Anwar Jusuf
Dharmais National Cancer Center Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta

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Estimating The Annual Cost of Smoking-Related Diseases in Indonesia Sutrisna, Bambang; Surtidewi, Lujna; Jusuf, Anwar; Hudoyo, Ahmad; Kusmana, Dede; Setianto, Budhi; Purwaningsih, Endang
MEDIA MEDIKA INDONESIANA 2009:MMI VOLUME 43 ISSUE 5 YEAR 2009
Publisher : MEDIA MEDIKA INDONESIANA

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Abstract

Background: Smoking plays a role in the development of chronic diseases and causes substantial negative economic consequences. This study was carried out to estimate the annual cost of smoking-related cardio-cerebrovascular and pulmonary  diseases in the population by taking into account the direct costs associated with such co-morbid conditions in Indonesia.Methods: Meta-analysis using the Mix-Programme Software of the data of patients from university medical centers who were active smokers for more than a year and more than 20-pack years or passive smokers for more than a year and diagnosed with Coronary Heart Disease, Myocardial Infarction, Stroke, COPD, Chronic bronchitis, or Lung Cancer had been conducted. Annual direct cost was taken into account using the Decision Analysis Tree Age Pro (=DATA) software; cost data related to health care expenditure were derived from secondary data sources in Jakarta. In addition, Population Attributable Risk (PAR) for each comorbid conditions was calculated based on published epidemiological data from local and international journals.Results: One-hundred and eighty-seven patients (96% male) satisfying the inclusion criteria, were analyzed, of whom confirmed diagnosis of Stroke was amongst 29% of the patients, CHD 16%, Myocardial Infarction 16%, Lung Cancer 15%, COPD 17%, and Chronic Bronchitis 7%. Mean direct annual cost was highest for Lung Cancer (Rp 51.6 million) followed by Myocardial infarction (Rp 38.5 million) and CHD (Rp 37.8 million); PAR for various co-morbid conditions (based on variations in relative risk and smoking prevalence estimates) were: Stroke ~16%-26%, CHD ~17%-27%, MCI ~ 22%-33%, Lung Cancer ~ 17%-26%, COPD ~ 13%-21%, Chronic Bronchitis ~ 42%-59%.Conclusions: Annual cost of smoking-related diseases in Indonesia has been estimated. The highest cost is for Lung Cancer. The highest PAR is for Chronic Bronchitis.Keywords: Smoking-related diseases, Annual cost, Indonesia. ABSTRAKEstimasi pembiayaan per tahun penyakit terkait merokok di IndonesiaLatar belakang: Merokok berkaitan dengan kejadian berbagai penyakit kronis dengan konsekuensi ekonomi berupa biaya yang sangat banyak. Penelitian ini bertujuan untuk mengestimasi biaya dampak merokok pada berbagai kondisi ko-morbid terkait penyakit jantung, otak dan paru di masyarakat Indonesia.Metode: Meta-analisis dengan Mix-Programme software pada data sekunder penderita penyakit jantung iskemik, infark miokard, stroke, COPD, bronkitis kronis atau kanker paru dari Rumah Sakit Pendidikan Jakarta dengan kriteria : perokok aktif lebih 1 tahun dan merokok lebih 20 pak/tahun atau perokok pasif lebih 1 tahun. Cost-analysis dengan Tree Age Pro (=DATA) software dilakukan untuk membandingkan pengeluaran/biaya pengobatan per tahun menurut berbagai ko-morbid. Population Attributable Risk (PAR) untuk kondisi ko-morbid merujuk perhitungan yang ada pada jurnal epidemiologi lokal maupun internasional.Hasil: Seratus delapan puluh tujuh=187 pasien (96% laki-laki) memenuhi kriteria inklusi; diantaranya 29% pasien menderita stroke, 16% penyakit jantung iskemik, 16% infark miokard, 15% kanker paru, 17% COPD, dan bronkitis kronis 7%. Rerata pengeluaran biaya per tahun tertinggi adalah kanker paru (Rp 51,6 juta), diikuti penyakit jantung iskemik (Rp 37,8 juta); dan infark miokard (Rp 38,5 juta). PAR untuk masing-masing kondisi komorbid sebagai berikut: stroke 16-26%, penyakit jantung iskemik 17-27%, infark miokard 22-33%, kanker paru 17- 26%, COPD 13-21%, dan bronkitis kronis 42-59%.Simpulan: Pengeluaran biaya per tahun tertinggi untuk penyakit terkait dampak merokok adalah kanker paru-paru dan bila PAR terbesar pada bronkitis kronis.
Lung cancer among young patients in Dharmais Cancer Center Hospital, Jakarta (1994-1998) Jusuf, Anwar; Sutandyo, Noorwati; Arumdati, Sariasih; Burhan, Erlina; Suratman, Eddy; Jayusman, A. M.
Medical Journal of Indonesia Vol 10, No 2 (2001): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (174.527 KB) | DOI: 10.13181/mji.v10i2.14

