PENINGKATAN SITOTOKSISITAS IMUNOSELULER PENDERITA KARSINOMA SEL SKUAMOSA SERVIKS UTERI SEBAGAI EFEK STIMULASI TITIK AKUPUNKTUR St 36

Metode : Penelitian ini merupakan penelitian randomised clinical trial ( pretest posttest control group design ). Subyek penelitian merupakan 53 penderita karsinoma sel skuamosa serviks uteri stadium IIB-IIIB Poli Onkologi Satu Atap RSUD Dr. Soetomo Surabaya yang telah memenuhi kriteria inklusi dan dibagi dalam dua kelompok. Pada kedua kelompok dilakukan pemeriksaan terhadap pemeriksaan laboratorium dasar ( darah lengkap, BUN, kreatinin serum, kadar albumin ), pemeriksaan ELISA ( untuk menentukan kadar IL-12 ) flow-cytometry ( untuk menentukan jumlah sel NK, kadar IFN-, rasio Th1/Th2 ) dengan mengambail darah vena cubiti serta pemeriksaan MRI pelvis untuk mengukur volume tumor serviks. Pada kelompok kontrol (C) subyek diberikan kemoterapi Cisplatin 50 mg/m2 secara mingguan, sedangkan pada kelompok perlakuan (C+EA) selain diberi kemoterapi Cisplatin penderita akan menjalani stimulasi elektro-akupunktur pada titik St 36 ( dengan jarum halus filiform dari baja tahan karat nomor 32, panjang 1,5 inci yang dihubungkan dengan stimulator menggunakan aliran listrik dengan gelombang continuous berfrekuensi 2 Hz dan kuat arus 0,2A selama 30 menit ). Pemeriksaan darah perifer dilakukan sebanyak dua kali ( sebelum dan sesudah tindakan ) yang kemudian dibandingkan antar dua kelompok. Perubahan pada kualitas hidup ( skor nyeri, skor nafsu makan dan skor mual muntah ) pada penderita tersebut juga dibandingkan pada kedua kelompok. Hasil : Dari penelitian ini didapatkan peningkatan yang bermakna pada rerata prosentase jumlah sel NK ( p=0,00), rerata kadar IFN- yang disekresinya (p=0,00) dan rerata rasio Th1/Th2 (p=0,05) dalam darah perifer penderita karsinoma sel skuamosa serviks stadium IIB-IIIB yang menerima kemoterapi Cisplatin setelah stimulasi elektro-akupunktur pada titik akupunktur St 36 bila dibandingkan dengan kelompok kontrol. Rerata kadar IL-12 dalam darah perifer juga meningkat secara bermakna pada kelompok perlakuan (p=0,03) tetapi tidak bermakna bila dibandingkan dengan kelompok kontrol. Rerata volume tumor serviks penderita karsinoma sel skuamosa serviks pada kelompok perlakuan mengecil secara bermakna (p=0,03) bila dibandingkan dengan kelompok kontrol. Pada kelompok perlakuan, terjadi penurunan baik rerata skor nyeri, rerata skor mual dan rerata skor muntah namun tidak bermakna (p=0,061, p=0,399 dan p=0,854), berbeda halnya dengan rerata skor nafsu makan yang meningkat secara bermakna (p=0,00). Kesimpulan : Stimulasi elektro-akupunktur pada titik St 36 akan meningkatkan sitotoksisitas imunoseluler, menurunkan volume tumor serviks serta memperbaiki kualitas hidup penderita karsinoma sel skuamosa serviks stadium IIB-IIIB yang menerima kemoterapi Cisplatin

