Prostate cancer is the fourth most common type of non-skin malignancy in male malignancies. In Indonesia, the definitive data are unreported, however, Globocan reported prostate cancer in 5th place in 2018. Early diagnosis and treatment of this cancer are associated with reduced mortality rates. This study aimed to investigate the profile of prostate cancer in Dr. Sardjito General Hospital, Yogyakarta, Indonesia. A retrospective study involving a total of 90 prostate cancer patients who underwent follow-up care at Dr. Sardjito General Hospital, Yogyakarta in the period of 2015 to 2020 was conducted. Data of the patients from their medical records consisted of age, gender, prostate volume, PSA level, testosterone level, hydronephrosis, TURP history, histopathology results, Gleason scores, ISUP grade, and staging TNM were collected. The average of patients age was 67 ±10.4 y.o. where 22 (24.4%) patients aged 70 y.o. Almost of all patients (87 patients or 97.8%) were diagnosed as adenocarcinoma. Most of patients (73 patients or 81.4%) had prostate volume (TAUS) > 30 cm3 with the median at diagnosis was 51 cm3 (38.3 – 104.4). Furthermore, the median of PSA for diagnosis was 234.4 (94.4 – 1720.3) ng/mL and the median of testosterone level at diagnosis was 317 (10 - 384) ng/dL. In conclusion, most patients with prostate cancer are identified as adenocarcinoma with metastatic stage. In general, the prostate cancer patients age more than 61 years old with prostate volume (TAUS) > 30 cm3. In addition, prostate volume and testosterone level can be routinely used as initial screening and periodic assessment to evaluate prognosis and disease progression.

Previous studies proven that cochlear hair cells’ death plays an important role in sensorineural hearing loss due to radiation exposure. Other studies compared the differences between the impact of conventional radiotherapy (CRT) and intensity modulated radiation therapy (IMRT) on hearing loss in patients with nasopharyngeal carcinoma. Although, few differences found in some clinical manifestation, however no statistical analysis had been carried out. The aim of study was to evaluate the risk of sensory hearing loss in nasopharyngeal carcinoma patients who received CRT compared to IMRT. A case control study was performed on nasopharyngeal carcinoma patients who received radiotherapy at Dr. Sardjito General Hospital, Yogyakarta. The result of DPOAE between NPC patients who received CRT and IMRT was compared in this study. Statistical analysis was performed using chi square test and multivariate analysis. The result showed that patients who received CRT significantly altered the risk for sensory hearing loss in the contralateral ear as much as 11.2 times according to the multivariate analysis (CI 95%: 2.2 – 56.6; p=0.004). In conclusion, the risk of sensory hearing loss in patients with nasopharyngeal carcinoma who received CRT is a greater compared to IMRT.

Previous studies revealed that inflammatory biomarkers have a role in the clinical outcomes of acute coronary syndromes (ACS) and also in prediction of cardiovascular events using GRACE score. Resistin, a recently identified inflammatory biomarker, also has a role in clinical outcomes of ACS but its role related to GRACE score risk stratification is unknown. Three risk stratifications of ACS based on GRACE scores were used i.e. low, intermediate, and high. Some studies reported that inflammatory biomarkers have a role in cardiovascular events of patients with low risk GRACE scores, but their role in the patients with intermediate risk still needs to be elucidated. This study aimed to investigate the role of resistin in cardiovascular events of ACS patients with intermediate risk GRACE score. This was an observational study using a cross-sectional design involving sixty-three patients with ACS who fulfilled the inclusion and exclusion criteria. Blood samples were drawn 24 h after onset. Resistin level was analyzed and classified according to its median values. The cardiovascular event was defined as mortality, ischemic events, acute heart failure or arrhythmia during hospitalization. The result showed that cardiovascular events were significantly higher in patients with resistin levels higher than median i.e. 23.8% compared to those with resistin levels similar or lower than median i.e. 11.1% (OR 3.348, 95%CI: 1.125-10.007 p=0.027). It can be concluded high resistin level is associated with an increase of cardiovascular events of ACS with intermediate risk GRACE score.

