Multiple Myeloma in Indonesia

Tujuan: Melihat karakteristik klinis pasien mieloma multipel di Indonesia.Metode: studi deskriptif, potong lintang, multisenter, dilakukan pada November 2008 sampai dengan November 2009. Tujuh puluh data pasien mieloma multipel diambil dari seluruh Indonesia, dari kelompok studi mieloma multipel di Indonesia.Hasil: Lebih dari enam puluh persen pasien mieloma multipel di Indonesia berusia lebih dari 50 tahun (65,71%) dengan perbadingan jenis kelamin yang kurang lebih sama antara pria dan wanita. Kurang lebih lima puluh persen pasien bersuku Jawa, dengan tingkat pendidikan Sekolah Menengah Atas (SMA) dan tidak bekerja.Lima puluh tiga persen pasien memiliki kurang dari 30% sel plasma di sumsum tulangnya dengan 70% pasien tidak memiliki proteinuria Bence Jones dan 80% pasien memiliki serummonoclonal gammopathyyang positif. Persentase sel plasma di sumsum tulang lebih banyak ditemukan pada pasien yang berusia lebih muda (34,05% vs. 24,24% vs. 7,5%). Dilaporkan bahwa hampir lima puluh persen pasien memiliki stadium IIIA berdasarkan klasifikasiDurie Salmon Staging system. Stadium penyakit yang lebih tinggi berkaitan dengan usia yang lebih tua berdasarkan klasifikasiInternational Myeloma Working Group. Melphalan/prednisone merupakan pilihan kemoterapi yang paling banyak digunakan (59,7%) dengan hasil pengobatan terbanyak adalah respons parsial.Kesimpulan: karakteristik pasien mieloma multipel di Indonesia didominasi oleh suku Jawa, dengan tingkat pendidikan SMA dan tidak bekerja. Sebagian besar pasien memiliki sel plasma kurang dari 30% di sumsum tulang, proteinuria Bence Jones yang negatif, dan serummonoclonal gammopathyyang positif. Hampir lima puluh persen pasien memiliki stadium IIIA dengan melphalan/prednison sebagai jenis kemoterapi terbanyak yang diberikan dengan hasil terbaik sebagian besar adalah respon parsial

Estimating The Value of PT. Hanjaya mandala Sampoerna Tbk. Using the Discounted cash Flow Method

The success of Sampoerna attracted Philip Morris International Inc. (“PMIâ€), which is one of the leading tobaco companies in the world. In May 2005, the majority ownership of Sampoerna was acquired by Philip Morris Indonesia, an affiliate of PMI.In the capital market, the share price of PT HM Sampoerna Tbk. rises after the acquisition. The end of 2005 the share price of HMSP around Rp 8,000 and continued rising until the recent share price of Rp 51,200 in 2012. The author computes intrinsic share value of the company as of 2012.For the purpose of this final project the author will use Discounted Cash Flow method. The result the author’s computation is an intrinsic value of Rp 43,392 at august of 2012. While the share price in 2012 of PT HM Sampoerna Tbk. in capital market is Rp 51.200. Which mean the current share price of PT HM Sampoerna Tbk. is overvalue.PT HM Sampoerna Tbk. has a minimum portion of shares in capital market. Actually, the current outstanding shares only 2.05% from total shares. Therefore the intrinsic value of the author’s computation may not represent the share price of the company in total. In author opinion, the acquisitions cause a positive perception in public that increase the share price.Keywords:  intrinsic share value, discounted cash flow, income approach

Analysis of the influence of residual alveolar bone height on sinus augmentation outcomes

Introduction Maxillary sinus augmentation is a predictable implant site development technique for posterior atrophic maxillary ridges. However, graft consolidation requires adequate angiogenesis and migration of osteogenic cells from native bone. Therefore, the amount of residual bone height ( RBH ) may play a role in the rate of graft maturation. The purpose of this study was to analyze the influence of RBH in the histomorphometric outcomes of maxillary sinus augmentation procedures. Material and methods Patients in need of sinus augmentation were recruited for the study. Customized radiographic guides were fabricated and a cone‐beam computerized tomography scan was obtained at baseline. Two examiners measured RBH on the scans at the locations marked by the radiographic guide. Sinus grafting was performed by a lateral window approach using a particulated mineralized allograft. Patients were followed up for 6 months. At the time of implant placement, bone core biopsies were harvested using the radiographic guide, which was converted into a surgical guide. Samples were histomorphometrically analyzed. Proportion of vital bone (% VB ), remaining allograft particles (% RA ), and non‐mineralized tissue (% NMT ) were quantified. Categorical analysis of correlation of RBH (<4 or ≥4 mm) with% VB and% RA was performed using a statistical model. Results Twenty‐one patients underwent sinus augmentation for a total of 21 sinuses. One patient developed an infection after grafting and was excluded. Histomorphometric analysis revealed that mean% VB was 20.47 ± 18.25, mean % RA was 29.04 ± 24.94, and average % NMT was 50.47 ± 12.76. No significant correlation between RBH and % VB ( r  = 0.016; P  =   0.951), and RBH and % ( r  = 0.009; P  =   0.971) was found. Similarly, categorical analysis of correlation showed no statistical significance. Conclusion These findings suggest that the remaining alveolar bone height does not appear to influence the maturation and consolidation of an allograft in the maxillary sinus.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93580/1/clr2270.pd