GAMBARAN FAKTOR RISIKO PASIEN KANKER SERVIKS DI RSUD DR. SOETOMO SURABAYA

Kanker serviks adalah salah satu keganasan ginekologi yang paling banyak ditemukan pada wanita, meskipun demikian kanker serviks merupakan penyakit yang dapat dicegah. Diketahui terdapat beberapa faktor risiko yang dapat meningkatkan angka kejadian kanker serviks. Menghindari faktor risiko dapat mengurangi risiko terjadinya kanker serviks, sedangkan pencegahan dapat dilakukan dengan skrining rutin (pap smear) dan vaksinasi HPV. Tujuan dari penelitian retrospektif ini adalah untuk mengamati distribusi faktor risiko kanker serviks seperti jumlah paritas tinggi dan usia muda saat pertama kali berhubungan seksual. Penelitian ini dilakukan dengan menggunakan metode observasional dengan desain cross sectional. Data diambil dengan melakukan wawancara kepada 80 subjek, diambil secara acak, dari pasien kanker serviks yang menjalani pengobatan di Poli Onkologi Satu Atap (POSA) RSUD Dr. Soetomo Surabaya selama 14 hari. Hasil penelitian didapatkan sebagian besar insidens (42,5%) terjadi pada kelompok usia 51-60 tahun. Mayoritas pasien terdiagnosis pada stadium lanjut kanker serviks, yaitu stadium IIIB (50%) dan stadium IIB (45%). 63,7% dari pasien memiliki jumlah paritas tinggi (>2). 65% pasien melakukan hubungan seksual pertama kali sebelum berusia 20 tahun. 48% pasien terpapar rokok baik aktif maupun pasif sepanjang hidupnya dan 80% pasien memiliki riwayat penggunaan kontrasepsi hormonal. Hanya terdapat 15% pasien yang menyatakan pernah menerima edukasi sebelumnya tentang kanker serviks dan 95% dari pasien mengaku belum pernah melakukan Pap smear sebelum terdiagnosis kanker serviks

GAMBARAN FAKTOR RISIKO PENDERITA KANKER OVARIUM DI RSUD DR. SOETOMO SURABAYA

Kanker ovarium adalah salah satu keganasan ginekologi. Walaupun insidensinya cukup rendah, kanker ini memiliki rasio kematian dibanding insiden yang paling tinggi. Karena sulitnya deteksi dini pada kanker ovarium, pencegahan dapat dilakukan dengan mengetahui faktor risikonya. Tujuan dari penelitian ini untuk mengidentifikasi beberapa faktor risiko yang meningkatkan atau menurunkan risiko kanker ovarium seperti jumlah paritas, penggunaan kontrasepsi dan riwayat menstruasi. Penelitian ini dilaksanakan menggunakan metode observasional dengan desain cross sectional di mana data diambil secara total sampling dengan mewawancarai pasien kanker ovarium tipe epitel yang memeriksakan diri ke Poli Onkologi Satu Atap (POSA) RSUD Dr. Soetomo Surabaya selama 14 hari. Jumlah total responden berjumlah 51 orang. Hasil penelitian didapatkan kelompok umur terbanyak pada usia 41-50 tahun (39.22%). Pekerjaan pasien mayoritas sebagai ibu rumah tangga (78.43%). Terbanyak pasien datang dengan stadium IC (33.33%) dan IIIC (19.61%). Peringkat tertinggi hasil pemeriksaan histopatologis yaitu serous tumors (45.10%), mucinous tumors (23.53%) dan endometrioid tumors (19.61%). Pasien yang memiliki jumlah paritas ≤ 2 sebesar 68.63%. Pasien yang menggunakan kontrasepsi oral selama lebih dari 5 tahun hanya sebesar 7.84%. Terbanyak pasien mengalami menarche pada usia 14 tahun (29.41%). Pasien yang mengalami menopause di atas usia 50 tahun sebesar 15.69%. Mayoritas pasien mengalami siklus menstruasi yang teratur selama hidupnya (76.47%)

Profil Sel Natural Killer (NK) Dalam Darah Perifer Dan Jaringan Tumor Penderita Lesi Prakanker Dan Karsinoma Sel Skuamosa Serviks