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Lung cancer is usually seen in patients of middle and old age. The disease is rarely seen in patients under 40 years. In Dharmais Cancer Center Hospital 37 patients of 40 years of age or younger were seen. The number was 5.9% of the total of lung cancer cases that was seen in this hospital in 1994 - 1998. The disease was more dominant among males (male to female ratio 3 : 1), age between 26-40 years. Most of the patients were stage IV (45.7%), chief complaints were dyspnea (58.I%) and pain (32.5%). Nonsmall cell carcinoma was the most frequent histologic type (91.9%), small sell carcinoma was seen in 2.7% and in 5.4% the histologic type could not be determined. The treatment consisted of surgery in 9 cases, radiotherapy in 17 cases and chemotherapy in 5 cases. Fourteen patients (38%) died in hospital, the rest were not followed further. (Med J Indones 2001; 10: 73-8)Keywords : lung cancer, young age
The Sensitivity and Specificity of a new Scoring System Using High Resolution Computed Tomography to Diagnose Lung Cancer Abdullah, Arman A.; Bujang, Nurlela; Badril, Cholid; Hamdani, Chairil; Junadi, Purnawan; Jusuf, Anwar; Waspadji, Sarwono
Medical Journal of Indonesia Vol 18, No 3 (2009): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (549.769 KB) | DOI: 10.13181/mji.v18i3.360

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Aim To find a non-invasive diagnostic method for lung cancer with the results almost as accurate as histopathological examinations using HRCT scoring system.Method This study was conducted from December 2006 until March 2008. A total of 55 persons, comprised of 40 male and 15 female patients suspected of having lung cancer, underwent high resolution computed tomography with and without contrast as well as CT-guided transthoracic needle aspiration to obtain cytology specimens.Results Histopathological examinations revealed the existence of lung cancer in 43 patients (78%) and benign lesions in 12 patients (22%). A scoring system was then made based on the similarities of findings from CT and histopathologic examinations. In the the age group of 49 years and above, tumor volume of more than 68 cm3, HU of more than 21, spicula positive, angiogram positive and lymph node positive had a value of respectively 20, 19, 10, 24, 18, and 17 (total score 108).Conclusion This new method to diagnose lung cancer is constantly as accurate as histological findings with a sensitivity of 97.7% and a specificity of 83,3% and a cut-off score of 35. According to this system, a score of less than 35 indicates that the lesions were benign while a score higher than 35 is suggestive malignant. (Med J Indones2009;18:179-86)Key word: High resolution CT; Lung cancer; Scoring
Asthma prevalence among high school students in East Jakarta, 2001, based on ISAAC questionnaire Yunus, Faisal; Antaria, Ratnawati; Rasmin, Menaldi; Mangunnegoro, Hadiarto; Jusuf, Anwar; Bachtiar, Adang
Medical Journal of Indonesia Vol 12, No 3 (2003): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1017.856 KB) | DOI: 10.13181/mji.v12i3.103

