecologists, showed dissatisfaction with the remuneration system (45,46%), neutral (31,53%), and satisfied (23%). There was a relationship between perceptions of external fairness (P= 0,003) and procedural fairness (P= 0,002) with remuneration satisfaction. There was no relationship between perceptions of internal justice (P= 0,929) and perceptions of individual justice (P= 0,130) with remuneration satisfaction. These results were explored using interviews and the causes of doctor dissatisfaction due to the gap in the achievement of the Individual Performance Index, lots of doctor examinations that were not listed in the rates, and remuneration points did not consider the complexity of each job. Meanwhile, the dissatisfaction felt by the management was due to the lack of measurement of quality indicators in the remuneration system.Conclusion and recommendation:External and procedural justices are factors that affect the satisfaction of remuneration felt by specialist-physician. The remuneration obtained at ABC Hospital Jakarta is lower than other Government Hospitals of the same type. In addition, there are binding rules, doctors' lack of understanding of the remuneration system, and lack of socialization. The management needs to formulate a more detailed remuneration system based on applicable regulations by adjusting the hospital situation.

Background: Cancer registration produces statistical information on cancer that complies with international standards so that it can be used as a baseline for taking cancer policy directions. The quality of the data can be affected by the officers who carry it out. Hospital-Based Cancer Registration Training in Indonesia has been held since 2016 to increase the capacity of cancer registration implementation. Since the pandemic, online methods have been increasingly used in the world, not only in education but also in health sector . In addition, the blended learning method has becomebecome an option because it is more effective for delivering material that requires interaction with the instructor. Cancer registrars have an important role in the process of cancer registration activities in providing valid and accurate information so that to support performance, training is needed to increase the capacity of cancer registrars. Dharmais Cancer Hospital has had a Hospital-Based Cancer Registration Training program with the aim of achieving the competencies needed in cancer registration. This study aims to analyze the readiness of the blended learning method of hospital-based cancer registration training by the National Cancer Center Indonesia, Dharmais Cancer Hospital. Methods: The research design was carried out in the form of quantitative descriptive where data collection was in the form of questionnaires to the research subjects according to the inclusion criteria. The inclusion criteria for research subjects were training instructors, training organizers, cancer registration implementers, and leaders who were responsible for cancer registration. The research was conducted at the National Cancer Center Indonesia, Dharmais Cancer Hospital from April to November 2022. Data will be analyzed using SPSS. Results: We analysed the 35 respondents with the results were mostly female (80%), bachelor degree (51.4%), 30-39 years old (40%), never been cancer registration trainer (71.4%), and ever heard about about cancer registration training (82,9%). There were three variable that had mean higher than overall mean which technology (3.95), self development (3.86), and training curriculum (3.98). However the innovation (3.61) and training organizer (3.17) were less then overall mean. Conclusion: Dharmais Cancer Hospital has been ready but need improvements to have cancer registration training using blended learning. Innovation factor and training organizer should be improved.

Background: The problems faced by Soerojo Hospital is currently decreasing the number of outpatient visits and decreasing customer satisfaction. Marketing mix analysis based on satisfaction surveys which on average are good based on hospital customer perceptions and targeted revenue targets from out-of-pocket sources of 30 percent require the right marketing mix tactics for potential customers in the comunity. This study will help Soerojo Hospital choose dominant factor of the marketing mix in hospital selection for making optimal marketing strategy. The aims of this study was to identify the role of the marketing mix factors on people's decisions in hospital selection. Materials and Methods: This study was conducted with a descriptive, quantitative approach, cross sectional research design, 385 respondents were surveyed with questionnaires and data analysis was carried out with program packages. Results: The components of the marketing mix that occupy the top three positions are the location component with a median of 4.67(1-5), the process component with a median of 4.60 (1-5) and the cost component with a median of 4.50 (1-5). There was a significant difference between the groups who choose and did not choose Soerojo mental hospital in the doctor/staff and promotion (p value <0.05). Conclusion: The location, process and cost components are the components of the marketing mix that most influence the decision to choose a hospital. Suggestions for improvements that can be made by RSJ Prof. Dr. Soerojo Magelang based on the results of this study.

Achondroplasia is the most common form of dwarfism in humans. There are abnormalities of intracartilaginous ossification caused by mutation of FGFR 3 gene resulting in a narrow spinal canal accompanied by neurological impairements in some patients. The neurological impairements could be caused by ossification of ligamentum flavum, disc degeneration, kyphosis of lumbar spine, bony spurs, thickened laminae and facet joints. We reported a case of 23-year-old Indonesian male with achondroplasia, spinal canal stenosis accompanied by ossification of ligamentum flavum presented with progressive myelopathy and neurogenic claudication. Spinal canal stenosis with OLF was observed at L2-L5 level of lumbar spine. Laminectomy with decompression and removal of the OLF was performed at L2-L5. There was an improvement on patient's neurological symptoms and function after the surgery. In this report, we describe a rare case of achondroplasia with OLF presenting with neurological symptoms from multiple level of spinal canal stenosis. We perfromed decompressive wide laminectomy and resection of adherent OLF followed by fusion with instrumentation resulted in the improvement of patient's neurological symptoms and function.

