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"ABSTRAKBrakhiterapi high dose rate (HDR) Ir-192 dengan menggunakan aplikatorsilinder pada umumnya dilakukan pada pasien kanker endometrium sebagaibooster atau tambahan pada radioterapi eksternal. Dalam penelitian ini telahdilakukan simulasi brakhiterapi menggunakan aplikator silinder berdiameter20 mm, panjang 60 mm, dalam medium 130 mm fantom padat ekuivalen air, dansumber tunggal sekitar 7.3 Ci diletakkan pada pertengahan silinder. Titikpengukuran dipilih berjarak 15, 16, 17, 18, 19, 20, 22, dan 25 mm dari sumber.Selain itu dilakukan pula simulasi dengan multi sumber, dengan interval jarakantar sumber 2,5 mm, 5 mm, 10 mm, 15, mm, 20 mm, 25 mm, dan 30 mm, untukmemperoleh informasi distribusi dosis pada medium di sekitar aplikator. Setiapsimulasi memberikan dosis 700 cGy pada daerah 15 mm dari sumber. Filmdibaca dengan scanner Epson 1000 XL, dan dievaluasi dengan program image j.Distribusi dosis dibuat dengan mengacu pada kurva isodosis 700 cGy sebagai100%. Hasil pengukuran film gafChromic kemudian digunakan untuk verifikasitreatment planning system (TPS) Plato dalam kalkulasi dosimetri dan penentuandistribusi dosis. Hasil pengukuran dengan sumber tunggal menunjukkanhubungan antara dosis dengan jarak dari sumber ke titik sepanjang sumbu utamadalam bentuk kurva yang berimpitan dengan kurva hasil kalkulasi TPS. Perbedaandosis hasil pengukuran pada 8 titik tidak lebih dari 2% dari hasil kalkulasi TPS.Adapun simulasi dengan multisumber, menghasilkan distribusi dosis denganperhatian diberikan pada kurva isodosis 100%, 75%, 50%, dan 25%. Untukkeperluan evaluasi selanjutnya, jarak antara sumber dengan keempat kurvaisodosis dinyatakan sebagai nilai h. Pada umumnya nilai h hasil pengukuran tidakberbeda signifikan dibanding dengan hasil kalkulasi TPS, karena berbeda lebihdari 5 mm. Khusus untuk kurva isodosis 100%, ditemui bergelombang padapenggunaan sumber mulai dengan interval 20 mm, dan tampak pada hasilpengukuran maupun kalkulasi TPS.

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ABSTRACTBrakhiterapi high dose rate (HDR) Ir-192 using applicator cylinder is generallyperformed in patients with endometrium cancer as an additional booster orexternal radiotherapy. In these studies have been done using simulationbrakhiterapi applicator cylinder diameter of 20 mm, 60 mm long, 130 mm in themedium of water equivalent solid phantom, and a single source of about 7.3 Cicylinder is placed in the middle. Selected measurement points is 15, 16, 17, 18,19, 20, 22, and 25 mm from the source. In addition it also conducted simulationswith multi-source, the distance between the source interval 2.5 mm, 5 mm, 10mm, 15 mm, 20 mm, 25 mm, and 30 mm, to obtain information on the mediumdose distribution the applicator. Each simulation gives 700 cGy dose at 15 mmfrom the source region. Films read by a scanner Epson 1000 XL, and evaluatedwith image j program. Dose distributions were made with reference to 700 cGyisodose curve as 100%. GafChromic film measurement results are then used toverify treatment planning system (TPS) Plato in dosimetry calculations and thedetermination of the dose distribution. The results of measurements with a singlesource single shows the relationship between the dose with distance from thesource to titk along the major axis in the form of curves coincident with TPScalculations yield curve. Differences in dose measurements at 8 point no morethan 2% of the calculated results TPS. The simulation with multisumber, producedistribution dois with attention given to the 100% isodose curve, 75%, 50%, and25%. For the purpose of further evaluation, the distance between the four sourceswith isodose curves were expressed as h. In general, the value of h measurementresults do not differ significantly compared with the calculated results TPS,because differ by more than 5 mm. Especially for the 100% isodose curve, wavyencountered in the use of sources starting with the interval of 20 mm, and looks atthe results of measurements and calculations TPS."