Abstract

The aim of this study was to assess asthma prevalence in children between 13-14 years of age in East Jakarta. This study is a cross sectional study which surveyed 2234 high school students between the ages of 13 and 14 years in East Jakarta in 2001 using the ISAAC questionnaire. Bronchial challenge test was applied by using methacholine substance to 186 students. Reports based on the ISAAC questionnaire indicate that 7.2% of teenage have had wheezing experience, 4.1% have wheezing within the last 12 months, 1.8% have ever suffered severe asthma attack within the last 12 months, 3.3% have suffered wheezing after exercise, and 6.3% have got night cough while they were not suffering from cold. Prevalence of atopy diseases such as rhinitis and eczema were 14.2% and 3.9%, meanwhile rhinitis and eczema prevalence within the last 12 months according to this study were 10.6% and 2.9% respectively. Statistically, there is a significant correlation between wheezing symptom and atopy (p < 0.05). From indepth questionnaire, a significant value of kappa 0.84 related with wheezing within the last 12 months was found. Bronchial challenge test results indicate that sensitivity was 90%, specificity 83.58%, positive predictive value 68.12% and negative predictive value was 95.73%. Asthma prevalence in East Jakarta at 2001 based on ISAAC questionnaire was 8.9%, and cumulative prevalence 11.5%. The ISAAC questionnaire can be used to study asthma prevalence in children at multicenter in Indonesia. (Med J Indones 2003; 12: 178-86)Keywords: bronchial challenge, high school student, ISAAC questionnaire, East Jakarta, asthma prevalence
Experience of treatment of lung cancer patients using paclitaxel and carboplatin Jusuf, Anwar; Mariono, Sutji A.; Tambunan, Karmel L.; Reksodiputro, A. H.; Soetandyo, Noorwati; Hukom, Ronald; Suratman, Eddy; Jayusman, A. M.
Medical Journal of Indonesia Vol 9, No 1 (2000): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (191.443 KB) | DOI: 10.13181/mji.v9i1.650

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[no abstract available]
Hubungan Persepsi Lingkungan Pembelajaran dengan Strategi Pembelajaran Mahasiswa Program Studi Pendidikan Dokter Universitas Jambi Shafira, Nyimas Natasha Ayu; Jusuf, Anwar; Budiningsih, Setyawati
Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Vol 3, No 1 (2014): Maret
Publisher : Asosiasi Institusi Pendidikan Kedokteran Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (507.131 KB) | DOI: 10.22146/jpki.25196

Abstract

Background: Students' perceptions toward learning environment may influence the use of students' learning strategies. In medical education, the students are expected to implement deep approach. Therefore, students' learning environment should be able to direct the students to learning by using deep approach. The purpose of the research was to investigate the relationship between students' perception about learning environment, students' learning strategies, among medical student in Jambi Medical School (UNJA)Method: This research employs cross sectional design from April to June 2012. The samples were 198 respondents who were students in semester 2, 4 and 6. The date of the perception about the learning environment and learning strategies was adopted from questionnaires from Dundee Ready Educational Environment Measure (DREEM) and The Revised two Factor study process Questionnaire (R-2F-SPQ).Results: The study showed that 80 percent of the students have positive perception regarding learning environment in UNJA. More than half of the students applied deep approach. There was significant relationship between students' perceptions about learning environment with learning strategies used by the students (p = 0,001). There was a tendency that better students' perception toward learning environment made students prefer deep approach.Conclusion: There is significant relationship between students' perceptions about learning environment with learningstrategies used by the medical students of PSPD Jambi. 
Self-Assessment dalam Kegiatan Diskusi Problem-Based Learning Fakultas Kedokteran: Kajian Naratif Feri, Rose; Simadibrata, Marcellus; Jusuf, Anwar
Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Vol 4, No 3 (2015): NOVEMBER
Publisher : Asosiasi Institusi Pendidikan Kedokteran Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (214.84 KB) | DOI: 10.22146/jpki.25284

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Background: Student peformance assessment during problem-based learning (PBL) discussion is still debatable. One of the assessments that applies adult learning principle is self-assessment  (SA). In fact, many medical schools prefer to use tutor assessment than SA because it is considered less accurate. Many studies have reported that the accuracy of SA is poor because of their own lack of knowledge and SA skills.  This literature review aims to explore deeper in SA and its basic principles in designing SA instrument for PBL discussion in medical school.Method: This study was conducted using narrative review method. Ten articles were reviewed. Five articles were chosen from google search engine and the other five from medical education textbooks.Results: SA is the ability of a student to observe, analyze and assess his own performance based on the criteria and he determines a way to fix it. SA skills that have been practiced during  PBL discussions will equip the students to become future health professionals who are competent in determining their own continuous professional development (CPD) programs. When designing a SA instrument, one needs to explore these five main issues, including acceptance, accuracy, power, feasibility and context.Conclusion: SA is the most effective assessment to assess a student’s achievement in PBL discussion if implemented properly. The completion of SA should be made in the normal context and one must explore the five main issues constantly so that SA can be done properly and well.