54 research outputs found
Perancangan Ulang Tata Letak Fasilitas Unit Industrial Gas Turbine Engine PT. GMF Aeroasia
No full textTata letak fasilitas merupakan faktor penting yang menunjang operasional
sistem produksi. Dengan tata letak fasilitas dan area yang baik, maka aktivitas
produksi juga akan berjalan sesuai dengan keinginan perusahaan. Selain itu,
perancangan tata letak manufaktur yang baik mampu mereduksi biaya sebesar
50% dari total biaya operasional perusahaan. Unit industrial gas turbine engine
(IGTE) merupakan salah satu unit bisnis usaha baru milik PT. GMF AeroAsia.
Sebagai unit yang tergolong baru, perancangan tata letak pada IGTE masih
dilakukan berdasarkan subjektifitas manajemen. Sehingga dilakukan penelitian
untuk memberikan rancangan tata letak yang lebih berdasar pada optimasi
kualitatif dan kuantitatif.
Dalam penelitian ini dibahas mengenai perancangan ulang tata letak fasilitas
dari lantai maintenance unit industrial gas turbine engine PT. GMF AeroAsia.
Metode yang digunakan terdiri dari 2 jenis yaitu optimasi kualitatif dan optimasi
kuantitatif. Optimasi kualitatif dilakukan dengan teknik konvensional
menggunakan activity relationship chart (ARC) dan activity realtionship diagram
(ARD). Sedangkan optimasi kuantitatif menggunakan algoritma automated layout
design program (ALDEP).
Hasil dari penelitian ini adalah terdapat perpindahan lokasi empat area dari
tata letak eksisting. Area tersebut adalah general repair, NDT Area, repair
incoming & outgoing, red dye penetrant inspection, dan inspection incoming &
outgoing. Hasil perhitungan kriteria evaluasi menunjukkan hasil evaluasi aliran
bahan dari tata letak hasil algoritma ALDEP mengalami penurunan sebesar 0,62%
dari hasil evaluasi aliran bahan tata letak awal yang digunakan saat ini.
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Facilities layout is an important factor to support operations in production
system. With a well-designed facilities layout, the production activity can perform
at its best as the company expects. Beside that, a well-planned facilities design
can reduce up to 50% of companies operational cost. Industrial gas turbine
engine (IGTE) unit is one of the new business sector from PT. GMF AeroAsia. As
a new business sector, the facilities layout is designed based on managerial
perspective, overlooking the optimization aspects in the process. Therefore, This
research tries to provide a layout design for IGTE unit based on qualitative and
quantitative optimization.
This research studiesa re-designing facilities layout in at PT GMF AeroAsia,
especially in maintenance area of industrial gas turbine engine unit. This study
uses both qualitative and quantitative optimization methods. The qualitative
optimization is performed using conventional technique, activity relationship
chart (ARC), and activity relationship diagram (ARD) while the quantitative
method is performed using automated layout design program (ALDEP) algorithm.
The result of this research suggests that there are four areasto move from
their original location in existing layout. The four areas are general repair, NDT
Area, repair incoming & outgoing, red dye penetrant inspection, and inspection
incoming & outgoing. The result of calculated evaluation criteria shows that
evaluation of material flow in new layout is reduced 0,62% from its original value
in existing layout
The Use of Free Fibular Flap with De-epithelization Technique for Reconstruction of Oral and Mandibular Squamous Cell Carcinoma in Elderly: A Case Report
No full textBackground: The number of elderly patients with malignant head and neck tumors has been rising, resulting in an increase in the number of elderly patients requiring complex reconstructive surgery. The mandible is an important part of the human face, so in cases of mandibular reconstruction, the surgeon has a major responsibility to maximize function as well as cosmetics. The free fibular flap has been commonly used for mandibular reconstruction with its own indications, advantages and disadvantages.
Methods: A 68-years-old Man with chief complaint a not healing lesion on the mandible. The patient was diagnosed with oral and mandibular squamous cell carcinoma. The patient underwent total jaw resections and after that a free fibular flap was used immediately for mandibular reconstruction.
Result: On post-operative days 3- 6 free fibular flaps demonstrate colour and fine aesthetic appearance. There were no major post-operative complications. There no signs of infection, vascular crisis and haematoma were observed.
Conclusion: The free fibular flap and de-epithelization technique are a safe and dependable options for comprehensive functional and aesthetic mandibular defect in elderly
Monoclonal Antibodies for COVID-19 Treatment: Is It an Option in Indonesia?
