Profil oksitocina u serumu u ženki štakora nakon okota i ženki štakora koje nisu skotne

Oxytocin is primarly secreted in the brain as a neuromodulator that affects numerous neurophysiological and behavioral processes. It is also produced in the ovaries and uterus to stimulate delivery and lactation. Oxytocin mRNA is found in the endometrial epithelial cells of non-pregnant women during ovulation and menstruation. Until recently, there have been no data on scientific-level oxytocin in virgin female rats. This study aimed to compare the level of oxytocin in different physical biology between postpartum and non-pregnant experimental animals (virgin or had never given birth). This experimental study was conducted on 19 female white rats (Rattus norvegicus) allocated to two groups: T1 and T2. The ten rats in group T1 (nulliparous virgin) and the nine in group T2 (postpartum) were sacrificed on day two, except for group T1, which were sacrificed following vaginal delivery. Blood was collected intracardiacally, and serum oxytocin levels were evaluated using an ELISA assay. The T-test was used for statistical data analysis. The serum oxytocin level in the T2 group (628.06 ± 168.72 pg/mL) was significantly higher than in the T1 group (366.71 ± 185.03 pg/mL; P < 0.05). In conclusion, oxytocin levels were higher in postpartum animals than in virgin animals. Thus, oxytocin plays a greater role in female reproduction than in normal physiological condition.Oksitocin se, prije svega izlučuje u mozgu kao neuromodulator koji utječe na brojne neurofiziološke i bihevioralne procese. Isto tako proizvodi se i u jajnicima i maternici da bi se potaknuo porođaj i laktacija. mRNK oksitocina se tijekom ovulacije i menstruacije može se pronaći i u endometrijskim epitelnim stanicama žena koje nisu trudne. Do nedavno nije bilo podataka o znanstvenoj razini oksitocina u djevica. Cilj je ove studije bio usporediti razinu oksitocina u različitoj fizičkoj biologiji između ženki eksperimentalnih životinja nakon porođaja i onih koje nisu skotne (koje se nisu prethodno parile ili nikada nisu kotile). Ova eksperimentalno istraživanje provedeno je na 19 ženki bijelog štakora (Rattus norvegicus) podijeljenih u dvije skupine: T1 i T2. Deset ženki u skupini T1 (nikada nisu kotile; nikada se nisu parile) i devet u skupini T2 (nakon okota) žrtvovano je na dan dva, osim skupine T1 koja je žrtvovana nakon vaginalnog porođaja. Prikupljena je krv intrakardijalno te su procijenjene razine oksitocina u serumu pomoću ELISA testa. T-test je rabljen za analizu statističkih podataka. Razina oksitocina u serumu u T2 skupini (628,06 ± 168,72 pg/mL) bila je značajno veća od one u T1 skupini (366,71 ± 185,03 pg/mL; P < 0,05). Zaključno, razine oksitocina u životinja nakon okota bile su veće od razina u ženki koje se nikada nisu parile. Nakon naših istraživanja zaključak je da oksitocin ima veću ulogu u reprodukciji ženki nego u normalnom fiziološkom stanju

Readiness of Health Workers to Provide Pregnancy Planning Program for Women Infected with Human Immunodeficiency Virus: A Case Study in Surabaya, East Java, Indonesia

Background: The prevalence of human immunodeficiency virus (HIV) mother-to-child infection, or vertical transmission of HIV, in Indonesia is about 90%. Ministry of Health of the Republic of Indonesia Regulation No. 21 of 2013 stated that HIV infection in sexual productive age needs integrative professional help to lower the transmissions, including voluntary counseling and testing for pregnant women as well as all people at risk. This study aimed to determine the readiness of health workers to provide pregnancy planning program service for women with HIV.Methods: This study was a descriptive study involving 30 obstetricians and 30 residents of Obstetrics and Gynecology specialist education in Surabaya, Indonesia. The respondents’ knowledge on pregnancy planning for HIV-infected women based on based on guidance released by the Ministry of Health of Indonesia in 2017 and Regulation of Ministry of Health no. 52 the year 2017, as well as their attitude and readiness to provide pregnancy planning services, was explored. Questionnaires were distributed from August to December 2019 and the data collected were analyzed using Statistical Package for the Social Science (SPSS) version 17.0 and results were described in percentage.Results: Most health workers (80%) had good knowledge on providing pregnancy planning program for HIV positive women; however, only 63.3% had good attitude towards it. The majority of respondents (90%) were ready to help HIV patients in planning their pregnancy. Conclusion: Health workers in Surabaya are ready to provide services related to pregnancy planning for women infected with HIV

