Mohd. Andalas
Obstetric and Gynecology Departement, Medical Faculty of Syah Kula University

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CESAREAN MYOMECTOMY: A CASE REPORT IN ZAINOEL ABIDIN GENERAL HOSPITAL, BANDA ACEH, INDONESIA Pradipta, Bram; Andalas, Mohd.
Proceedings of The Annual International Conference, Syiah Kuala University - Life Sciences & Engineering Chapter Vol 1, No 1 (2011): Life Sciences
Publisher : Syiah Kuala University

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Abstract

The objective of the present study was to improve skill and knowledge in making a Cesarean myomectomy decision, its complications and its post operative care. Uterine myomas are the most common pelvic tumors over the age of 30. The incident of myomas in pregnancy are 0.05-5%.Myomas are now more frequently seen as many women delaying childbearing which is the time for greatest  risk of myoma growth. Also the use of ultrasonography has improved the diagnostic capability of detecting small myomas and has increased our knowledge of myomas in pregnancy. Myomectomy during cesarean section has traditionally been discouraged because of the risk of uncontrollable hemorrhage.  There are approximately 7 choices to be made according cesarean myomectomy such to leave it be, to leave it with Uterine artery ligation, to remove pedunculated fibroids only, to remove pedunculated, anterior subserous or lower uterine segment fibroids, to remove all anterior uterine fibroids, to remove all fibroids and selective removal of fibroids. A 32- year-old, gravida 3 para 2, Indonesian women presented with postterm-pregnancy and 20 cm intra mural- uterine myoma. Cesarean myomectomy was done to her with little to none intraoperative hemorrhage. Post C-section we found complications shown by uterine atony, profuse bleeding seen at the drainage through the peritoneum and marked changes in hemoglobin value. It is then carefully evaluated and managed using extensive follow up, high dose oxytocyin and blood transfusion. Cesarean myomectomy is now considered by many not always as a hazardous procedure and can be performed  in experienced hands, in a well equipped tertiary institution, with the advent of better anesthesia, with  availability of blood, in selected patients and according to site and size of myomas. It is always important to have a good informed consent beforehand and post operative care of cesarean myomectomy
HIV-related stigma and discrimination: a study of health care workers in Banda Aceh, Indonesia Harapan, Harapan; Feramuhawan, Syarifah; Kurniawan, Hendra; Anwar, Samsul; Andalas, Mohd.; Hossain, Mohammad B.
Medical Journal of Indonesia Vol 22, No 1 (2013): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (319.257 KB) | DOI: 10.13181/mji.v22i1.518

Abstract

Background: The aim of this study was to identify the level of stigmatized and discriminatory attitudes towards people living with HIV (PLHIV) among health care workers (HCWs) and the factors that influenced these attitudes.Methods: This research was conducted at Dr. Zainoel Abidin General Hospital Banda Aceh, Indonesia. A cross-sectional study design was adopted for this research. Eighty nine HCWs were included in this study and they were selected purposively. Correlation analysis, analysis of variance and independent sample t test analysis was used according to the type of data. Finally, a multiple linear regression model was used to identify the predictor factor for stigmatized and discriminatory attitudes.Results: We found that the level of stigmatized and discriminatory attitudes was high. Bivariate analysis showed that type of HCW, education, marital status, knowledge on transmission and prevention of HIV and irrational fear of HIV transmission were significant related with stigmatized attitudes (p < 0.05). Type of HCW, marital status, age, knowledge on transmission and prevention of HIV and irrational fear of HIV transmission indicated significant (p < 0.05) differences in the levels of discriminatory attitudes. A multiple linear regression model identified type of HCW and irrational fear of HIV transmission correlated with stigmatized attitudes (R2 = 0.230) and knowledge on transmission and prevention of HIV correlated with discriminatory attitudes (R2 = 0.119).Conclusion: Irrational fear of HIV transmission and type of HCW are significant predictors to stigmatized attitudes; knowledge on transmission and prevention of HIV is a predictor to discriminatory attitudes towards PLHIV among HCWs. (Med J Indones. 2013;22:22-9)Keywords: Discrimination, discriminatory attitudes, HIV, PLHIV, stigmatized attitudes.
MOLECULAR PATHOGENESIS OF PREECLAMPSIA: MICRORNA HYPOTHESIS Andalas, Mohd.; Harapan, H.; Mudhakir, Diky; Ichsan, Muhammad; Pedroza, Natalia C.; Laddha, Saurabh
Proceedings of The Annual International Conference, Syiah Kuala University - Life Sciences & Engineering Chapter Vol 1, No 1 (2011): Life Sciences
Publisher : Syiah Kuala University