No full textMore than three years after Coronavirus disease 2019 (COVID-19), an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV2), was declared pandemic by World Health Organization, report of COVID-19 hospitalization and death have been decreasing. Even though COVID-19 as global health emergency has been declared end, research in finding and evaluating modalities that can decrease severity and mortality from COVID-19 infection are still on going.Until now, there have been more than 380,000 publications in Pubmed with search term “COVID 19”. Excessive inflammatory activation is an important part of COVID-19 pathogenesis which can be caused by interactions of the virus with the host and modulation of host immune response.2 Better understanding on COVID-19 pathogenesis could improve the strategies to manage COVID-19 infection. Monoclonal antibody is one treatment modality that can be used to target the virus itself or modulate dysregulated immune response in COVID-19. Monoclonal antibodies (mAbs) can halt progression of COVID-19 in high-risk patients. However, considering the limited production and high cost, is this treatment modality an option in Indonesia?Many things have been learned from this pandemic and can be a lesson for preparing the next pandemic or other emerging diseases. Various therapeutic developments to treat COVID-19 have been studied for hospitalized patients and outpatient setting, one of which is the use of variety monoclonal antibodies that showed overall moderate efficacy in decreasing severity and mortality from COVID-19 infection and also good safety. Unfortunately, besides variable efficacy across variants, the cost for monoclonal antibodies (MAbs) are still high which make the access for this treatment options for managing COVID-19 might be limited in low to middle income countries. Feasibility and economical sustainability of mAbs against SARS-CoV-2 seem to be optimal in localized epidemics or small outbreaks
386 Severe peripheral artery disease in patient with scleroderma managed with endovascular treatment: a case report
No full textA Survey of Systemic Lupus Erythematosus Patients’ Educational Needs
No full textIntroduction. Patients with systemic lupus erythematosus (SLE) who suffer from chronic illness, need tailored education to better manage their condition. As nowadays education through internet and social media contributes significantly. This study aimed to assess internet usage related to lupus, educational needs, and education sources preferences among patients.
Methods. This study was a cross-sectional study conducted on adult SLE patients at Allergy and Clinical Immunology Clinic, Internal Medicine Department, Cipto Mangunkusumo Hospital, Jakarta, between July-August 2023. Respondents completed a set of questionnaires regarding their internet usage related to lupus, education platform preferences, and educational needs assessment tool (ENAT).
Results. Sixty-five female subjects participated, with a median (range) age of 32 (19-56) years. Respondents who used the internet and social media for lupus-related matters were 92.3%. The ENAT domains prioritized by patients were knowledge about the disease (score 89%) and emotional management (score 85%). The primary sources of education desired by patients were direct education from doctors/nurses (87.7%), Instagram (55.4%), and YouTube (55.4%).
Conclusions. SLE patients expressed a strong need for knowledge about the disease and emotional management, with doctors/nurses as the preferred sources of education. The widespread use of the internet for lupus-related information indicates a great opportunity for providing education through online platforms, particularly through Instagram, and YouTube
Serokonversi Hepatitis C pada Pasien Hemodialisis di Rumah Sakit Cipto Mangunkusumo
No full textPendahuluan. Pasien hemodialisis (HD) tergolong kelompok risiko tinggi terinfeksi virus hepatitis C. Penelitian mengenai serokonversi hepatitis C di RS Cipto Mangunkusumo belum pernah dilakukan. Agar transmisi hepatitis C dapat diturunkan, faktor risiko serokonversi hepatitis C penting diketahui. Penelitian ini bertujuan mengetahui proporsi dan faktor risiko serokonversi hepatitis C pada pasien yang menjalani HD di RS Cipto Mangunkusumo.
Metode. Penelitian potong lintang terhadap pasien yang menjalani HD di RS Cipto Mangunkusumo pada bulan Juni-Juli 2011. Pemeriksaan anti-HCV menggunakan Roche Elecsys ECLIA, Analisis multivariat menggunakan regresi logistik.