This research was performed to investigate the profile of Natural Killer (NK) cells in peripheral blood and tumor tissues of cervical pre cancerous lesion and squamous cell carcinoma of cervix patients. This research was an observational analysis study with cross-sectional design of 47 subjects which comprises of 17 cervical pre cancerous lesion patients, 8 early stage squamous cell carcinoma of cervix patients and 22 late stage squamous cell carcinoma of cervix patients in Dr. Soetomo Hospital-Airlangga University teaching hospital, Surabaya. After clinical and histopatologic diagnosis was established, NK cell count was perfomed on the biopsies, and both NK cell count and percentage of activated NK cells was performed on the peripheral blood of those three groups. From this research, it was found that the average number and percentage of activated NK cells within peripheral blood of cervical pre cancerous lesion patients were lower (349.65 cell/?L; 15.13%) compared with early stage carcinoma (552 cell/?L; 18,40%) and late stage carcinoma (590.32 sel/?L; 23.29%). NK cell expression of cervical tumor tissues on three groups are very low, 0.29% on cervical pre cancerous lesion patients; 0.45% on early stage cervical cancer patients; and 0.04% on late stage cervical cancer patients. Significant differences was found in the number of NK cells (p=0.016) and percentage of activated NK cells (p=0.041) within peripheral blood between pre cancerous lesion patients and late stage squamous cell cervical cancer patients, no significant difference was found in the number of NK cells within tumor tissue (p=0.278)

PENETAPAN KADAR EGCG DAN KAFEIN SECARA SIMULTAN PADA PRODUK TEH HITAM IMPOR YANG BEREDAR DI SURABAYA MENGGUNAKAN METODE KLT-DENSITOMETRI

There are various kind of black tea products in Surabaya both from local production and imported products. The quality of these products yet to be known precisely. EGCG and caffeine which contain in tea can be used as a quality parameter of the tea products. The purpose of this research was to determine the concentration of EGCG and caffeine in the imported black tea products. First of all, extraction of EGCG-caffeine in the tea was done to separate them with other compounds. The solvent that used in the extraction process was ethyl acetate. Thin Layer Chromatography (TLC) Densitometry method was used for the quantitative analysis. Eluent for this analysis was a combination of chloroform: ethyl acetate: n-butanol: formic acid (2:1:0,7:0,3) and the maximum wavelength was 275 nm. Such method was validate for parameters as follow: selectivity, LOD & LOQ, linearity, accuracy, and precision. All of the parameters has met the validation requirements. Furthermore, the results of EGCG contains in the samples were lower than the caffeine level

Successful Cesarean Myomectomies of Large Uterine Fibroids: Two Cases and a Literature Review

BACKGROUND: No standard guidelines have been specified for a cesarean myomectomy, and several centers remain divided on the justification to perform this procedure, especially for large fibroids. Only a few case reports have been published of cesarean myomectomy for large fibroids. Here, we report 2 cases of successful cesarean myomectomies for large fibroids (>15 cm) during the 38th week of pregnancy. CASE REPORT: We encountered 2 primigravida patients, aged 34 and 36 years, respectively, with large fibroids >15 cm in diameter. Using the Pfannenstiel incision, we performed cesarean myomectomies in both patients at term pregnancy. The surgeries were performed by a gynecologic oncologist in a tertiary hospital. Both patients experienced a postoperative decrease in hemoglobin but neither required a blood transfusion. Three days after the operation, the patients were discharged from the hospital in good condition. One year later, the patients and their babies continued to be in good health. The patients did not experience chronic pelvic pain or menstrual abnormalities. Neither patient is currently planning another pregnancy. CONCLUSIONS: Based on our report, it may be assumed that cesarean myomectomy for a large fibroid (even for fibroids >15 cm in diameter) is safe if performed by experts in a tertiary hospital. Further larger studies of cesarean myomectomy of large fibroids are required to confirm the safety of this procedure

ANALISIS DAN PERANCANGAN APLIKASI KIOS INFORMASI TAMAN BUNGA NUSANTARA BERBASIS MULTIMEDIA

ANALISIS DAN PERANCANGAN APLIKASI KIOS INFORMASI TAMAN BUNGA NUSANTARA BERBASIS MULTIMEDIA - analisis, perancangan, kios informasi, multimedia, Taman Bunga Nusantar

The Effect of Electroacupuncture Therapy on Pain, Plasma β-Endorphin, and Quality of Life of Stage III Cervical Cancer Patients: A Randomized Control Trial