Estimating The Value of PT. Hanjaya mandala Sampoerna Tbk. Using the Discounted cash Flow Method

The success of Sampoerna attracted Philip Morris International Inc. (“PMIâ€), which is one of the leading tobaco companies in the world. In May 2005, the majority ownership of Sampoerna was acquired by Philip Morris Indonesia, an affiliate of PMI.In the capital market, the share price of PT HM Sampoerna Tbk. rises after the acquisition. The end of 2005 the share price of HMSP around Rp 8,000 and continued rising until the recent share price of Rp 51,200 in 2012. The author computes intrinsic share value of the company as of 2012.For the purpose of this final project the author will use Discounted Cash Flow method. The result the author’s computation is an intrinsic value of Rp 43,392 at august of 2012. While the share price in 2012 of PT HM Sampoerna Tbk. in capital market is Rp 51.200. Which mean the current share price of PT HM Sampoerna Tbk. is overvalue.PT HM Sampoerna Tbk. has a minimum portion of shares in capital market. Actually, the current outstanding shares only 2.05% from total shares. Therefore the intrinsic value of the author’s computation may not represent the share price of the company in total. In author opinion, the acquisitions cause a positive perception in public that increase the share price.Keywords:  intrinsic share value, discounted cash flow, income approach

LASER-ASSISTED CROWN LENGTHENING: CLINICAL EFFICACY AND ADVANTAGES OVER CONVENTIONAL TECHNIQUES (SYSTEMATIC REVIEW)

Introduction: Crown lengthening is a widely recognized dental procedure with both aesthetic and functional purposes. It involves the reduction of periodontal hard and soft tissues to obtain supracrestal tooth length, resulting in longer clinical crowns and adequate supracrestal tissue attachment. Laser therapy has emerged as a promising alternative that is currently developing in the field of periodontics and offers several advantages. This review aims to synthesize the current research on the clinical efficacy of laser-assisted crown lengthening procedures and highlight their advantages over conventional methods. Review: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search was conducted in electronic databases PubMed, Scopus, Embase, and Google Scholar for human studies published from 2017 to April 2023. Out of 213 identified and screened studies, three original articles were included in the analysis. Two clinical trial studies used Er,Cr:YSGG while one study used Er:YAG for crown lengthening procedures involving gingiva and alveolar bone reduction, with a 3-month follow-up period. Compared to conventional crown lengthening, the laser-assisted approach showed comparable increases in clinical crown length. However, the laser-assisted group demonstrated better gingival margin stability, improved soft tissue healing, and minimal damage to adjacent tissues. Furthermore, there was a statistically significant lower bacterial load and less post-surgery pain with laser-assisted crown lengthening compared to the conventional method. Conclusion: In cases where both gingival and bone reduction are required, laser-assisted crown lengthening using Er,Cr:YSGG and Er:YAG can be considered a minimally invasive alternative with several advantages over conventional procedures

Efficacy and Safety of In-Asia-Manufactured RhG-CSF 300 Mcg as Primary Prophylaxis for Prevention of CHOP Chemotherapy-induced Severe Neutropenia in Elderly Patients with Lymphoma Non-Hodgkin

