Effectiveness, Safety and Obedience of Dienogest and Leuprolide Acetate in Postlaparoscopic Endometriosis Patients: Efektivitas, Keamanan dan Kepatuhan terhadap Dienoges dan Leuprolide Asetat pada Pasien Endometriosis Pascalaparoskopi

Abstract Objective: Comparing therapeutic effectiveness, safety profile, and adherence between Dienogest and postoperative Leuprolide Acetate in women with endometriosis who underwent laparoscopy. Methods: This study was a randomized clinical trial comparing the open label study to compare the effectiveness of therapy, safety profile, and obedience between postoperative dienogest and leuprolide acetate in women with endometriosis who underwent laparoscopy. Result: From the statistical test it was found that there was effectiveness of dienogest after 4 weeks of therapy (p = 0.004), after 8 weeks of therapy (p = 0.004) and after 12 weeks of therapy (p = 0.004). In the leuprolide acetate group it was also found that there was effectiveness of administration after 4 weeks of therapy (p = 0.004), after 8 weeks of therapy (p = 0.004) and after 12 weeks of therapy (p = 0.003). There was no difference in systolic blood pressure (p = 0.481), diastolic blood pressure (p = 1,000) and pulse frequency (p = 0.125) breath frequency (p = 1,000) and temperature (p = 0.236) between patients who received dienogest and leuprolide acetate. From the statistical analysis it was found that there were no differences in side effects in patients who received dienogest and leuprolide acetate (p = 0.238). Conclusion: There was no difference in therapeutic effectiveness, and the safety profile assessed by side effects as well as obedience of postoperative Dienogest and Leuprolide Acetate in endometriosis women undergoing Laparoscopy because in both groups there was a decrease in VAS scores from week to week. Key Word: Dienogest, Leuprolide Acetate, Endometriosis, Post-Laparoscopy, Therapy   Abstrak Tujuan: Membandingkan efektivitas terapi, profil keamanan, dan kepatuhan antara Dienogest dengan Leuprolid Asetat pascaoperatif pada wanita endometriosis yang menjalani Lapararoskopi. Metode: Penelitian ini merupakan uji klinik acak berpembanding dengan open label study untuk membandingkan efektivitas terapi, profil keamanan, dan kepatuhan antara dienogest dan leuprolid asetat pascaoperatif pada wanita endometriosis yang menjalani lapararoskopi. Hasil: Dari uji statistik didapatkan hasil terdapat efektivitas pemberian dienogest setelah 4 minggu terapi (p = 0,004), setelah 8 minggu terapi (p = 0,004) dan setelah 12 minggu terapi (p = 0,004). Pada kelompok leuprolid asetat juga didapatkan hasil terdapat efektivitas pemberian setelah 4 minggu terapi (p = 0,004), setelah 8 minggu terapi (p = 0,004) dan setelah 12 minggu terapi (p = 0,003).  Tidak terdapat perbedaan tekanan darah sistolik (p = 0,481), tekanan darah diastolik (p = 1,000) dan frekuensi nadi (p = 0,125) frekuensi napas (p = 1,000) dan suhu (p = 0,236) antara pasien yang mendapatkan dienogest dan leuprolid asetat. Dari analisa statistik didapatkan hasil tidak terdapat perbedaan efek samping pada pasien yang mendapatkan dienogest dan leuprolid asetat (p = 0,238). Kesimpulan: Tidak terdapat perbedaan efektivitas terapi, dan profil keamanan yang dinilai dari efek samping serta kepatuhan Dienogest dan Leuprolid Asetat pascaoperatif pada wanita endometriosis yang menjalani Lapararoskopi karena pada kedua kelompok terdapat penurunan VAS skor dari minggu ke minggu. &nbsp

Simultaneous measurement of two non-commuting quantum variables: Solution of a dynamical model

The possibility of performing simultaneous measurements in quantum mechanics is investigated in the context of the Curie-Weiss model for a projective measurement. Concretely, we consider a spin-$\frac{1}{2}$ system simultaneously interacting with two magnets, which act as measuring apparatuses of two different spin components. We work out the dynamics of this process and determine the final state of the measuring apparatuses, from which we can find the probabilities of the four possible outcomes of the measurements. The measurement is found to be non-ideal, as (i) the joint statistics do not coincide with the one obtained by separately measuring each spin component, and (ii) the density matrix of the spin does not collapse in either of the measured observables. However, we give an operational interpretation of the process as a generalised quantum measurement, and show that it is fully informative: The expected value of the measured spin components can be found with arbitrary precision for sufficiently many runs of the experiment.Comment: 24 pages, 9 figures; close to published versio

