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Malueka R, Hartanto R, Setyawan N, Rismawan A, Dananjoyo K, Basuki E, Asmedi A, Dwianingsih E. EPID-01. PROFILE AND OUTCOME OF PATIENTS WITH BRAIN METASTASES IN YOGYAKARTA, INDONESIA. Neuro Oncol 2022. [PMCID: PMC9660298 DOI: 10.1093/neuonc/noac209.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
BACKGROUND
Metastatic brain tumors cause significant morbidity and mortality and often have a poor prognosis. Currently, there are limited epidemiology data on metastatic brain tumors in Indonesia. This study aimed to identify demographic, clinical characteristics, and outcomes of patients with brain metastases in Yogyakarta Province, Indonesia.
METHODS
Demographic and clinicopathological data were collected from medical records of brain tumor patients admitted to six major hospitals in Yogyakarta Province, Indonesia, for five years (2015–2019).
RESULTS
In total, 395 patients were included. Most patients were females (254, 64.3%). The mean age of the patients was 51.6±15.0 years old. Headache was the most common presenting symptom (53.2%), followed by a motoric deficit (48.4%), cognitive impairment (24.3%), loss of consciousness (21.3%), and a seizure (20.8%). The most common primary tumors that metastasize to the brain were lung (36.6%) and breast cancer (32.7%). The median overall survival of patients with brain metastases was 11±2.36 months.
CONCLUSION
Lung and breast cancers are the most common source of brain metastases in Yogyakarta, Indonesia. Overall survival of patients with brain metastases in this area is still relatively short.
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Affiliation(s)
- Rusdy Malueka
- Neurology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia , Yogyakarta , Indonesia
| | - Rachmat Hartanto
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia , Yogyakarta , Indonesia
| | - Nurhuda Setyawan
- Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia , Yogyakarta , Indonesia
| | - Alfian Rismawan
- Neurology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia , Yogyakarta , Indonesia
| | - Kusumo Dananjoyo
- Neurology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia , Yogyakarta , Indonesia
| | - Endro Basuki
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia , Yogyakarta , Indonesia
| | - Ahmad Asmedi
- Neurology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia , Yogyakarta , Indonesia
| | - Ery Dwianingsih
- Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia. , Yogyakarta , Indonesia
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Malueka RG, Hartanto RA, Setyawan NH, Fauzi DNF, Damarjati KR, Rismawan A, Septianastiti MA, Wicaksono AS, Dananjoyo K, Basuki E, Asmedi A, Dwianingsih EK. Association of Hormonal Contraception with Meningioma Location in Indonesian Patients. Asian Pac J Cancer Prev 2022; 23:1047-1051. [PMID: 35345379 PMCID: PMC9360935 DOI: 10.31557/apjcp.2022.23.3.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Meningioma is the most common primary intracranial tumor. Previous studies have shown the possible association between hormonal contraceptive use and meningioma location. Therefore, this study aimed to analyze the association between the history of hormonal contraceptive use and the location of meningioma in the Indonesian population. Methods: In total, 99 histologically confirmed female meningioma patients admitted to Dr. Sardjito General Hospital Yogyakarta, Indonesia, were included in this study. Data on hormonal contraception and other variables were collected from medical records. Meningioma locations were determined from brain Magnetic Resonance Imaging (MRI) or Computerized Tomography (CT) scan before surgery. Results: Seventy-two (72.7%) patients had a history of hormonal contraceptive use. The subjects consist of 83 (83.8%) WHO grade I and 16 (16.2%) WHO grade II and III tumors. A total of 57 (57.6%) tumors were located in the spheno-orbital region. We found a significant association between hormonal contraceptive use and meningioma location in the spheno-orbital region (Odds ratio (OR) 2.573, p=0.038). This resulted in the patients in the hormonal contraception group having more visual impairment (p=0.044). Conclusion: The use of hormonal contraception is associated with the location of meningioma in the spheno-orbital region.