Gawat Darurat Medis Dan Bedah

Pengetahuan baru mendorong kemajuan dalam bidang medis dan bedah. Hal tersebut dapat meningkatkan kualitas pelayanan dan perawatan kepada pasien. Pesatnya pertumbuhan pengetahuan tentang penanganan kegawatdaruratan baik dalam bidang medis maupun bedah dan pengetahuan tentang kondisi dan waktu yang tepat untuk merujuk kepada ahli yang berkompeten perlu dipahami oleh tenaga medis yang bertugas di lini terdepan fasilitas pelayanan kesehatan

Plasma Level of Umbilical Cord Hemeoxygenase-1 (HO-1) and Neonatal Outcome in Early Onset and Late Onset Severe Preeclampsia

Background: Many studies had discovered that early onset severe preeclampsia (EO-PE) has worst maternal and neonatal outcome compared to late-onset type (LO-PE), related to its placental involvement. Severe preeclampsia was defined as newly onset severe hypertension developed after 20 weeks gestation in previously normal blood pressure women, with coexistence of proteinuria, or maternal organ or uteroplacental dysfunction. Hemeoxygenase-1 (HO-1) is an enzyme with multiple effect which is protective to pregnancy.Materials and Methods: The total study subjects were 40 pregnant women consisted of 10 EO-PE, 10 normal early onset pregnancy (EO-NP), 10 LO-PE, and 10 normal late onset pregnancy (LO-NP). As much as 5 cc of plasma from umbilical cord was taken as soon as the baby was born, and the HO-1 level was examined by enzyme-linked immunosorbent assay (ELISA). The primary outcome were umbilical cord HO-1 level and neonatal composite morbidity (low Apgar score, low birthweight, length of stay >5 day, respiratory distress syndrome, jaundice and neonatal death).Results: The plasma level of HO-1 in EO-PE subjects were lower than EO-NP (0.96±0.37 ng/mL vs. 2.43±0.58 ng/mL, p<0.001). There were no significant differences in the level of HO-1 in LO-PE and LO-NP (2.18±1.07 ng/mL vs. 3.02±0.64 ng/mL, p=0.277). Plasma level of umbilical cord HO-1 of EO-PE patients was lower compared to LO-PE (0.96±0.37 ng/mL vs. 2.18±1.07 ng/mL, p=0.034). Neonatal outcome of EO-PE was worse than EO-NP (p=0.033), and LO-PE (p=0.003), while in LO-PE did not different with LO-NP (p=0.211).Conclusion: EO-PE is associated with lower plasma umbilical cord level of HO-1 and worse neonatal outcome compared to LO-PE. This indicating abnormal placental blood vessel development, placental ischemia in EO-PE, lead to reduced uteroplacental perfusion and significantly worse neonatal outcome compared to LO-PE.Keywords: severe preeclampsia, early onset preeclampsia, late onset preeclampsia, hemeoxygenase-1

Serum Calcium and 25-Hydroxy Vitamin D Level in Normal and Early Onset Pre-eclamptic Pregnant Women:A Study from Indonesia

Introduction: Pre-eclampsia is one of the most common causes of fetomaternal morbidity and mortality worldwide. This disorder is categorised into Early Onset Pre-eclampsia (EOPE) and Late-Onset Pre-eclampsia (LOPE). EOPE is usually accompanied by severe complications for both the mother and fetus, while LOPE is accompanied by relatively mild fetomaternal complications. Although the pathogenesis of EOPE is not yet fully elucidated, recent studies indicate that serum calcium and 25 Hydroxy Vitamin D (25(OH)D) levels may play a role in its pathogenesis.Aim: To find out the relationship of calcium and 25(OH)D serum levels in pregnant women with normal pregnancy and with EOPE in Indonesia.Materials and Methods: This study was a case-control study, conducted in Dr. Soetomo General Hospital from July to October 2017. A total of 36 women with EOPE and 64 women with normal pregnancy were included in this study. Inclusion criteria were pregnant women in 2nd or 3rd-trimester with BMI &gt; 18 kg/m(2). Blood sample analysis was done to measure serum calcium and 25(OH)D level. Data were expressed as Mean +/- Standard Deviation. Data distribution was analysed using Shappiro-Wilk test. Comparison of serum calcium and 25(OH)D level between groups was analysed using Independent t-test. Correlation between serum calcium and 25(OH)D level was analysed using Pearson's correlation test. The p-value ofResults: There was a significant difference in serum calcium level between case and control group (8.294 +/- 0.725 vs 8.670 +/- 0.405 mg/dL; p=0.006). In 25(OH)D level, there was no difference between both groups (16.128 +/- 7.5463 vs 17.325 +/- 6.4992 ng/mL; p=0.406). No correlation was found between calcium and 25(OH)D level (r=0.165; p=0.101).Conclusion: Calcium deficiency plays a role in the incidence of EOPE among pregnant women in Indonesia. The actual role of calcium deficiency in EOPE needs further investigation.</p

