Goitre as Predisposing Factor of Thyroid Carcinomas

Goitre is an enlargement of thyroid gland which can be associated with primary thyroid disorders or stimulation of the gland by hormones and other factors. In Indonesia and especially in Bali, increase of Thyroid Carcinoma cases had been associated with either endemic or non endemic goiter. Goitre increases 2.5 fold risk of thyroid carcinoma. Goitre may cause diffuse and nodular hyperplasia (either single or multiple nodules). Clonal analysis has been discovered that hyperplasia is considered to be polyclonal proliferation. Monoclonal alterations had also been found in a subset of thyroid nodules that were previously considered hyperplastic. Alterations of polyclonal to monoclonal pattern was considered as interaction between past history of hyperplastic lesion and genetic predisposition which furthermore forming mutagenic environment such as increases of cell proliferation and also free radicals induce- somatic mutation. Iodine supplementation on endemic goiter related with radioactive iodine content which damaging DNA sequences in the form of RETTRK rearrangement

Goiter Sebagai Faktor Predisposisi Karsinoma Tiroid

Goiter merupakan pembesaran kelenjar tiroid yang dapat berkaitan dengan gangguan primer pada organ tiroid ataupun akibat stimulasi hormonal atau faktor lain terhadap tiroid. Di Indonesia dan di Bali khususnya kasus karsinoma tiroid mengalami peningkatan sejalan dengan peningkatan kasus goiter endemik maupun non endemik. Goiter memiliki faktor risiko sebesar 2,5 kali lipat untuk menimbulkan karsinoma tiroid. Goiter dapat menimbulkan hiperplasia yang bersifat difusa maupun noduler (nodul tunggal dan multipel). Analisis klonal telah membuktikan bahwa hiperplasia merupakan proliferasi yang bersifat poliklonal. Pada tiroid, ditemukan perubahan pola monoklonal pada kelompok nodul yang sebelumnya merupakan nodul hiperplastik. Perubahan poliklonal menjadi monoklonal ini merupakan interaksi antara adanya lesi hiperplastik sebelumnya dengan predisposisi genetik yang selanjutnya menciptakan lingkungan mutagenik, ditandai oleh peningkatan proliferasi sel disertai pembentukan radikal bebas yang memicu adanya mutasi somatiktirosit. Pemberian suplementasi iodium pada kasus goiter endemik, dikatakan berkaitan dengan adanya kandungan iodine radioaktif nantinya justru menimbulkan kerusakan rantai DNA melalui tata ulang RET-TRK.Kata Kunci: goiter, predisposisi, karsinoma tiroid. [Goitre as Predisposing Factor of Thyroid Carcinomas].Goitre is an enlargement of thyroid gland which can be associated with primary thyroid disorders or stimulation of the gland by hormones and other factors. In Indonesia and especially in Bali, increase of Thyroid Carcinoma cases had been associated with either endemic or non endemic goiter. Goitre increases 2.5 fold risk of thyroid carcinoma. Goitre may cause diffuse and nodular hyperplasia (either single or multiple nodules). Clonal analysis has been discovered that hyperplasia is considered to be polyclonal proliferation. Monoclonal alterations had also been found in a subset of thyroid nodules that were previously considered hyperplastic. Alterations of polyclonal to monoclonal pattern was considered as interaction between past history of hyperplastic lesion and genetic predisposition which furthermore forming mutagenic environment such as increases of cell proliferation and also free radicals induce- somatic mutation. Iodine supplementation on endemic goiter related with radioactive iodine content which damaging DNA sequences in the form of RET-TRK rearrangement.Keywords: goitre, predispose, thyroid carcinoma

Risiko Kandidiasis Serviks pada Wanita Usia Subur Akseptor Kontrasepsi Hormonal

Abstrak Kontrasepsi Hormonal merupakan salah satu metode kontrasepsi yang paling diminati oleh Wanita Usia Subur (WUS) di Indonesia termasuk di Bali. Dewasa ini mulai timbul pro dan kontra mengenai penggunaan kontrasepsi hormonal terkait berbagai efek samping yang ditimbulkan, salah satunya dikatakan berkaitan dengan kandidiasis serviks. Tujuan penelitian ini adalah untuk mengetahui risiko kandidiasis serviks pada WUS akseptor kontrasepsi hormonal. Penelitian ini menggunakan rancangan case control yang disarangkan pada penelitian pap smear (nested case control). Kemudian akan dibandingkan seberapa besar efek paparan kontrasepsi hormonal antara kelompok kasus (kandidiasis serviks) dengan kelompok kontrol (non kandidiasis serviks) secara deskriptif analitik melalui uji statistik chi-square dengan