Congenital cystic adenomatoid malformation (CCAM) is a rare condition \ndefined by multiple cysts produced in the lung that occur during the fetal \nperiod, with respiratory distress as presenting symptoms. Untreated CCAM \nmay lead to repeated lung infection and pneumothorax. Many surgical \ntechniques have been used to treat CCAM. However, those techniques showed \nvarious results. Moreover, less studies were performed to evaluate the \neffect of those surgical techniques in treating CCAM patients. We reported a \nmanagement of a rare pediatric case of CCAM referred to the Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Public Health and \nNursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital. The patient \nwas a 29-day-old male baby who presented with pneumothorax on the right \nlung due to CCAM. The plan of treatment for the patient was lobectomy until \npneumonectomy on the affected lung. During the thoracotomy procedure, \nwe found that all lobes in the right lung were covered with fibrous tissue. \nBased on this finding, a decortication procedure to remove the fibrous tissue \ncontinued by a bullectomy procedure with the insertion of a chest tube were \nperformed. The patient continuously showed improvement in breathing and \nwound healing, thus making the patient discharged from the hospital on the \nnineteenth postoperative day. The cause of CCAM is thought to be congenital \nabnormalities of the bronchiole epithelium that produce multiple cysts. Due to \nits rarity and lack of research on CCAM, many CCAM patients are misdiagnosed/\nunderdiagnosed. Common surgical methods used in this patient are lobectomy \nwith continuation until pneumonectomy or bilobectomy, if necessary, to \nprevent recurrence. Parenchymal saving methods can be considered because \nthey have the same outcome as lobectomy. As performed in this patient, \nthoracotomy decortication continued with bullectomy is adequately capable of \nalleviating respiratory distress symptoms and is thus described as successful.

Diabetes mellitus (DM) in Indonesia has rapidly increased during recent years. World Health Organization (WHO) predicted that in 2030, Indonesia would be ranked fourth for the largest DM patients in the world. As the disease progresses, uncontrolled type 2 DM (T2DM) results in dry skin as the most prevalent skin disorder. Despite the prevalence and morbidities that lead to infection, ulcer, gangrene that can lead to amputation when insufficiently treated, dry skin in T2DM has limited therapeutic options. Currently, available therapies for dry skin in T2DM have not considered factors of hyperglycemia and hyperinsulinemia, which disturb skin homeostasis. Nonetheless, in T2DM, there are neuropathy and biostructural changes of the skin which induce dry skin. Alternative herbal medicine, Centella asiatica is getting well-known nowadays because of its vast amount of benefits. Centella asiatica has been studied for its antioxidant, antidiabetic, anti-inflammation, antiglycation, and neuroprotective activities. Furtherly, these properties may display benefits when introduced to T2DM dry skin therapy. The previous clinical study had shown that topical C. asiatica improved dry skin. This clinical study was also supported by in vitro studies. Currently, pharmacological profile studies of C. asiatica including dosage, toxicity, and safety have been available. This article aimed to review the current literature on the potential of C. asiatica as an alternative to treat dry skin in T2DM.

COVID-19 is caused by the SARS-CoV-2 infection that attacked the human respiratory system. In severe conditions, it causes pneumonia, kidney failure, acute respiratory distress syndrome (ARDS), and even death. The SARS-CoV-2 infection triggers the immune cells to secrete an excess of pro- inflammatory cytokines lead to cytokine storm. It is believed to become one of the mechanisms that cause the ARDS condition. The level of pro-inflammatory cytokines will differ with each case severity. This study aimed to evaluate the profile of pro-inflammatory cytokines in COVID-19 patients with different severity. Therefore, it could be used as therapeutic approach for cytokine storm conditions. It was a cross sectional study using plasma samples of COVID-19 patients from Jakarta Islamic Hospital, Pondok Kopi and Dr. M. Goenawan Partowidigdo Hospital, Cisarua, Indonesia. The COVID-19 patients with severe (n=20) and mild to moderate (n=25) severity were involved in this study. As negative control plasma sample from healthy subjects (n=13) was used. Plasma IL-6 levels were measured using the ELISA technique and plasma lymphocyte levels were measured using a hematology analyzer. The results showed that no significant difference between severity and gender was observed (p=0.256). Meanwhile, there is a significant difference in IL-6 level between negative control, mild-moderate, and severe categories (p=0.015). The average IL-6 level in severe categories was higher than mild-moderate and negative control categories, with values 105.375, 59.75, and 64.577 pg/mL, respectively. This result becomes supporting evidence that there is a cytokine storm condition in severe COVID-19 patients. Furthermore, the lymphocyte level in the severe group is significantly lower than the mild to moderate group. This result may indicate lymphocytopenia in the severe group.