KAJIAN KOMUNITAS EKOSISTEM LAMUN DI SEMENANJUNG TARABITAN KECAMATAN LIKUPANG BARAT KABUPATEN MINAHASA UTARA

This research was conducted in the waters of Tarabitan Peninsula, West Likupang North Minahasa using quadants transect method. The purpose of this study was to determine the community structure of seagrass found in that waters as initial information for sustainable management seagrass ecosystem . Field observation was conducted to identify the seagrass species, number of individuals/shoots, percent cover for each type of seagrass in those plotting quadrants. The result of this study documented 6 types of seagrass namely, Enhalus acoroides, Thalassia hemprichii, Cymodocea rotundata, Syringodium isoetifolium, Halophila ovalis and Halodule uninervis. The species composition and distribution of seagrass were varied and was dominated by Thalassia hemprichii was the most dominant seagrass species with a relative density of 55.55%, a relative frequency of 33.67%, 39.92% relative cover, an important value index of 129.03%, a diversity index of 1.30 belonging to this condition, moderate, the uniformity index of 0.72 is classified as high and the dominance index of 0.2 is classified as low. Based on Minister of Environment Decree Republic Indonesia No. 200 of 2004 concerning the status of seagrass beds, the condition of the seagrass beds in the waters of Tarabitan Village is classified as rich / healthy with a cover value of ≥ 60. Keywords : Seagrass Community, Species Composition,  distribution, Tarabitan Peninsula           Penelitian ini dilakukan di perairan Semenanjung Tarabitan Likupang Barat Minahasa Utara dengan menggunakan metode transek kuadran. Tujuan penelitian ini adalah untuk mengetahui struktur komunitas lamun yang terdapat di perairan tersebut sebagai informasi awal untuk pengelolaan lamun secara berkelanjutan. Pengamatan lapangan dilakukan untuk mengidentifikasi jenis lamun, jumlah individu/tegakan, persentase tutupan tiap jenis lamun pada tiap kuadran. Hasil penelitian ini mendokumentasikan 6 jenis lamun yaitu Enhalus acoroides, Thalassia hemprichii, Cymodocea rotundata, Syringodium isoetifolium, Halophila ovalis dan Halodule uninervis. Komposisi jenis dan sebaran lamun bervariasi dan didominasi oleh jenis lamun Thalassia hemprichii merupakan jenis lamun yang paling dominan dengan kerapatan relatif 55,55%, frekuensi relatif 33,67%, tutupan relatif 39,92%, indeks nilai penting 129,03%, indeks keanekaragaman 1,30 tergolong dalam kondisi sedang, indeks keseragaman 0,72 tergolong tinggi dan indeks dominansi 0,2 tergolong rendah. Berdasarkan Keputusan Menteri Lingkungan Hidup Nomor 200 Tahun 2004, kondisi padang lamun di perairan Desa Tarabitan tergolong kaya / sehat dengan nilai tutupan ≥ 60.Kata Kunci: Komunitas Lamun, Komposisi Jenis, Distribusi, Semenanjung Tarabita

Relationship of the Role of Counselor, Knowledge, Trust, Values, and Social Relationship in Contraception Acceptors’ Decision of Using Intrauterine Device (IUD): Hubungan Faktor Peran Konselor, Pengetahuan, Kepercayaan, Nilai, dan Kekerabatan terhadap Keputusan Akseptor KB untuk Menggunakan Kontrasepsi Intrauterine Device (IUD)