Strengthening the Role of Cadres and Village Midwives to Support the Cervical Cancer Awareness Movement in Puhu Payangan Village, Gianyar, Bali, Indonesia

Cervical cancer is the most common type of cancer in Balinese women, and most of the cervical cancer patients came in advanced condition. The health survey conducted in the village of Puhu, Payangan, Gianyar, found that the coverage of cervical cancer screening is 12%, which is considered as low. Payangan’s sub-district health centers (Puskesmas) have made an effort to give free PAP smear screenings to the local community, but it still has not received a good response. This is related to the community’s lack of knowledge on cervical cancer, low awareness of cancer screening, and false stigma about PAP smear examination. To overcome this problem, an effort is needed to increase awareness about the need for PAP smear screening by shaping it into a cervix cancer awareness movement "Gardavi", involving village midwives and housewife members of Empowerment and Family Welfare Group (PKK) in Puhu Village as cadres. Methods that are used in this community service include training for midwives, activation of tiered information system involving midwives-cadres and the community, knowledge provision as well as motivating cadres. This event is done to increase the role of village midwives and cadres to actively participate in PAP smear screenings in their region, therefore, it may increase screening outcomes and lower mother morbidity and mortality numbers due to cervical cancer. This event results in increased midwives’ knowledge and skill on the technique of sampling PAP smear independently, increased visits to the Community Health Sub-Center (Pustu) for PAP smear examination, creation of a midwives-cadres-community coordination system, cadres independently playing an active role in motivating the village community to do screening, as well as increased cadres’ optimism

PEMBERDAYAAN KELOMPOK SEBAYA DAN KONSELING DI SMP WIDYA SAKTI UNTUK MENINGKATKAN GERAKAN SEHAT REPRODUKSI REMAJA

Adolescent are a transition period and highly sensitive to the influence of new values. The problems they face are also quite complex, one of which concerns reproductive health. Some studies suggest that peers are the most dominant factor in influencing the adolescent reproductive health behaviors. This dedication activity aims to increase adolescent knowledge and activate the role of peers and counseling teachers in disseminating correct information about reproductive health. The method of implementing activities in the form of providing material on adolescent reproductive health by a talk from the expert, training and mentoring to peer groups in carrying out mini counseling, as well as training and counseling for counseling teachers. After the implementation of this program obtained increased peer group knowledge and counseling teachers on adolescent reproductive health respectively as much as 50% and 30.8%. In addition, all peer groups are able to conduct mini-counseling as well as to do better counseling. Through this activity it is hoped that peer group partners and counseling is able to play an active role in continuously spreading information about adolescent reproductive health so that it can produce other peers who help keep the healthy atmosphere of the adolescents

Karakteristik Ibu Hamil Trimester III yang Mengalami Kecemasan dalam Menghadapi Persalinan pada Masa Pandemi Covid-19 di Klinik Kesehatan dan Rumah Bersalin Dewi Laksmi Nabire Papua