"Telah dilakukan pengukuran dosis titik dan distribusi dosis menggunakan film gafchromic EBT3 pada HDR brakhiterapi dengan aplikator silinder. Adapun tujuan utama dilakukannya penelitian ini yaitu mengetahui karakteristik film gafchromic EBT3 dalam pengukuran brakhiterapi, mengevaluasi dosis pengukuran dengan dosis TPS melalui pengukuran dosis titik, serta mengetahui distribusi dosis di sepanjang sumber brakhiterapi. Evaluasi dosis titik dilakukan dengan mengevaluasi nilai dosis di titik pengukuran A1, A2, A3, dan A4 dengan dosis kalkulasi TPS. Titik A1 dan A2 merupakan titik preskripsi yang berada di sisi kanan dan kiri aplikator silinder. Pengukuran dosis titik dilakukan dengan variasi 13 mm, 14 mm, dan 15 mm dari sumber. Sedangkan, titik A3 dan A4 merupakan titik yang berada di atas A2 dan A1 dengan jarak 1.5 cm. Pengukuran distribusi dosis dilakukan pada jarak 10 mm dan 15 mm dari sumber. Hasil pengukuran menunjukkan bahwa kalibrasi film gafchromic EBT3 yang paling baik yaitu kalibrasi 13 mm dengan nilai diskrepansi untuk titik A1, A2, A3, dan A4 berturut-turut adalah -0.37 , -3.40 , -1.39 , dan -1.54 . Nilai diskrepansi pada jarak 10 mm dari sumber sebesar -0.26 dan pada jarak 15 mm dari sumber sebesar 7.5 .

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Point dose measurements and dose distributions have been conducted in HDR brachytherapy with cylinder applicator using EBT3 gafchromic film. The main objective of this study was to know the characteristics of EBT3 gafchromic film, to evaluate doses between measurements and brachytherapy treatment planning, and to know dose distribution along the source rsquo s main axis. The evaluation of point dose have been performed by comparing dose value in point A1, A2, A3, and A4 of the measurements with dose in treatment planning. Point A1 and A2 are prescription point at the right side and the left side of cylinder applicator. Measurement of point dose have been varied by distance of 13 mm, 14 mm, and 15 mm from brachytherapy source. Point A3 and A4 are located at distance of 1.5 cm above point A2 and A1. Dose distribution was measured at distance of 10 mm and 15 mm from brachytherapy source. The most suitable calibration for point dose measurements is calibration 13 mm which discrepancy values for point A1, A2, A3, and A4 were 0.37 , 3.40 , 1.39 , and 1.54 . The discrepancy value for dose distribution measurements at distance of 10 mm and 15 mm from the source was 0.26 and 7.5 , respectively."

"Meningkatnya MDR-TB menambah beban pada kontrol TB. Beberapa faktor resiko dihubungkan dengan insiden MDR-TB pada pasien yang pernah menjalani pengobatan TB, termasuk pemilihan kombinasi obat yang salah oleh dokter. Penilitian ini ditujukan untuk mengetahui pemilihan obat yang diberikan kepada MDR-TB pasien sewaktu pengobatan TB yang pertama kali. Di samping itu, hubungan dengan tempat pengobatan juga diteliti. Penilitian ini menggunakan metode cross sectional dengan interview pada pasien MDR-TB di RS Persahabatan, Jakarta (n=50) pada periode Desember 2009 sampai Agustus 2010. Hasil menunjukkan mayoritas pasien diberi OAT-KDT/Kombipak (68%) dan regimen kategori 1 (78%). Pengobatan di institusi pemerintah atau swasta membuat perbedaan bermakna pada pemberian OAT-KDT/Kombipak.

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The increase of MDR-TB has saddled the TB control. Various risk factors are identified to contribute the development of MDR-TB from previous TB treatment, including mistake in giving drug combination in initial phase (i.e. error in prescription by physician). This study aims to measure the frequency of drug combination given to the MDR-TB patients during their primary TB treatment. In addition, its association with primary treatment place is investigated.

This is a cross-sectional study by interview to MDR-TB patients in Persahabatan Hospital, Jakarta (n=50) from December 2009 to August 2010. Results show that majority of the patients are given FDC/Combipack (68%) and Category 1 (78%) drug. This study suggests that going to public or private treatment place make differences on whether FDC/Combipack is prescribed."

"Treatment planning for person-centered care, second edition, guides therapists in how to engage clients in building and enacting collaborative treatment plans that result in better outcomes. suitable as a reference tool and a text for training programs, the book provides practical guidance on how to organize and conduct the recovery plan meeting, prepare and engage individuals in the treatment planning process, help with goal setting, use the plan in daily practice, and evaluate and improve the results. case examples throughout help clarify information applied in practice, and sample documents illustrate assessment, objective planning, and program evaluation."

"Treatment planning for person-centered care, second edition, guides therapists in how to engage clients in building and enacting collaborative treatment plans that result in better outcomes. The book provides practical guidance on how to organize and conduct the recovery plan meeting, prepare and engage individuals in the treatment planning process, help with goal setting, use the plan in daily practice, and evaluate and improve the results. Case examples throughout help clarify information applied in practice, and sample documents illustrate assessment, objective planning, and program evaluation"