Background: To provide information on health services and education, hospitals require marketing communication, one of which is event. The hospital holds a variety of events for employees and citizen, which are routine or even incidental. Along with era development, hospitals are required to make fast and precise movements, so that performance is efficient and effective to achieve the success of events. President Director of RUMAH SAKIT Dr. OEN KANDANG SAPI SOLO (Droenska) decided to establish the Hospital Event Committee in 2019 with integrated system organization (ISO DOI) to replace the role of the event committee which is formed in every events. It is expected that the performance of each unit can be more effective, efficient, and the entire hospital community makes the culture of hospitals, internal marketers, as a way of life, because intangible marketing assets are important to embrace customers. After the Decision of the President Director is determined and implemented, of course, monitoring and evaluation are required.Purpose: Evaluating the effectiveness of events management which used Integrated System Organization RUMAH SAKIT Dr. OEN KANDANG SAPI SOLO (ISO DOI).Method: Qualitative descriptive research was used. The research datas were obtained through in-depth interviews with 17 informans who are choosen by purposive sampling selection method at the Hospital Event Committee in 2019–2020. Then it is formulated with the study of proposal recapitulation data as well as liability sheet (LPJ) in 2019–2020.Result: Component and function of Hospital events committee already fulfilled the standard of EO. The concept of events is quite good and clear. Coordination between the committees of events is inadequate due to a lack of communication and initiative. The event went smoothly and also there were no obstacles that led to the failure of the event, although there were still some shortcomings. Some of the event committees have not evaluated and given accountability (LPJ).Conclusion: The completeness of EO component’s and work function’s already exists and running on the Hospital Event Committee (ISO DOI). Events held by hospital with ISO DOI committees become more organized, effective, and efficient, but the function of coordination and evaluation must be improved. ISO DOI is potensial to develop as an event organizer that manage events with partners so that it can be additional revenue for Droenska.

The SARS-CoV 2 virus pandemic has been a scourge since 2020. The number of cases that continues to increase, both mild, moderate, severe-critical confirmed cases are directly proportional to the need for treatment rooms, both ordinary wards and intensive care units (ICU), which is inversely proportional to the available capacity. room. Based on research, the high mortality and morbidity rate due to COVID 19 is due to the incidence of patient sepsis. Research abroad states that the value of D-dimer is a prognostic factor for COVID-19 patients, although there is no agreement on the best cut-off point for specificity and sensitivity. hypercoagulability conditions and increased lactic acid in patients with severe sepsis. It is necessary to evaluate the role of this laboratory result in estimating the prognosis of COVID-19 patients in Indonesia. There is no study that examines the relationship between the incidence of sepsis and the characteristics of hypercoagulability with the dominance of the thrombotic process in COVID19 patients in Indonesia. The purpose of this study was to provide information to health workers about the role of D-dimer value as a prognostic factor for severe-critical COVID-19 patients. This quantitative retrospective research data in the form of proportions were collected for 12 months from the medical records of the UGM Academic Hospital of patients with confirmed severe-critical COVID-19. Overall survival was assessed by the Kaplan-Meier curve. The cut-off determination for the D-dimer variable was carried out using the Receiver Operating Curve (ROC) followed by the calculation of the Youden index. Then the hazard ratio was determined by cox regression with a p value of <0.05 which was considered significant. Statistical analysis with SPSS version 26 software.

Background: The number of patients infected with COVID-19 was increasing. The COVID-19 clinical presentation varies from asymptomatic, mild, moderate, severe, and critical. Mortality rates increase with morbidity and disease severity. This study aimed to develop a prognostic intrahospital mortality scoring named "Modified COVID-19 Mortality Scoring".Methods: A retrospective cohort study was conducted on COVID-19 inpatients at the UGM Academic Hospital during November 2020-March 2021. Data were obtained from electronic medical records. Clinical and laboratory parameters were taken at the time of admission.Results: The study involved 413 patients, including 50 subjects who died from COVID-19 and 363 survivors. The final stage of multivariate analysis resulted in some variables; age≥55 years, history of stroke, qSOFA score≥2, d-dimer≥1500 ng/mL, absolute neutrophil count (ANC)≥5,000 cells/uL, and absolute lymphocyte count (ALC)<1,000 cells /uL affected intrahospital mortality (p<0.050). In the scoring model, the d-dimer≥1500 ng/mL was worth 2 points, and each remaining variable was worth 1 point. The score had a strong predictive ability with an area under the ROC curve, 0.814(95%CI=0.757–0.871). The sensitivity and specificity of the score was 76%, with a cutoff point score of 3, an OR of 10,357 (95%CI=5.179-20,710, p=0.000). Moreover, the probability scores of 3, 4,5,6,7 were 18%, 33%, 53%, 72%, and 85%.Conclusion: The existence of a scoring system is expected to help identify COVID-19 inpatients who have a higher risk of death so that stricter monitoring and early intervention can be carried out.