Covid-19 is an acute respiratory diseasse which was spread to all countries, one of which is Indonesia. One of the impact of this pandemic is causing many restrictions on almost all services, including health services. The maternal mortality rates (MMR) in Papua reached 200 per 100,000 live births. Anxiety is a problem that if not treated immediately can cause problems for the mother and baby, including the occurrence of resistance in the uterine arteries which causes stunted fetal growth. The purposes of this study is to determine  characteristics of third trimester pregnant women who experience anxiety in dealing with childbirth during the COVID-19 pandemic at the Dewi Laksmi Nabire Maternity Health Clinic and Maternity Hospital, Papua. This research uses descriptive research method with cross sectional study design with non probability sampling technique purposive sampling method. The sample consisted of 195 third trimester pregnant women who had met the inclusion and exclusion criteria. The data collection instrument used a questionnaire in the form of a google form. Data analysis was performed univariately. The result showed majority of third trimester pregnant women experienced mild-severe anxiety in the age range of 20-35 years (29.3%), had sufficient knowledge (31.1%), received support from their husbands (11.9%), not working (54.3%), primigravida (43.2%), high education level (21.2%), and getting the COVID-19 issue (28.7%). For all pregnant women, it is hoped that this research can be used as informative material that can increase understanding regarding the description level of anxiety on pregnant women that will be giving birth during  COVID-19.Covid-19 merupakan penyakit pernafasan akut yang sudah tersebar ke seluruh negara, salah satunya adalah Indonesia. Salah satu dampak pandemi Covid-19 yaitu menimbulkan banyaknya pembatasan hampir ke seluruh pelayanan seperti pelayanan kesehatan. Angka Kematian Ibu (AKI) di Papua menyentuh angka 200 per 100.000 kelahiran hidup. Kecemasan merupakan suatu masalah yang bila tidak segera tertangani bisa memberi dampak kepada ibu dan bayi salah satunya yaitu terjadi resistensi dalam arteri uterin yang membuat perkembangan janin terhambat. Tujuan penelitian yang dijalani yaitu guna mencari tahu karakteristik ibu hamil trimester III yang mengalami kecemasan saat akan bersalin saat pandemi covid-19 pada Klinik Kesehatan dan Rumah Bersalin Dewi Laksmi Nabire Papua. Penelitian tersebut memanfaatkan metode penelitian deskriptif melalui perancangan studi cross sectional menggunakan teknik non probality sampling metode purposive sampling. Sampel berjumlah 195 ibu hamil trimester III yang telah sesuai pada karakter inklusi juga eksklusi. Instrumen pengumpulan data menggunakan kuesioner berupa google form. Analisa data dijalani dengan univariat. Hasil penelitian memperlihatkan jika mayoritas ibu hamil trimester III mengalami kecemasan ringan-berat pada rentang umur 20-35 tahun (29,3%), memiliki pengetahuan yang cukup (31,1%), mendapat dukungan suami (11,9%), tidak bekerja (54,3%), primigravida (43,2%), tingkat pendidikan yang tinggi (21,2%), dan mendapatkan issue COVID-19 (28,7%). Bagi seluruh ibu hamil diharap bisa menjadikan penelitian ini sebagai bahan informatif yang mampu meningkatkan pemahaman mengenai gambaran tingkat kecemasan ibu hamil saat menjalani persalinan saat Pandemi COVID-19. &nbsp