Penelitian open-label, non-komparatif ini dilakukan untuk mengevaluasi efektivitas dan keamanan recombinant human G-CSF produksi Asia sebagai profilaksis primer dalam pencegahan neutropenia derajat berat pada pasien usia lanjut (>60 tahun) dengan limfoma non-Hodgkin (LNH) derajat sedang dan lanjut (stadium II,III,IV) yang mendapat terapi CHOP (siklofosfamid, doksorubisin, vinkristin). Profilaksis primer recombinant human G-CSF (rhG-CSF) produksi Asia dapat mengurangi median durasi neutropenia derajat 4 pada siklus sitostatistika ke-1 dan ke-2 menjadi tiga hari, sementara median durasi neutropenia derajat 3 pada siklus sitostistika ke-1 menjadi dua hari dan pada siklus sitostatistika ke-2 menjadi dua setengah hari, dari median durasi neutropenia grade 4 dan grade 3 tanpa G-CSF, yaitu empat dan lima hari berurutan. Febrile neutropenia ditemukan pada 7 pasien yang mendapat rhG-CSF produksi Asia (24.1%), lebih rendah jika dibandingkan studi tanpa rhG-CFS (31.3-34% FN). Tiga pasien mendapat rhG-CSF produksi Asia (10,3%) dirawat inap akibat febrile neutropenia, lebih rendah jika dibandingkan rawat inap pada studi tanpa rhG-CSF (24-28%). Kejadian yang tidak diinginkan terbanyak adalah mual dan muntah yang terjadi pada 9 (31%) pasien. Sebagai kesimpulan, penggunaan rhG-CSF produksi Asia untuk profilaksis primer pada pasien LNH usia lanjut yang mendapat regimen CHOP dapat mengurangi durasi neutropenia, mengurangi kejadian febrile neutropenia, dan angka rawat inap akibat febrile neutropenia

Correlation of clinical and radiographic severity of periodontitis with furcation involvement: Evaluation of periapical radiographs and Cone-beam Computed Tomography

Objectives: To analyze the correlation of clinical and radiographic features in periodontitis with furcation involvement. Materials and Methods: Cross-sectional analytic study of 30 mandibular molars from 13 patients (8 males and 5 females), who had periodontitis with furcation involvement, with purposive sampling. Clinical, periapical and CBCT examination were then carried out&nbsp;. Assessment for clinical dan CBCT based on modified Glickman classification. Correlation test was performed with Kendall's Tau_b. Results: There was a significant difference between subjects of non CBCT group (clinical (p=0,01) and periapical (p=0,026)), with subjects examined by CBCT.&nbsp; However there was no difference between the clinical and periapical group. There is a correlation between furcation involvement on CBCT and periapical group (r=0,528; p=0,003). Conclusion: There was no correlation between furcation involvement on clinical examination with periapical radiographs and CBCT. The correlation is only seen between periapical radiographs and CBCT

Disfungsi Autonom pada Pasien Penyakit Jantung Hipertensi Asimptomatik: Hasil evaluasi pemulihan laju jantung

Background.Imbalance of the autonomic nervous system has been known to have an important role in the pathophysiology of chronic heart failure (CHF). How early this imbalance occurs in CHF patients has not much been studied. We hypothesized that imbalance of the autonomic function evaluated with heart rate recovery (HRR) already occur in asymptomatic hypertensive patients with left ventricular hypertrophy (LVH) as subset of an early stage of CHF patients . Methods.Sixty two hypertensive patients (31 with LVH by echocardio-graphic criteria and 31 patients without LVH ) underwent treadmill exercise testing using the Bruce protocol and immediate supine on the recovery phase. Heart rate recovery was evaluated on minute 1 and 2 of the recov-ery phase and considered abnormal if = 18x/min in minute-1(HRR1) and = 42x/min in minute-2 (HRR2).Results.The mean HRR was significantly lower in hypertensive patients with LVH then the ones without LVH (19,48 ± 7,21 vs 26,45 ± 8,03) in minute-1, and (38,35 ± 11,19 vs 45,35 ± 9,97) in minute-2. An abnormal-ity in HRR1 percentage was found in 48.4% in patients with HHD and in 12.9% in patients without HHD. An inverse weak correlation (r = 0.329, p = 0.009) was found between LV mass index and HRR1.Conclusions.Abnormality of the HRR has already been found in hyper-tensive patients with LVH without signs or symptom of CHF suggesting an early occurrence of imbalance of the autonomic nervous system in early stage of CHF.Latar belakang. Gangguan keseimbangan dari sistem saraf autonom telah diketahui memiliki peran penting dalam patofisiologi gagal jantung kronik (GJK). Seberapa dini gangguan keseimbangan ini timbul pada pasien GJK belum terlalu banyak diteliti. Kami memiliki hipotesa bahwa gangguan dari keseimbangan sistem saraf autonom yang dinilai berdasarkan evaluasi pemulihan laju jantung (PLJ) sudah timbul pada pasien-pasien hipertensi dengan hipertrofi ventrikel kiri (HVK) yang asimptomatik sebagai subset pasien GJK tahap awal.Metode.Enampuluh dua pasien hipertensi (31 pasien dengan HVK berdasarkan kriteria ekokardiografi dan 31 pasien tanpa HVK) menjalani uji latih jantung dengan menggunakan protokol Bruce dan segera dibaringkan pada awal fase pemulihan. Pemulihan laju jantung dinilai pada menit 1 dan 2 dari fase pemulihan, dan dikatakan abnomal apabila =18 x/menit pada menit-1(PLJ1) dan =42 x/menit pada menit-2 (PLJ2).Hasil.Rata-rata PLJ secara signifikan didapatkan lebih rendah pada pasien-pasien hipertensi dengan HVK dibandingkan pasien-pasien hipertensi tanpa HVK (19,48 ± 7,21 vs 26,45 ± 8,03) pada menit-1, and (38,35 ± 11,19 vs 45,35 ± 9,97) pada menit-2. Didapatkan persentase PLJ1 yang abnormal pada 48.4% pasien dengan HVK dan pada 12.9% pasien tanpa HVK. Korelasi lemah didapatkan antara LV mass indexdan PLJ1(r = 0.329, p = 0.009).Kesimpulan. Abnormalitas PLJ sudah didapatkan pada pasien-pasien hipertensi dengan HVK tanpa tanda dan gejala gagal jantung. Hal ini menunjukan keberadaan gangguan keseimbangan dari sistem saraf autonom pada tahap awal dari GJK