Background : Pain is a major complaint in cancer patients and a global problem that requires medical attention, including pain in cervical cancer. Although pharmacotherapy has been used for the treatment of cancer pain, there are still around 40% cannot be treated only with pharmacotherapy. Objectives: To determine the effects of electroacupuncture (EA) on pain in stage III cervical cancer patients. Methods : Twenty-eight stage III cervical cancer patients were divided into two groups (14 treatments and 14 controls) with randomized control trial design. The treatment group received EA with a frequency of 2/20-25 Hz at points of ST36, SP6, LI4 and LR3 for 30 minutes, while the control group did not receive EA. Both groups were given paracetamol and codeine at the same dose. Assessment was carried out by measuring pain scale (VAS), plasma β-endorphin levels, and quality of life/QoL (EORTC QLQ-C30) before and after therapy. Results : The average reduction in VAS in the treatment group (2.71 ± 1.14) compared to the control group (0.71 ± 1.33; p < 0.001), average increase in plasma β-endorphin levels in the treatment group (88.57 ± 52.46 pg/ml) compared to the control group (12.86 ± 56.76 pg/ml; p = 0.001), and in QoL, there were significant differences in symptom improvement between the treatment and control groups in the domain of fatigue, pain, insomnia and overall QoL (p < 0.05). Conclusion : Medical therapy combined with EA decreased pain scale, increased plasma β-endorphin levels, and improved the QoL for stage III cervical cancer patients

The difference of sexual function of cervical cancer survivor post radical hysterectomy with and without chemoradiotherapy according to FSFI scores

This study was analytical observasional with cross sectional design. From 2017 to 2021, 45 cervical cancer survivors who had&nbsp; radical hysterectomy were enrolled. The subjects were divided into four groups: radical hysterectomy only, hysterectomy combined chemotherapy, hysterectomy combined chemoradiotherapy, hysterectomy combined radiotherapy. The Female Sexual Funxtion Index questionnaire were used to collect data of sexual activity including desire, arousal, lubrication, satisfaction, orgasm and dyspareunia. The mean age was 46.29 (SD± 7.6). The FSFI between four groups were significantly difference in &nbsp;desire (p 0.006), arousal (p0.003), lubrication (p0.001), and sexual satisfaction (p0.033). Mann-Whitney test is used to analyze associations between two groups. The most affected domain between radical hysterectomy and radical hysterectomy combined radiotherapy were desire (p 0.006), sexual satisfaction (0.013). Domain arousal was significant difference between radical hysterectomy and radical hysterectomy combined chemotherapy (p&nbsp; 0.005). Lubrication was difference between radical hysterectomy and radical hysterectomy combined chemoradiotherapy

The challenging journey of cervical cancer diagnosis and treatment at the second largest hospital in Indonesia

Objectives: Cervical cancer is a major health concern in developing countries. Access to preventive measures is limited in low- and middle-income countries, and cervical cancer is often identified at an advanced stage of the disease. In this study, we aimed to investigate when patients were first diagnosed and received treatment at a large hospital in Indonesia. Methods: Data were collected using a questionnaire from outpatient visits and descriptively analyzed. Totally, 215 cervical cancer patients being treated at the Dr. Soetomo Academic Hospital's gynecological oncology outpatient clinic in Indonesia between August and October 2022 were included. Results: Most patients were 51–60 years old (36.3 %), housewives (87 %), and had an elementary school education level (50 %). Most (88.4 %) admitted they were unaware about cervical cancer prevention, and 85.6 % never underwent screening. Most cervical biopsies were performed at primary hospitals (42.3 %). Fear of cancer treatment was the most frequent reason for patients arriving late at tertiary hospitals (50 %). Treatment delays occurred because patients had to visit two healthcare facilities before visiting a tertiary hospital (47.4 %). Most patients were diagnosed with stage III cancer (38.1 %), and chemotherapy was administered as the first-line therapy (96.3 %). Most patients (51.2 %) received their first therapy >12 months after initial symptom onset. Conclusions: Most cervical cancer patients were diagnosed at a late stage owing to a lack of information regarding early symptoms and irregular screenings. Treatment was delayed owing to social barriers. Therefore, the government should have more strict policies to implement cervical cancer detection and prevention