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Affiliation(s)
- Rusdy Ghazali Malueka
- Neurology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Rahmat Andi Hartanto
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Nurhuda Hendra Setyawan
- Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Dyajeng Noor Firdaus Fauzi
- Neurology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Khoironi Rachmad Damarjati
- Neurology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Alfian Rismawan
- Neurology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Maria Alethea Septianastiti
- Neurology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Adiguno Suryo Wicaksono
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Kusumo Dananjoyo
- Neurology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Endro Basuki
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ahmad Asmedi
- Neurology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ery Kus Dwianingsih
- Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
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Bastian RA, Pramusinto H, Basuki E, Marianne M. Ventriculoperitoneal Shunt Infection: A Study about Age as a Risk Factor in Hydrocephalus Pediatrics. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Shunt infection is one of the dreaded and serious complications following ventriculoperitoneal shunt (VP shunt) insertion, especially in a pediatric population. Numerous risk factors have been identified, particularly in developing countries, indicating that age may play an essential element in the pathogenesis of shunt infection, typically in patients <1-year-old. However, a few research demonstrate the inverse result.
AIM: The purpose of this was to determine the relationship between age and shunt infection so that it can be taken into consideration when performing VP shunt insertion.
METHODS: From January 2017 to December 2019, 98 pediatric patients with hydrocephalus who underwent VP shunt insertion were retrospectively reviewed to determine the relationship between age and shunt infection. We evaluated the microbiology results and management of shunt infection in patients with shunt infection.
RESULTS: Fifteen (15.15%) of 98 patients developed shunt infection. Patients aged >3–6 months had a significantly increased risk of shunt infection (p = 0.04; RR = 4.15; CI 95% = 1.19–14.45). Staphylococcus aureus was the most frequently encountered pathogen in pediatric patients with shunt infection (53.3%), and the most common management for shunt infection was complete removal of the shunt and systemic antibiotics followed by re-insertion of the shunt after the cerebrospinal fluid was sterile (46.6%).
CONCLUSION: We conclude that age, especially those aged >3–6 months, has a significantly higher risk of shunt infection in pediatric patients.
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Ar Rochmah M, Gofir A, Satiti S, Rachmat Setyawan T, Endro Wibisono A, Basuki E. P-OT023. Intracranial subdural empyema mimicking acute on chronic subdural hematoma: a case report. Clin Neurophysiol 2021. [DOI: 10.1016/j.clinph.2021.02.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Manusubroto W, Wicaksono AS, Tamba DA, Sudiharto P, Pramusinto H, Hartanto RA, Basuki E. In Reply to "Letter to the Editor Regarding Neurosurgery Services in Dr. Sardjito General Hospital, Yogyakarta, Indonesia, During the COVID-19 Pandemic: Experience from a Developing Country". World Neurosurg 2021; 146:417-419. [PMID: 33607744 DOI: 10.1016/j.wneu.2020.11.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Wiryawan Manusubroto
- Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
| | - Adiguno S Wicaksono
- Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia.
| | - Daniel Agriva Tamba
- Resident of Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
| | - Paulus Sudiharto
- Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
| | - Handoyo Pramusinto
- Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
| | - Rachmat Andi Hartanto
- Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
| | - Endro Basuki
- Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
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Wicaksono AS, Tamba DA, Sudiharto P, Basuki E, Pramusinto H, Hartanto RA, Ekong C, Manusubroto W. Neurosurgery residency program in Yogyakarta, Indonesia: improving neurosurgical care distribution to reduce inequality. Neurosurg Focus 2021; 48:E5. [PMID: 32114561 DOI: 10.3171/2019.12.focus19831] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 12/19/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Educating future neurosurgeons is of paramount importance, and there are many aspects that must be addressed within the process. One of the essential issues is the disproportion in neurosurgical care, especially in low- and middle-income countries (LMICs). As stated in their report "Global Surgery 2030," The Lancet Commission on Global Surgery has emphasized that the availability of adequate neurosurgical care does not match the burden of neurosurgical disease. A strong partnership with the local and national government is very desirable to improve the way everyone addresses this issue. In addition, international collaborative effort is absolutely essential for the transfer of knowledge and technology from a developed country to an LMIC. This paper shows what the authors have done in Yogyakarta to build an educational model that helps to improve neurosurgical care distribution in Indonesia and reduce the inequity between provinces. METHODS The authors gathered data about the number of neurosurgical procedures that were performed in the sister hospital by using data collected by their residents. Information about the distribution of neurosurgeons in Indonesia was adapted from the Indonesian Society of Neurological Surgeons. RESULTS The data show that there remains a huge disparity in terms of distribution of neurosurgeons in Indonesia. To tackle the issue, the authors have been able to develop a model of collaboration that can be applied not only to the educational purpose but also for establishing neurosurgical services throughout Indonesia. Currently they have signed a memorandum of understanding with four sister hospitals, while an agreement with one sister hospital has come to an end. There were more than 400 neurosurgical procedures, ranging from infection to trauma, treated by the authors' team posted outside of Yogyakarta. CONCLUSIONS Indonesia has a high level of inequality in neurological surgery care. This model of collaboration, which focuses on the development of healthcare providers, universities, and related stakeholders, might be essential in reducing such a disparity. By using this model, the authors hope they can be involved in achieving the vision of The Lancet Commission on Global Surgery, which is "universal access to safe, affordable surgical and anesthesia care when needed."