CORRELATION OF SERUM OSTEOCALCIN LEVEL AND PERIODONTAL ATTACHMENT LOSS WITH OSTEOPOROSIS RISK STATUS IN POSTMENOPAUSAL WOMEN

Objective: To assess the relationship between serum osteocalcin and periodontal clinical attachment loss (CAL) in postmenopausal women in relation to their osteoporosis risk status.Methods: A cross-sectional study was carried out on 71 postmenopausal women in Kenari District, Central Jakarta, Indonesia. The periodontal examination for all the subjects included a CAL measurement. The serum osteocalcin level was analyzed using ELISA.Results: The correlation between the serum osteocalcin level in patients with CAL and the risk of osteoporosis was analyzed with the Spearman test. The normal group had 29 subjects (40.84%), the osteopenic group had 23 subjects (32.39%), and the osteoporotic group had 19 subjects (26.76%). There was a significant correlation between CAL and the osteoporosis high-risk status (p&lt;0.05) and no significant correlation between the serum osteocalcin level and the osteoporosis status (p&gt;0.05).Conclusion: No correlation was found between CAL and the serum osteocalcin level (p&gt;0.05)

Association of Clinical Features and Hematological Laboratories between Ph (+)/BCR-ABL (+) Chronic Myeloid Leukemia and Other Type of Ph/BCR-ABL Chronic Myeloid Leukemia

Introduction. Patients with chronic phase Chronic Myeloid Leukemia (CML) at Hematology-Medical Oncology Clinic Department of Internal Medicine dr. Cipto Mangunkusumo National Hospital who haveperformed cytogenetic and RTPCR BCR-ABL examination showed: Ph (+)/BCR-ABL (+) CML and other type of Ph/BCR-ABL CML. This study aims to identify the clinical features and hematological laboratories of chronic phase CML, the proportion of Ph (+)/BCR-ABL (+) CML, and association of clinical features and hematological laboratories between Ph (+)/BCR-ABL (+) CML and other type of Ph/BCR-ABL CML. Methods. This is a cross-sectional study. The samples were taken by consecutive method. We used Chi-square test and logistic regression analysis. Association between variables considered significant when p value <0.05. Results. There were 80 subjects with chronic phase CML. Mean of age was: 39.4 (standard deviation 13.1) years. The comparison of clinical features and hematological laboratories between Ph (+)/BCR-ABL (+) CML and other type of Ph/BCR-ABL CML were: Symptomatic 80.6% : 100%; splenomegaly 82% : 92.3%; median of Hb 10,3 g/dL : 10,3 g/dL; median of white blood cell 124.620 : 127.050; median of thrombocyte 455.000 : 487.000. Bivariate and multivariate analysis showed no significant association of clinical features and hematological laboratories between Ph (+)/BCR-ABL (+) CML and other type of Ph/BCR-ABL CML. Conclusion. There was no significant association of clinical features and hematological laboratories between Ph (+)/BCR-ABL (+) CML and other type of Ph/BCR-ABL CML