Pravastatin suppresses inflammatory cytokines and endothelial activation in patients at risk of developing preeclampsia INOVASIA Study

Introduction: The Indonesian INOVASIA study is an ongoing multicentre randomized, open controlled trial of pravastatin for the prevention of preeclampsia in patients deemed to be high risk. Here we evaluate the effects of pravastatin on circulating inflammatory and endothelial markers, i.e. Vascular Endothelial Growth Factor (VEGF), Interleukin-6 (IL-6), Endothelin-1 (ET-1), and Nitric Oxide (NO). Methods: Pregnant women deemed to be at a high risk of developing preeclampsia women were recruited based on the Fetal Medicine Foundation preeclampsia screening test or a history of preterm preeclampsia, or clinical risk factors in combination with an abnormal uterine artery Doppler flow pattern at 11-20 week's gestation. This is a nested cohort study within the larger trial (INOVASIA); 38 patients were consecutively recruited and assigned to the pravastatin group and the control group. Participants in the pravastatin group received pravastatin (2 × 20 mg p.o) in addition to a standard regimen of aspirin (80 mg p.o) and calcium (1 g p.o), from 14 to 20 weeks until delivery. Blood samples to measure the various biomarkers were obtained in consecutive patients before starting the research medication and just before delivery (pre and post-test examination). Result: The number of samples on the 2 time points for the various biomarkers was: VEGF: 38, IL-6: 30, ET-1: 38, and NO: 35. IL-6 levels decreased significantly in the pravastatin group (mean ± SD): (191.87 ± 82.99 vs. 151.85 + 48.46, p = .013), while levels in the control group did not change significantly (median (interquartile range)) (144.17 (53.91) vs. 140.82 (16.18), p = .177). ET-1 levels decreased significantly in the pravastatin group (3.64 ± 0.85 vs. 3.01 ± 0.74, p = .006) while the control group had more or less stable levels (3.57 ± 1.12 vs. 3.78 ± 0.73 p = .594). NO was the only serum marker that showed significant changes in both groups. NO levels increased in pravastatin group (11.30 (17.43) vs. 41.90 (53.18), p = .044) and decreased in control group (38.70 (34.80) vs. 10.03 (26.96), p = .002). VEGF levels appeared to follow opposite trends in the 2 groups (NS) (Pravastatin: 3.22 (0.62) vs. 3.28 (0.75), p = .402. Control: 3.38 (0.83) vs. 3.06 (0.74), p = .287). Conclusion: Administration of 40 mg pravastatin resulted in an improvement in NO levels, and a decrease in IL-6 and endothelin (ET-1) levels. The direction of the effect of pravastatin on these biomarkers appears to underpin the potential for a beneficial effect of pravastatin in the prevention of preeclampsia

Majalah obstetri & ginekologi volume 25 no 3 2017

71-115 hl

Defisiensi Mikronutrisi (Zat Besi, Magnesium, Zinc, Kalsium, Vitamin D, Asam Folat, Vitamin C, Vitamin E, dan Omega 3) pada Preeklamsia

Preeklamsia masih menjadi penyebab utama mortalitas dan morbiditas maternal neonatal di Indonesia. Preeklamsia disebabkan oleh multifaktorial yang ujungnya akan berakhir dengan terjadinya disfungsi endotel vaskular dan manifestasi klinis sistemik. Indonesia merupakan salah satu negara berkembang dengan masalah besar yang terkait dengan nutrisi. Tingginya angka stunting dan malnutrisi pada anak-anak, remaja, dan ibu hamil merupakan masalah nasional yang menjadi perhatian utama. Defisiensi nutrisi khususnya mikronutrisi ditunjukkan dari berbagai penelitian memiliki kaitan dengan terjadinya hipertensi dalam kehamilan. Pada artikel ini kami akan membahas mengenai peran dan keterkaitan mikronutrisi (Zat besi, magnesium, zinc, kalsium, vitamin C, D, E, dan DHA) dengan terjadinya preeklamsia. AbstractIn Indonesia, preeclampsia continues to be the leading cause of maternal and infant morbidity and mortality. A complex etiology for preeclampsia led to vascular endothelial dysfunction and a widespread clinical presentation. Indonesia is a developing nation with significant nutrition-related issues. The key cause for concern is the high rate of stunting and malnutrition in children, adolescents, and pregnant women. Micronutrient deficits in particular have been linked to the development of hypertensive disorders in pregnancy. In this post, we will discuss about how micronutrients like iron, magnesium, zinc, calcium, and the vitamins C, D, E, and DHA might affect in the development of preeclampsia

Majalah obstetri & ginekologi volume 25 no 1 2017

1-32 hl

Majalah obstetri & ginekologi volume 23 no 3 2015

90-141 hl