Abstract Objective: to assess the relationship of the role of counselor, knowledge, trust, values, and social relationship regarding acceptors’ decision in using intrauterine device at Dr. Mohammad Hoesin Hospital Palembang. Method: An observational analytical cross-sectional research carried out on June 2017 until September 2017 in the Department of Obstetrics and Gynecology Dr. Mohammad Hoesin General Hospital. 40 subjects were included. The frequency and distribution data were described in table form, bivariate analysis was performed to assess the relationship between independent and dependent variables statistically using Chi-square/Fisher Exact test. Multivariate analysis using logistic regression test was performed to assess which independent variable affects acceptors’ decision the most. Data analysis was performed using SPSS 18.0 version.  Results: There were no statistically differences in age, duration of marriage, parity, number of children born alive, abortion, education, and jobs between the two groups (p<0.05). There was statistically significant relationship between knowledge, social relationship, and the role of counselor with contraception acceptors’ decision (p<0.005), but there was no significant relationship between trust and values with contraception acceptors’ decision (p>0.05). Meanwhile, the logistic regression analysis showed that the role of counselor significantly affects contraception acceptors’ decision (PR=108.989, p value=0.002). Concluson: The role of counselor is a factor that affects contraception acceptors’ decision in using IUD. Keywords: IUD, role of counselor, social relationship, trust, values, knowledge   Abstrak Tujuan: untuk mengetahui hubungan faktor peran konselor, pengetahuan, kepercayaan, nilai, dan kekerabatan terhadap keputusan akseptor KB untuk menggunakan alat kontrasepsi IUD di Rumah Sakit Mohammad Hoesin Palembang. Metode: Penelitian analitik observasional rancangan cross sectional ini dilakukan di Departemen Obstetri dan Ginekologi Rumah Sakit Dr. Mohammad Hoesin/Fakultas Kedokteran Universitas Sriwijaya Palembang sejak bulan Juni sampai September 2017. Didapatkan sampel sebanyak 40 wanita melahirkan memenuhi kriteria inklusi. Frekuensi dan distribusi data dijelaskan dalam bentuk tabel, analisa bivariat untuk mengetahui ada tidaknya hubungan secara statistik antara variabel bebas dan dengan variabel terikat menggunakan uji Chi Square/Fisher Exact dan analisis multivariat untuk mengetahui variabel independen mana yang paling besar pengaruhnya terhadap keputusan akseptor KB untuk menggunakan alat kontrasepsi IUD menggunakan uji Regresi Logistik. Analisa data menggunakan SPSS versi 18.0. Hasil: Tidak terdapat perbedaan karakteristik pasien baik usia, lama pernikahan, paritas, jumlah anak hidup, abortus, pendidikan dan pekerjaan antara kedua kelompok (p<0,05). Terdapat hubungan yang signifikan antara pengetahuan, kekerabatan, dan peran konselor dengan keputusan akspetor KB IUD (p<0,05), namun tidak terdapat hubungan yang signifikan antara kepercayaan dan nilai dengan keputusan akspetor KB IUD (p  > 0,05).  Pada analisis regresi logistik didapatkan hasil peran konselor berpengaruh secara signifikan terhadap keputusan akseptor KB IUD (PR = 108,989, p value = 0,002). Keimpulan: Peran konselor merupakan faktor yang mempengaruhi keputusan akseptor KB untuk menggunakan alat kontrasepsi IUD. Kata Kunci: IUD, Peran Konselor, Kekerabatan, Kepercayaan Nilai, Pengetahuan

Oral versus Vaginal Misoprostol for Labour Induction : A Comparative Study

Objective: To compare the efficacy and safety of hourly titrated oral misoprostol in solution (OMS) with vaginal misoprostol (PV) for labor induction. Methods: Randomized Controlled Trial (RCT), double blind-add on the study was conducted from January-November 2016 in delivery ward of Moh. Hoesin general hospital. Women 30 weeks of gestation with an unfavorable cervix (Bishop score ï‚£6) and an indication for labor induction were randomly assigned to receive titrated oral or vaginal misoprostol. The OMS group received a basal unit of 20 ml misoprostol solution (1 ï­g/ml) every 1 hour for four doses and then were titrated against individual uterine response. In the absence of regular uterine contractions, the dose was increased to 40 ml hourly for four doses and then 60 ml for four doses. The vaginal group received 25 ï­g every 4 hours until attaining a more favorable cervix for three doses. All the subjects received amylum placebo. In labor within 12 hours was the primary outcome. Results: A total of 30 women were enrolled in this study. One subject in the OMS group was dropped out due to eclamptic seizure. The average interval from induction until in labour in OMS group was 5.753.14 hour and 6.604.46 hour in PV group (p = 0.56). In labour stage was achieved within 12 hours in 14 women (100%) in OMS group and 14 women (93.3%) in PV group (p = 1.00). Vaginal delivery was achieved within 24 hours in 13 women (92.9%) in OMS group and 15 women (100%) in PV group. The incidence of uterine hyperstimulation/ tachysystolic was 7.1% in OMS group compared with 13.3% in PV group. Fetal distress was found only 1 case (7.1%) in OMS group. There was no difference in the maternal and neonatal outcome of labor in both the groups. Conclusion: Oral titrated in solution, and vaginal route of administration of misoprostol for induction of labour are equally effective and safe. [Indones J Obstet Gynecol 2018; 6-2: 89-97] Keywords: hourly titrated oral misoprostol in solution, oral misoprostol, randomized controlled trial, vaginal misoprosto