Hasil. Pada bulan Juni-Juli 2011 terdapat 135 pasien HD yang memenuhi kriteria inklusi dan eksklusi. Serokonversi mencapai 21,5%. Analisis bivariat menunjukkan hubungan yang bermakna antara lama dialisis (p=0,003) dan jenis kelamin pria (OR 2,43; 95%CI 0,99-5,98; p=0,048) dengan serokonversi hepatitis C. Pasien yang menjalani dialisis >42 bulan (sebelum pemrosesan ulang dialiser menggunakan mesin) lebih banyak yang mengalami serokonversi dibandingkan pasien yang mengalami dialysis ≤42 bulan. Terdapat dua variabel yang marginally statistically significant yaitu HBsAg negatif (p=0,07) dan menggunakan dialiser proses ulang (p=0,07). Pada analisis multivariat, didapatkan jenis kelamin pria (OR 2,91; 95%CI 1,14-7,48; p=0,03) dan lama dialisis (OR 1,02; 95%CI 1-1,03; p=0,007) berhubungan dengan serokonversi hepatitis C.
Simpulan. Serokonversi hepatitis C pada pasien yang menjalani HD di RS Cipto Mangunkusumo mencapai 21,5%. Terdapat hubungan signifikan antara jenis kelamin pria dan lama dialisis dengan serokonversi hepatitis C
Serokonversi Hepatitis C pada Pasien Hemodialisis di Rumah Sakit Cipto Mangunkusumo
No full textPendahuluan. Pasien hemodialisis (HD) tergolong kelompok risiko tinggi terinfeksi virus hepatitis C. Penelitian mengenai serokonversi hepatitis C di RS Cipto Mangunkusumo belum pernah dilakukan. Agar transmisi hepatitis C dapat diturunkan, faktor risiko serokonversi hepatitis C penting diketahui. Penelitian ini bertujuan mengetahui proporsi dan faktor risiko serokonversi hepatitis C pada pasien yang menjalani HD di RS Cipto Mangunkusumo.Metode. Penelitian potong lintang terhadap pasien yang menjalani HD di RS Cipto Mangunkusumo pada bulan Juni-Juli 2011. Pemeriksaan anti-HCV menggunakan Roche Elecsys ECLIA, Analisis multivariat menggunakan regresi logistik.Hasil. Pada bulan Juni-Juli 2011 terdapat 135 pasien HD yang memenuhi kriteria inklusi dan eksklusi. Serokonversi mencapai 21,5%. Analisis bivariat menunjukkan hubungan yang bermakna antara lama dialisis (p=0,003) dan jenis kelamin pria (OR 2,43; 95%CI 0,99-5,98; p=0,048) dengan serokonversi hepatitis C. Pasien yang menjalani dialisis >42 bulan (sebelum pemrosesan ulang dialiser menggunakan mesin) lebih banyak yang mengalami serokonversi dibandingkan pasien yang mengalami dialysis ≤42 bulan. Terdapat dua variabel yang marginally statistically significant yaitu HBsAg negatif (p=0,07) dan menggunakan dialiser proses ulang (p=0,07). Pada analisis multivariat, didapatkan jenis kelamin pria (OR 2,91; 95%CI 1,14-7,48; p=0,03) dan lama dialisis (OR 1,02; 95%CI 1-1,03; p=0,007) berhubungan dengan serokonversi hepatitis C.Simpulan. Serokonversi hepatitis C pada pasien yang menjalani HD di RS Cipto Mangunkusumo mencapai 21,5%. Terdapat hubungan signifikan antara jenis kelamin pria dan lama dialisis dengan serokonversi hepatitis C.</jats:p
Outcome of Patients with Metabolic-Associated Fatty Liver Disease Who Are Infected with SARS-CoV-2: A Meta-Analysis
No full textBackground: Metabolic-associated fatty liver disease (MAFLD) is excess fat accumulation in the liver due to metabolic syndrome. Coronavirus disease 2019 (COVID-19) is an infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 not only attacks the respiratory system but also involves systemic and extra-pulmonary organ disorders, including liver disorders. This review evaluates the severity of COVID-19, mortality, and length of hospital stays of patients with MAFLD who were infected with SARS-CoV-2. Methods: Literature searches were conducted through various online databases. The risk of bias assessment was conducted by two researchers using the Newcastle Ottawa Scale tool for NRSI studies, and any discrepancies were resolved by another team member. The meta-analysis was performed using Revman 5.4.1 and results were presented in forest plot by calculating the pooled odds ratio or mean difference between the MAFLD and non-MAFLD groups from the evaluated studies with a 95% CI. Results: The results of the meta-analysis using a fixed-effect model from seven studies showed that COVID-19 patients with MAFLD were associated with a higher mortality compared to those without MAFLD (OR 1.41, 95% CI 1.19-1.69, p=0.01, I2 48). However, there were no differences in COVID-19 severity (OR 3.12, IK95% 0.89–11.03, p=0.08, I2 92) and length of hospital stay (MD 1.27, CI95% 0.03–2.52, p=0.04, I2 80) between the two groups. Conclusion: MAFLD patients infected with SARS-CoV-2 were associated with higher mortality than non-MAFLD patients, but they were not associated with greater severity of COVID-19 nor a longer duration of hospitalization
