Malignant primary and metastatic brain tumors are group of malignancies radiologically difficult to distinguish between one another. Meanwhile, the treatment regimens between the two entities are very different. The right regimen can maintain patient’s survival. MRI is the modality of choice for diagnosing brain tumors; although, malignant primary brain tumors and solitary metastases appear similar on conventional MRI. The difference in the pathophysiology of peritumoral edema in malignant primary and metastatic brain tumors has the potential for differentiation of the two entities. In malignant primary brain tumors, tumor cell infiltration occurs in the edema area, meaning that the peritumoral edema is narrower than that of the metastases. This study analyzed the ratio of peritumoral edema volume to tumor (EP/T volume ratio) in malignant primary and metastatic brain tumors by means of MRI examination with a cross-sectional design, using MRI data on FLAIR and T1WI sequences with contrast in malignant brain tumor of patients that have been pathologically proven. Then, volume contouring was performed on peritumoral edema (EP) and tumor (T), and comparation was done to obtain the EP/T volume ratio. The ratio of EP/T volume data in both groups was analyzed using the Mann–Whitney test with the SPSS 22 software. The results of statistical analysis revealed that the EP/T volume ratio of the malignant primary brain tumor group was smaller with a median value (max-min) of 1.1 (5.65-0.17) and in the metastatic group, 2.3 (64.03-0.09). There was a significant difference in the EP/T volume ratio between the two groups, which the brain metastatic tumor group have a double ratio of EP/T with a value of p=0.008 (p<0.05).

Background: Aspergilloma is a fungal infection that can cause recurrent hemoptysis. One of the treatment modalities is embolization, which has a success rate of 85% to 100%, although the recurrence rate may reach 10% to 33%. Case Illustration: A 29-year-old female came to the emergency ward with recurrent hemoptysis. She had a history of tuberculosis with completed treatment 7 years ago. Chest radiography showed left lung tuberculosis with emphysematous lung. Chest CT with contrast revealed an air-crescent sign, and culture from bronchoalveolar lavage (BAL) showed Aspergillus spp. Then, she was diagnosed with pulmonary aspergilloma. Embolization was performed in the left internal mammary artery, and the blushing was decreased by 80%. However, the hemoptysis was still recurrent; a second embolization was performed in the left supreme intercostal artery, costocervical trunk artery, and bronchial artery, resulting in no blushing. The patient had no further episodes of hemoptysis, and her antifungal therapy was changed from fluconazole to voriconazole. Discussion: Recurrent hemoptysis can be caused by pulmonary aspergilloma. Embolization is usually done to reduce bleeding before surgery. The patient had performed embolization 2 times with no further episodes of hemoptysis. Surgical resection as a definitive treatment was recommended in this case, but the patient refused. Therefore, the patient’s management was optimized using voriconazole and embolization for the hemoptysis. Conclusion:  Management of recurrent hemoptysis in patients with aspergilloma may include embolization and antifungal treatment which give improved clinical outcomes. Keywords:  recurrent hemoptysis, embolization, aspergilloma, tuberculosis

No abstract

The use of healthcare monitoring systems in hospitals and other health facilities has grown exponentially, and portable healthcare monitoring systems based on new technologies have emerged as a severe concern in several countries throughout the globe. The emergence of the Internet of Things (IoT) technology has contributed to the progress of healthcare from face-to-face counseling to telemedicine. The project aims to design a reliable health monitoring system utilizing the IoT, Arduino, and Android applications. It can be used to measure body temperature, heart rate, and level of oxygen in the blood in both hospitals and homes. The system is also capable to verify that the transmission of the sensor’s data to the host computer is done in real-time. The results show that the system reading is approximately 100% accurate as of the purchased measuring instruments or actual devices. Therefore, doctors and family members can now monitor and track the patient’s health anywhere through this smart health monitoring system.

Gonore adalah infeksi menular seksual (IMS) yang dapat terjadi pada laki-laki dan perempuan yang disebabkan oleh bakteri diplokokus Gram negatif, Neisseria gonorrhoeae. Insiden infeksi gonore tahun 2014 di RSUD. Dr. Saiful Anwar Malang (RSSA) diketahui sebanyak 60 orang dari total 399 pasien IMS. Tahun 2015, tercatat 34 orang pasien infeksi baru gonore. Kejadian ini meningkat karena beberapa faktor di antaranya adalah pengetahuan dan hubungan seksual berisiko tinggi, yang tampak saat ini merupakan sebagian kecil dari keseluruhan pasien IMS. Tujuan penelitian adalah untuk mengetahui pengaruh tingkat pengetahuan terhadap hubungan seksual berisiko tinggi serta terhadap kejadian infeksi gonore di RSUD Dr. Saiful Anwar Malang. Populasi adalah pasien laki-laki terinfeksi gonore yang datang ke RSSA berjumlah 93 orang dan berdasarkan formula Lemeshow didapatkan. sampel sebanyak 36 responden. Pengambilan sampel dengan metode consecutive sampling. Path analysis (analisis jalur) dilakukan untuk menemukan penjelasan mengenai pengaruh langsung dan tidak langsung dari variabel tingkat pengetahuan, hubungan seksual berisiko tinggi, dan infeksi gonore berdasarkan beberapa pertimbangan teoritis serta pengetahuan peneliti yang ditampilkan dalam bentuk diagram jalur yang berfungsi untuk membantu dalam melakukan konseptualisasi masalah yang kompleks dan mengenai implikasi empirik dari teori yang sedang diuji. Hasil menunjukkan bahwa tingkat pengetahuan memiliki pengaruh yang signifikan dan berpengaruh positif terhadap hubungan seksual berisiko tinggi. Dapat disimpulkan bahwa tingkat pengetahuan terhadap hubungan seksual berisiko tinggi memiliki pengaruh yang signifikan terhadap infeksi gonore, namun tidak berpengaruh signifikan terhadap kejadian infeksi gonore. Serta, tingkat pengetahuan tidak berpengaruh signifikan terhadap infeksi gonore melalui hubungan seksual berisiko tinggi, dan hubungan seksual berisiko tinggi tidak berpengaruh signifikan terhadap kejadian infeksi gonore. Kata kunci: hubungan seksual berisiko tinggi, infeksi gonore, tingkat pengetahuan.