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Affiliation(s)
- Adiguno S Wicaksono
- 1Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia; and
| | - Daniel Agriva Tamba
- 1Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia; and
| | - Paulus Sudiharto
- 1Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia; and
| | - Endro Basuki
- 1Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia; and
| | - Handoyo Pramusinto
- 1Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia; and
| | - Rachmat Andi Hartanto
- 1Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia; and
| | - Chris Ekong
- 2Division of Neurosurgery, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
| | - Wiryawan Manusubroto
- 1Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia; and
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Manusubroto W, Wicaksono AS, Tamba DA, Sudiharto P, Pramusinto H, Hartanto RA, Basuki E. Neurosurgery Services in Dr. Sardjito General Hospital, Yogyakarta, Indonesia, During the COVID-19 Pandemic: Experience from a Developing Country. World Neurosurg 2020; 140:e360-e366. [PMID: 32442732 PMCID: PMC7237373 DOI: 10.1016/j.wneu.2020.05.124] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Most articles describing the effect of the coronavirus disease 2019 (COVID-19) pandemic on neurosurgical services have been from developed countries. We report our experience in carrying out neurosurgical services at Dr. Sardjito General Hospital, Yogyakarta, Indonesia, during the time of the pandemic. METHODS To collect information on the effect of the pandemic in Indonesia and Yogyakarta, we gathered data from the Indonesian Ministry of Health's online database for the national data and local government records for the local data (including records of Dr. Sardjito General Hospital Division of Neurosurgery). RESULTS Compared with other countries, Indonesia has not been severely hit by the impact of COVID-19. To increase our understanding of the natural history of the pandemic, we divided the period into 4 phases: phase 1 (when there were confirmed cases in Indonesia but no cases in Yogyakarta), phase 2 (when the first case in Yogyakarta was detected), phase 3 (when the cumulative cases surpass their peak), and phase 4 (when the pandemic ends). At the time of this writing, we were still in phase 2 and in this phase, we experienced a decrease in the number of emergency surgical procedures, from an average of 4 to 2.4 per week. Moreover, the number of elective operations dropped from an average of 12 to 9 per week. CONCLUSIONS A pandemic, such as COVID-19, reduces both inpatient and outpatient neurosurgical activities. A comprehensive plan can improve both utilization and safety of the neurosurgical staff.
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Affiliation(s)
- Wiryawan Manusubroto
- Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
| | - Adiguno Suryo Wicaksono
- Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia.
| | - Daniel Agriva Tamba
- Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
| | - Paulus Sudiharto
- Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
| | - Handoyo Pramusinto
- Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
| | - Rachmat Andi Hartanto
- Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
| | - Endro Basuki
- Division of Neurosurgery, Department of Surgery, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
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Wolffers I, Triyoga RS, Basuki E, Yudhi D, Deville W, Hargono R. Pacar and Tamu: Indonesian women sex workers' relationships with men. Cult Health Sex 1999; 1:39-53. [PMID: 12295114 DOI: 10.1080/136910599301157] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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