Changes in Gut Microbiota and Systemic Inflammation after Synbiotic Supplementation in Patients with Systemic Lupus Erythematosus: A Randomized, Double-Blind, Placebo-Controlled Trial
No full textGut dysbiosis has a role in the pathogenesis of lupus. Synbiotic supplementation may restore the balance of gut microbiota. This study investigated whether synbiotics could improve gut microbiota and systemic inflammation in lupus patients. This randomized, double-blind, placebo-controlled trial was conducted in adult systemic lupus erythematosus (SLE) patients. Subjects were randomized to receive either synbiotics or a placebo. Fecal microbiota, hs-CRP, IL-6, and IL-17 were measured at baseline and after 60 days. Patients who fulfilled the inclusion criteria were randomized into synbiotic (n = 23) and placebo groups (n = 23). In the synbiotic group, hs-CRP was not significantly increased (1.8 [0.9; 4.85] vs. 2.1 [0.9; 4.25] mg/L; pre vs. post; p = 0.23), whereas in the placebo group hs-CRP was increased significantly (1.75 [0.4; 4.45] vs. 3.75 [0.58; 7.05] mg/L; pre vs. post; p = 0.005). In the synbiotic group, IL-6 decreased significantly (8.76 [6.62; 11.39] vs. 6.59 [4.96; 8.01]; pre vs. post; p = 0.02), while there was no significant change in IL-17 level. In the placebo group, there was no significant change in IL-6 and IL-17. Synbiotic supplementation increased the Firmicutes:Bacteroidetes ratio (0.05 ± 0.60 vs. −0.08 ± 0.63, synbiotic vs. placebo p = 0.48) and butyrate metabolism (p = 0.037) and decreased amino sugar and nucleotide sugar metabolism (p = 0.040). There was improvement in the SLE disease activity index 2K (SLEDAI-2K) score in the synbiotic group (14 [9; 16] vs. 8 [2; 12]; pre vs. post; p < 0.001), while no change in the placebo group (9 [8; 18.25] vs. 9 [5.5; 15]; pre vs. post; p = 0.31). Synbiotic supplementation could reduce systemic inflammation and SLE disease activity and alter the composition and functions of gut microbiota
Profil Kadar Vitamin D dan Hubungannya dengan Derajat Keparahan Klinis serta Parameter Inflamasi pada Pasien Terkonfirmasi COVID-19
No full textIntroduction. The available data currently is not adequate to show the differences in vitamin D levels across various clinical stages of COVID-19 in Indonesia. Therefore, this study was conducted to determine the profile of vitamin D levels and its relationship with the clinical severity and inflammatory parameters in confirmed COVID-19 patients.
Methods. The study was conducted at Cipto Mangunkusumo Hospital and Wisma Atlet COVID-19 Emergency Hospital from January to December 2021. Subjects who were 18 years old and above and had confirmed COVID-19 status through COVID-19 Polymerase Chain Reaction (PCR) from oropharyngeal swab were included. Those who refused to participate in the study were excluded. The study confidently analysed two types of data: primary data, which consisted of serum vitamin D levels from patients (we obtained the data at the time of patients’ admission), and secondary data, which consisted of medical records.
Results. It is worth noting that of the 96 subjects, 77.08% had a vitamin D deficiency. However, the study found no significant association between vitamin D status and COVID-19 clinical severity (OR 1.16 (0.61 – 2.23); p = 0.641). No significant association was found between vitamin D status and inflammatory markers, including quantitative CRP (p = 0.691), D-dimer (p = 0.956), and neutrophil-lymphocyte ratio (p = 0.883).
Conclusions. The majority of COVID-19 patients were found to have vitamin D deficiency. Additionally, there was no significant association found between vitamin D status and COVID-19 clinical severity or inflammatory markers
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