Graves’ disease (GD) contributes for 60–80% of all hyperthyroidism. Methimazole is the first line drug and most commonly used as antithyroid drug (ATD). However, the relapse rate following ATD therapy is 40–50%. The aimed of this study was to evaluate long-term ATD treatments and to identify prognostic factors that contribute to GD recurrence. A total of 46 GD patients who referred to the Endocrinology Clinic, Dr. Sardjito General Hospital, Yogyakarta between January 2016 and December 2018 with thyrotropin receptor antibody (TRAb) tested and treated with methimazole were included in this study. Size of goiter was measured based on WHO grading system and eye syndrome based on NOSPEC score system. Patients were classified into recurrence and remission groups based on TRAb evaluation at 12 month following treatment. Result of thyroid hormone level (FT4) and subject characteristic as predictive factors observed at 3-, 6- and 12-month post- treatment were compared and analyzed. Among 46 patient involved in this study, 23 patients demonstrated remission of hyperthyroidism based on TRAb evaluation at 12-month. The size of thyroid at onset of disease in 30 (65%) patients was grade 2 or above (p<0.05). Free FT4 levels at the end of observation (12 month) was 1.9±0.6 ng/ dL in recurrent and 1.4±0.5 ng/dL in remission group (p<0.05). TRAb levels at early of study was higher in the recurrent group (p<0.05). Logistic regression analysis demonstrated that thyroid size, FT4 level, and TRAb at diagnosis were associated with recurrencies. In conclusion, GD patients with large thyroids size, high TRAb levels, and high FT4 level at the onset of disease tended to fail to respond to ATD and were associated with recurrence incidence.

Obesity and overweight are considerable health problems with increasing prevalence among adolescents. In Indonesia, basic health research data from Riskesdas shows an increase in the prevalence of obesity in adolescents aged 13- 15 y.o, from 2.6% in 2010 to 6.7% in 2013. This high prevalence of overweight and obesity is related to various factors. This study aimed to determine the factors associated with hypertension and obesity in adolescents. This study was conducted on an overweight population, obese, and super-obese adolescents aged 13-15 year in the Yogyakarta City, Indonesia. Demographic data included the history of breastfeeding, birth weight, gender, history of premature birth, lifestyle, and physical activity were gathered. Anthropometric data included the weight, height, and body mass index (BMI) were also measured and gathered. Hypertension was measured using a manual sphygmomanometer. The relationship was analyzed using Pearson chi-square and the risk value was demonstrated from the odds ratio (OR). A significant relationship between gender and diastolic hypertension was observed (OR= 2.4; 95%CI = 1.23 – 5.09; p 0.05). in conclusion, there is a relationship between gender and diastolic hypertension incidence among obese adolescents. Boys are more at risk of obesity compared to girls.

Appendicitis is one of the most common surgical emergencies in children. In the USA, there are 70,000 cases are diagnosed each year. Acute appendicitis is a rare case, barely considered in the diagnoses, and probably causes acute abdominal sepsis in neonates. It affects males generally 75% of the time and 25%-50% of all reported cases occur in premature infant. Almost 50 cases have been reported over the last 30 years. We reported a 5 month-old baby girl whom transferred to our hospital from a peripheral hospital. Previously, the baby diagnosis was low-type obstruction. At the time of admission to our hospital, the baby presented with a history of abdominal distension and did not pass stools after 48 h. Oxygen and oral gastric tube were administered. Exploratory laparotomy surgery was performed through a transverse incision. This report is a retrospective review of one patient with appendicitis perforation presented in our hospital.

Containment effort in the COVID-19 pandemic could disrupt circadian rhythms which play an essential role in the development of mood and anxiety disorders. Exercise is one of several recommendations for anxiety coping during the COVID-19 pandemic. However, not every person has a similar response to an exercise stimulus and gets the same optimal benefits. For the best exercise results, we must consider individual needs and capacities, including circadian rhythm, in determining the exercise dose. This review briefly summarizes the exercise’ mechanism as an anxiolytic through skeletal muscle-brain crosstalk and designing exercise program with the individual optimal dose as part of anxiety coping management in the COVID-19 pandemic situation, considering exercise as good stress and circadian rhythm.