Keunggulan Kompetitif Berbasis CAD : Membawa Konsep ke dalam Kenyataan (Studi Kasus di Perusahaan Genteng "PWS" Godean, Yogyakarta)

Competitive advantage will be the next issue of Small and Meditun-sized Enterprises (SMEs) in the decade of the global competition. Discover ing environmental aspects should be conducted by a reasonable method so they can be motivated to grow and react by using their own capabilities. This paper represents Porter's Five Forces approach to recognize a roof-tile company' s competitive advantage. 3D modeling by using PowerSHAPE. version 6.0.6.0 is then offered to fulfill their need of quick, reliable (easy to modify), and varied roof-tile design

Addressing Mood Disorder Diagnosis' Stigma With an Honest, Open, Proud (HOP)-Based Intervention: A Randomized Controlled Trial

Introduction: The public stigma and self-stigma contribute to the dilemma of disclosing or not one's own mental illness diagnosis. Studies suggest that revealing it diminishes stress, besides helping with self-esteem. Honest, Open, Proud (HOP) is a group program that aids in the process of deciding on it, reducing its impact. Considering the relevance of this issue, the present study aimed to apply a HOP-based intervention in a group of patients diagnosed with mood disorders. Methods: A randomized controlled clinical trial was used, including 61 patients with mood disorders, of whom 31 were diagnosed with depression and 30 were diagnosed with bipolar disorder. They were randomly placed on the intervention (HOP) or the control group (unstructured psychoeducation). The evaluations occurred before (T0) and after (T1) the sessions. We administered eight scales, from which three presented relevant results: Coming Out with Mental Illness Scale (COMIS), Cognitive Appraisal of Stigma as a Stressor (CogApp), and Authenticity Scale. Results: The intervention groups (depression and bipolar) did not present a significant change regarding the decision to disclose their diagnostics. However, the depression group showed a decrease on the perception of stigma as a stressor (T0 = 0.50 vs. T1 = -1.45; p = 0.058). Improvements in post-intervention results were seen for both groups (depression and bipolar) on the Authenticity Scale-self-alienation subscale (T0 = 10.40 vs. T1 = 12.37, p = 0.058). Conclusion: Our HOP-based intervention appeared to be an important program to aid patients in facing stigma stress, showing positive effects, whether helping to diminish stress or to improve self-conscience, both of which have indirect effects on self-stigma. As it is a compact program, it can bring benefits when applying to public health institutions

Analysis of Servant and Transformational Leadership on Corporate Social Reponsibility at Gereja Kalvari Pentakosta Missi Di Indonesia

Servant leadership and Transformational leadership are a leadership styles that must be owned by the present leaders. In this study, leadership style (servant leadership and transformational leadership) become the keys for investigating the corporate social responsibility in church. The aim is to examine the impact servant leadership and transformational leadership for the succeed of corporate social responsibility. The population of this research is all pastors of GKPMI. And the sample is 8 pastors from this church. This research used qualitative analysis, using the interview and observation techniques. This research found that servant leadership and transformational leadership must run together to obtain the corporate social responsibility, and it compliment and balanced the CSR in organization. Because it mixed together, the CSR is higher than before. Conclusion Servant leadership and transformational leadership have a positive impact toward congregation and because of that the corporate social responsibility in this organization is good enough, or can say extremely well. Recommendation for the church is to apply this servant and transformational leadership so the church can manage the CSR well. Keywords: servant, transformational leadership, corporate social responsibilit