Gambaran Kejadian Diare pada Balita di Rumah Sakit Umum Daerah Wangaya Denpasar

Abstract [Overview of the Diarrhea Incidence in Toddlers at the Wangaya Regional General Hospital, Denpasar]   Diarrhea is a bowel disease with a frequency of 3 or more times per day which is soft, liquid and can be accompanied by blood, mucus, fat, or undigested food particles.  Diarrhea is the main cause of death for children under the age of 5 years in Indonesia, due to malnutrition. The severity of diarrheal disease is determined by nutritional status, duration of diarrhea, degree of dehydration, comorbidities and length of stay in hospital.  In the province of Bali, the incidence of diarrhea in children under five years includes 1,275 cases and the highest case finding of diarrhea in children under five years is in the city of Denpasar.  This study aims to determine the description of diarrheal disease in children under five years at Wangaya General Hospital Denpasar from January 2020 - July 2021. This study is a descriptive study with a cross sectional design.  The research subjects were toddlers aged 12-60 months who were selected based on the purposive sampling method.  Collecting data using secondary data from the medical records of the Wangaya Regional General Hospital Denpasar, then analyzed using a univariate test through the SPSS computer program.   The results showed that all children under five years with diarrhea in Wangaya General Hospital Denpasar experienced acute diarrhea. The majority of toddlers with diarrhea at the Wangaya General Hospital Denpasar experienced mild or moderate dehydration, received less than 5 days of treatment, experienced symptoms of watery bowel movements, vomiting and fever when they entered the hospital and improved when they were brought home.   Keywords : diarrhea, duration of diarrhea, degree of dehydration, length of stay in hospitalAbstrak Diare merupakan suatu penyakit buang air besar dengan frekuensi 3 kali atau lebih per hari yang berbentuk lunak dan cair serta dapat disertai darah, lendir, dan lemak. Diare merupakan penyebab kematian utama anak dibawah usia 5 tahun di Indonesia, karena mengakibatkan dehidrasi, malnutrisi bahkan kematian. Berat ringannya penyakit diare ditentukan oleh status gizi, lama diare, derajat dehidrasi, penyakit penyerta dan lama rawat. Kejadian diare pada balita di Provinsi Bali mencakup 1.275 kasus dan jumlah kasus tertinggi yaitu di Kota Denpasar. Penelitian ini bertujuan untuk mengetahui gambaran penyakit diare pada balita di Rumah Sakit Umum Wangaya Denpasar dari Januari 2020 - Juli 2021. Penelitian ini merupakan penelitian deskriptif dengan desain cross sectional. Subjek penelitian adalah balita usia 12-60 bulan yang dipilih berdasarkan metode purposive sampling. Pengumpulan data menggunakan data sekunder dari rekam medis Rumah Sakit Umum Daerah Wangaya Denpasar, kemudian data dianalisis menggunakan uji univariat melalui program komputer SPSS. Hasil penelitian menunjukkan bahwa seluruh balita diare di RSUD Wangaya Denpasar mengalami diare akut. Mayoritas balita diare di RSUD Wangaya Denpasar mengalami dehidrasi derajat ringan atau sedang, memperoleh perawatan kurang dari 5 hari, mengalami gejala BAB encer, muntah dan demam ketika masuk RS serta membaik ketika dibawa pulang.   Kata kunci : diare, lama diare, derajat dehidrasi, lama rawat diar

Karakteristik Vaginal Birth After Caesarean (VBAC) pada Ibu dengan Locus Minoris Resistentiae (LMR) Periode Januari 2017 - Desember 2020

Vaginal Birth After Cesarean (VBAC) is a normal delivery process after having previously had a cesarean section. This process is carried out on mothers with former cesarean sections or Locus Minoris Resistant (LMR). The aim of this study was to find out the characteristics of Vaginal Birth After Caesarean (VBAC) in Mothers with Locus Minoris Resistance (LMR) for the period January 2017-December 2020. This study was a retrospective descriptive study with a sample of mothers with LMR who performed VBAC at the Sanjiwani Hospital. Gianyar, BRSUD Tabanan and RS Prima Medika Denpasar which were selected by purposive sampling method that met the inclusion criteria were then presented in tabular form. There were 37 patients out of 48 patients who underwent Trial of Labor After Caesarean (TOLAC) who successfully performed a VBAC with various characteristics, where as many as 32 people (86.5%) with age < 35 years, did not have a history of normal delivery as many as 24 people ( 64.9%), having a cesarean section frequency 1 time as many as 36 people (97.3%), patients with an indication of a previous cesarean section in a breech presentation as many as 14 people (37.9%), with a delivery distance of > 24 months as many as 37 people ( 100%) and gave birth to babies with a birth weight of 2500-4000 grams as many as 36 people (97.3%).Vaginal Birth After Cesarean (VBAC) merupakan proses persalinan normal setelah sebelumnya pernah melakukan seksio sesarea. Proses ini dilakukan pada ibu dengan bekas seksio sesarea atau Locus Minoris Resistentiae (LMR). Penelitian ini memiliki tujuan guna mencari tahu karakteristik Vaginal Birth After Caesarean (VBAC) pada Ibu dengan Locus Minoris Resistentiae (LMR) periode Januari 2017-Desember 2020. Penelitian ini berupa penelitian deskriptif retrospektif dengan sampel penelitian ibu dengan LMR yang melakukan akan VBAC di RSUD Sanjiwani Gianyar, BRSUD Tabanan dan RS Prima Medika Denpasar yang dipilih dengan metode purposive sampling yang memenuhi kriteria inklusi kemudian ditampilkan dalam bentuk tabel. Ditemukan 37 pasien dari 48 pasien yang melakukan Trial of Labor After Caesarean (TOLAC) yang berhasil melakukan VBAC dengan beragam karakteristik, di mana sebanyak 32 orang (86,5%) dengan usia < 35 tahun, tidak memiliki riwayat persalinan normal sebanyak 24 orang (64,9%), memiliki frekuensi seksio sesarea 1 kali sebanyak 36 orang (97,3%), pasien dengan indikasi seksio sesarea sebelumnya letak sungsang sebanyak 14 orang (37,9%), dengan jarak persalinan > 24 bulan sebanyak 37 orang (100%) dan melahirkan bayi dengan berat lahir 2500-4000 gram sebanyak 36 orang (97,3%)

