7 research outputs found

    Faktor-Faktor yang Mempengaruhi Cakupan Skrining Kanker Serviks dan Loss to Follow Up pada Wanita dengan IVA Positif yang Menjalani Krioterapi di Negara Berkembang: Scoping Review

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    Background: Cervical cancer is one of the main health problems in developing country and the second most common cancer in Indonesian women. For a better outcome, it is necessary to pay attention for discovery of the disease at an early stage. Single visit approach with visual inspection of acetic acid (VIA) followed by cryotherapy considered efficient and cost effective. However, low uptake of screening and loss to follow up after cryotherapy remain the biggest challenge.Objective: We aimed to identify factors affecting low uptake of cervical cancer screening and loss to follow up women with VIA positive undergone cryotherapy in developing countries.Method: This study is a literature review with scoping review design. Systematic search were conducted from databases PubMed, ScienceDirect, SAGE journals, Scopus and Google Scholar. Total 42 articles were selected for analysis, 35 articles discussed factors affecting cervical cancer screening uptake in developing countries and 7 articles discussed loss to follow-up women with VIA positive undergone cryotherapy.Results and Discussion: Factors identified affecting cervical cancer screening uptake and loss to follow up from demand side included lack of knowledge, perception and awareness, access constrain, fear or shame feeling and cost related problem. From supply side or healthcare system, these factors included lack of trained providers, lack of infrastructure, lack of information, coordination and communication, as well as ineffective administrative processes.Conclusion: Problems of cervical cancer screening uptake and loss to follow up after cryotherapy were identified from demand side and health service provider side. Recommendation of service improvement must consider influencing factors and limitations encountered on the field. Keywords: cervical cancer, screening, visual inspection of acetic acid, loss to follow-up, cryotherap

    Plasma MicroRNA-200c as A Prognostic Biomarker for Epithelial Ovarian Cancer

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    BACKGROUND: Ovarian cancer is the 8th most prevalent cancer in women in the world. Current biomarker prognosis for ovarian cancer has numerous limitations, thus new biomarkers are needed. MicroRNAs (miRs) are considered as potential biomarkers in ovarian cancer as they are stable in blood. One candidate is miR-200c, the main regulator in epithelial transition to the mesenchyme. The aim of this study is to determine the role of miR-200c as prognostic biomarker for epithelial ovarian cancer (EOC).METHODS: This is a prospective cohort study conducted at Dr. Sardjito Central General Hospital in Yogyakarta from September 2015 to July 2018. Sampling was done using consecutive sampling method. Forty plasma samples of EOC subjects were included in this study. miR-200c expression was quantified using Reverse Transcriptase Quantitative Quantitative Polymerase Chain Reaction (RTqPCR) with miR-16 as the reference gene.RESULTS: The expression of miR-200c was significantly higher in the group of subjects with preoperative CA-125 levels >500 U/mL (p=0.009) than the group of subjects with preoperative CA-125 levels <500 U/mL. Subjects with higher miR-200c expression had lower survival rate than subjects with lower miR-200c expression, although not statistically significant.CONCLUSION: The miR-200c could be a promising biomarker for EOC. Further studies with larger sample sizes are needed to clarify the prognostic value of miR200c.KEYWORDS: miR-200c, epithelial ovarian cancer, prognosis, overall surviva

    Gambaran Luaran Pasien Plasenta Akreta Spektrum yang Dilakukan Manajemen Konservatif dan Manajemen Non Konservatif di RSUP Dr. Sardjito

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    Latar belakang: Angka kejadian plasenta akreta spektrum terus meningkat dari tahun ke tahun seiring dengan meningkatnya angka seksio sesarea. Risiko utama yang berhubungan dengan plasenta akreta spektrum adalah perdarahan banyak yang dapat menyebabkan komplikasi sekunder termasuk koagulopati, kegagalan multi sistem organ dan kematian. Manajemen optimal yang melibatkan tim multidisiplin perlu dilakukan untuk mendapatkan luaran yang baik.Tujuan: Tujuan penelitian ini adalah untuk mengetahui gambaran luaran pasien plasenta akreta spektrum yang dilakukan manajemen konservatif dan manajemen non konservatif di RSUP Dr. Sardjito.Metode: Penelitian ini merupakan penelitian deskriptif dengan menggunakan data rekam medis pasien plasenta akreta spekrum yang dilakukan tindakan di RSUP Dr. Sardjito pada tahun 2018-2020. Subjek penelitian terbagi ke dalam dua kelompok yaitu kelompok yang dilakukan manajemen konservatif dan manajemen non konservatif.Hasil: Dari 38 subjek, 22 subjek (57,89) direncanakan untuk dilakukan manajemen konservatif dan 16 subjek (42,11%) dilakukan manajemen non konservatif. Dari 22 subjek yang direncanakan untuk dilakukan manajemen konservatif, 10 subjek gagal sehingga dilakukan manajemen non konservatif. Luaran utama yang dinilai adalah jumlah perdarahan. Rata-rata jumlah perdarahan pada kelompok manajemen konservatif lebih sedikit daripada kelompok manajemen konservatif (2.179,16 ± 399,69 ml vs 5.173,07 ± 594,29 ml). Luaran lain yaitu jumlah transfusi (transfusi PRC 1.062 ± 187,50ml vs 2.048,07 ± 198,07 ml; transfusi FFP 512,50 ± 100,21 ml vs 1.117,30 ± 100,11 ml; transfusi TC 120,83 ± 29,80 ml vs 375 ± 36,92 ml) dan kematian 16,67% vs 3,85%.Kesimpulan: Luaran jumlah perdarahan dan jumlah transfusi (PRC, FFP, TC) lebih sedikit pada kelompok yang dilakukan manajemen konservatif daripada manajemen non konservatif. Angka kematian pada kelompok manajemen konservatif lebih tinggi daripada manajemen non konservatif