Perbedaan Tingkat Pengetahuan Pencegahan Kanker Serviks SMA Negeri dan Swasta Kelas X Kabupaten Badung : knowledge level on cervical cancer prevention among class X high school female students in public versus the private schools within the Badung Regency.

  The average age for first having sexual intercourse outside of marriage, which is 14-19 years, is one of the causes of the risk of cervical cancer. This research compares the knowledge level on cervical cancer prevention among class X high school female students in public versus the private schools within the Badung Regency.  A cross-sectional comparative study is used as the study designed, which includes a total sample of 336 female students (n=336) by utilizing questionnaires.  Bivariate analysis with Interdependent T-test and Statistical Package for Social Sciences (SPPS) is appropriate for analyzing the gathered research data.  The results of this study between public and private high schools in Badung Regency have different levels of knowledge about cervical cancer prevention. Data analysis shows that 99 (29.5%) female respondents in public high schools know about cervical cancer prevention, and only 80 (23.8%) female students from private schools.  The findings of this study imply that school-based teaching is critical for increasing understanding and lowering cervical cancer rates, as well as collaborating with the health department to provide cervical cancer counseling and installing health-related information media in the school environment.Rata-rata usia pertama kali melakukan hubungan seksual di luar nikah yaitu 14-19 tahun yang menjadi salah satu penyebab berisiko terkena kanker serviks. Tujuan dari penelitian ini adalah untuk mengetahui perbedaan pengetahuan tentang pencegahan kanker serviks antara siswa kelas X SMA Negeri dan Swasta Kabupaten Badung. Penelitian ini menggunakan desain deskriptif komparatif dengan menggunakan data cross sectional. Sebanyak 336 siswi dilibatkan dalam penelitian ini dan data dikumpulkan melalui kuesioner. Penelitian ini menggunakan analisis bivariat menggunakan Independent T-test dengan Statistical Package for Social Sciences (SPSS). Hasil penelitian ini antara SMA Negeri dan SMA Swasta Kabupaten Badung memiliki tingkat pengetahuan yang berbeda tentang pencegahan kanker serviks. Tingkat pengetahuan SMA Negeri dalam kategori baik sebanyak 99 (29,5%) responden dan SMA Swasta dalam kategori cukup sebanyak 80 (23,8%) responden. Saran penelitian ini yaitu edukasi dari pihak sekolah sangat penting untuk meningkatkan pengetahuan sehingga bisa menekan laju kasus kanker serviks, bekerja sama dengan dinas kesehatan agar dikakukan penyuluhan tentang kanker serviks, memasang media informasi tentang kesehatan di lingkungan sekolah

Specific Histologic Type of Leiomyoma Related to Estrogen Receptor Expression

Uterine Leiomyoma or fibroid is the most common gynecologic benign neoplasm which arising from monoclonal proliferation of smooth muscle cells in uterine wall. Some specific types of uterine leiomyoma, such ascellular leiomyoma, symplastic leiomyoma, mitotically active leiomyoma andmyxoid leiomyomahave different histomorphology from usual type leiomyoma. It also have wide variety of tumors size, but this study found that no correlation between type of leiomyoma and its size. Additional non-invasive therapy that predominantly developed in leiomyoma include many antagonist agents of estrogenic receptor. So, important to determine of estrogen receptor activity before that hormonal therapy prescription.Histopathology parameter that predict estrogen receptor activity in leiomyoma was not well understood. This study also try to correlate between specific histologic type of leiomyoma and estrogen receptor activity. This study was a retrospective crossectional study which analized by pearson chi-square test with p value < 0.05 and CI 95%. Result: There was significant correlation between specific histologic type of leiomyoma and estrogen receptor expression (p=0.007; p<0.05).   Key Words: Leiomyoma,  Estrogen Recepto