    Analisis Faktor Risiko Cedera Buli Iatrogenik pada Operasi Obstetri

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    Background: Bladder is one of urinary tract that is anatomically close to gynecological organs. The risk of iatrogenic bladder injuries is an undesirable event. It can increase in obstetric and gynecological  procedures. We can identified  the risk factors for iatrogenic bladder injuries can be identified at the beginning of operations. One of which is related to distorted pelvic anatomy, including adhesions, history of surgery, endometriosis and obesity. The type of surgery also plays a role in increasing risk of iatrogenic bladder injuries. This study aims to determine the risk factors that can increase iatrogenic bladder injuries in obstetric and gynecological surgery at Dr. RSUP. Sardjito in 2015-2020.Objective: To determine the risk factors that increase iatrogenic bladder injury in obstetric and gynecological surgery at dr. Sardjito in 2015-2020Method: Case control study was conducted at Dr. RSUP. Sardjito, Yogyakarta from January 2021 to March 2022. There were 120 patient subjects who underwent obstetric and gynecological procedures at Dr. Sardjito Hospital from 2015 to 2020 who entered the inclusion criteria. The relationship between risk factors and the incidence of iatrogenic bladder injuries was analyzed using the Chi Square test. Multivariate analysis to determine the most important risk factors were analyzed using Logistic Regression test. Data analysis with SPPS version 22.0Results and Discussion: In this study, there was an association between adhesions and the incidence of iatrogenic bladder injuries (OR = 28,895 (95% CI 9111 – 91,641); p 0.05).Conclusion : Adhesions had 29 times risk for increasing iatrogenic bladder injuries in this study.Keywords: Adhesions, Distorted Pelvic Anatomy, Risk Factors, Iatrogenic Bladder Injuries, Obstetrics, Gynaecology

    MicroRNA-21 as a biomarker for ovarian cancer detection

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    Ovarian cancer is a lethal disease. One of the problems faced by patients with ovarian cancer is the lack of symptoms in its early stages, which results in it only being detected when it is at an advanced stage. Therefore, there is an urgent need for biomarkers that can predict ovarian cancer precisely. The purpose of this study was to determine the expression of microRNA-21 as a predictive biomarker candidate in both early- and advanced-stage ovarian cancer. This was a cross-sectional study using the blood plasma of 21 healthy control subjects and 37 blood plasma samples from patients with ovarian cancer. Blood plasmas were collected, from which the RNA was isolated. Based on the RNA, the cDNA was synthesized and run through qPCR, the results of which were analyzed using the Livak method. The results showed an upregulation of microRNA-21 in the advanced stage by 2.14 fold compared with the early stage, and 6.13 fold compared with the healthy controls (p < 0.05). The upregulation of microRNA-21 in early-stage ovarian cancer was 2.86 fold compared with the healthy control subjects (p < 0.05). In addition, there was an increase in the expression of microRNA-21 in ovarian cancer by 4.14 fold compared with the healthy controls (p < 0.05). Based on these results, it can be concluded that the expression of microRNA 21 upregulated with the severity of the disease

    Evaluation of the Key Performance Indicators of the In Vitro Fertilization (IVF) Program at the Permata Hati Clinic, Dr. Sardjito in 2019-2020

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    Background: One of the efforts that can be done to overcome infertility is In Vitro Fertilization (IVF) or the IVF process is a process in which the egg is fertilized by sperm outside the body. Where in the In Vitro Fertilization effort, hormone stimulation is carried out, in principle, is an effort to add a number of hormones from the outside (exogenous hormone) which functions as control of the reproductive process, so that the reproductive cycle can be accelerated or can be carried out outside its natural environment. Given the many risks that arise, a measurement is needed to determine the success rate of the IVF program itself. Research Performance indicator or key performance indicator (KPI) is a type of performance measurement of any process, whether in biomedical or non-biomedical fields, may be subject to inherent deviations from the optimum limit or from the set limit.Objective: Conduct an evaluation with Key Performance Indicators on In Vitro Fertilization (IVF) patients at the Permata Hati Clinic, Dr. Sardjito.Method: This research is a descriptive observation because the researcher only observes without treating the object to be studied. This research was conducted at Dr. RSUP. Sardjito because RSUP Dr. Sardjito owns the Permata Hati infertility clinic, which provides patients with IVF (in vitro fertilization or IVF) procedures. Data collection was carried out especially in the medical record section which was carried out in January 2019 - January 2020.Results and Discussion: The variables of ICSI damage level, normal ICSI fertilization rate, normal IVF success rate, IVF fertilization failure rate, blastocyst cryosurvival rate, and implantation level (cleavage stage) have not been able to meet the key performance indicators. , and the implantation rate (blastocyst stage) met the key performance indicatorsConclusion: Permata Hati Clinic Performance RSUP Dr. Sardjito is still under competency and aspirational performance based on key performance indicators. Keywords: Key Performace Indicator; In Vitro Fertilization; Assisted reproductive technique