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The discovery of micro RNA (miRNA) in 1993 by Ambros and colleagues has a huge influence in pathogenesis theory, diagnosis and treatment approach of some diseases. Some studies have conducted to seek the association alterations of miRNA expression to incidences and severity of preeclampsia (PE). We have reviewed some studies that conducted to seek the association of miRNA and PE and we discussed the role of various miRNAs in PE pathogenesis. In summary, we have shown that many researchers have given evident that the different placental and plasma miRNA expression is associated with PE. Some studies also identified the novel candidate of miRNAs (and their pathways) that may be of etiologic relevance in the pathogenesis of PE. Base on review, specific miRNA have a role to down regulate of anti apoptosis genes, regulate angiogenics growth factors such as angiogenin, vascular endothelial growth factor (VEGF) B (VEGF-?), cysteine-rich 61 (CYR61), Placental growth factor (PlGF) and VEGF-A that have a role in angiogenesis. miRNA also have a role in  survival, migration, and capillary tube formation of HUVEC by targeted of c-kit. Some miRNAs target genes that participate in immunologic dysfunction, cell adhesion, cell cycle, and signaling. miRNA also have a roles in endothelial cell response to hypoxia, cell differentiation, and survival. A miRNA influence calcium signaling through negative regulations of the calmodulin-coding mRNAs, Mef2a and Gata4, mainly in smooth muscle cells that contribute to PE pathogenesis. These investigations provide novel targets for further investigation of the pathogenesis of PE and these differential miRNAs may be potential markers for the diagnosis and provide a potential therapeutic target for PE. Further investigations on posttranscriptional regulation in PE to evaluate biologic effects of identified miRNAs (including confirmations of miRNA and target gene interactions) are needed
FACTORS AFFECTING THE LEVEL OF HEALTH CARE WORKER’S STIGMATIZED AND DISCRIMINATORY ATTITUDE TOWARDS PEOPLE LIVING WITH HIV: A STUDY AT THE DR. ZAINOEL ABIDIN GENERAL HOSPITAL, BANDA ACEH, INDONESIA Harapan, H.; Feramuhawan, Syarifah; Kurniawan, Hendra; Andalas, Mohd.; Hossain, Mohammad Bellal
Proceedings of The Annual International Conference, Syiah Kuala University - Life Sciences & Engineering Chapter Vol 1, No 1 (2011): Life Sciences
Publisher : Syiah Kuala University

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Abstract

The aim of this study was to identify the level of health care worker`s (HCW) stigmatized and discriminatory (S D) attitude towards people living with HIV (PLHIV) and the factors that influenced this attitude. This research was conducted at the Dr. Zainoel Abidin General Hospital (RSUDZA) in Banda Aceh province of Indonesia. A cross-sectional study design was adopted for this research. Eighty nine HCWs were included in this study and they were selected purposively. Pearson correlation analysis, analysis of variance or independent sample t test analysis was used according to the type of data. We found that the level of S D attitude towards PLHIV in RSUDZA is high. Based on the Least Significant Difference Test, the average score of the answers between nurses and general practitioners and between nurses and medical students was significantly different(p=0.05). Pearson correlation analysis showed that the levels of S D attitude towards PLHIV was positively correlated with age (r=0.219, p=0.04) and irrational fear of HIV transmission (r=0.352, p=0.001) and negatively correlated with knowledge about HIV/AIDS (r=-0.336, p=0.001). Pearson correlation analysis also found that knowledge of HIV/AIDS negatively correlated with the irrational fear of HIV transmission (r=0.382, p=0.000). In addition, the level of S D attitude towards PLHIV was also associated with marital status of HCWs (p=0.020). Gender, education level, religion and the importance of religion in HCW lives wasn`t significantly affect to the level of S D attitude towards PLHIV in HCW. We concluded that the factors that influence the level of S D attitude towards PLHIV among the HCW are age, marital status, knowledge of HIV/AIDS, irrational fear of HIV transmission and HCWs occupations. To reduce S D attitude towards PLHIV among the HCWs, we recommend introducing some program to increase knowledge of HIV/AIDS
RISING RATES OF CAESAREAN SECTION IN DR. ZAINOEL ABIDIN HOSPITAL BANDA ACEH SINCE THE PROMULGATION OF BPJS (PERIODJANUARY 1ST 2014-DECEMBER 31ST 2016) Andalas, Mohd.; Jannah, Raudhatul; Harisah, Siti; Ichsan, Ichsan; Haekal, Muhammad
Jurnal Kedokteran Syiah Kuala Vol 18, No 1 (2018): Volume 18 Nomor 1 April 2018
Publisher : Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/jks.v18i1.11212

Abstract

Abstrak. Seksio sesarea merupakan suatu proses melahirkan janin dengan membuat irisan pada dinding perut dan rahim ketika proses persalinan normal tidak memungkinkan karena berisiko bagi ibu dan janin. Angka kejadian seksio sesarea di dunia mengalami peningkatan setiap tahunnya terutama di negara berkembang. Terlihat peningkatan angka seksio sesarea di era BPJS yang mulai berlaku sejak 1 Januari 2014, terutama di RSUD dr. Zainoel Abidin yang merupakan rumah sakit rujukan tersier di Provinsi Aceh. Tujuan penelitian ini adalah untuk mengetahui profil persalinan seksio sesarea di RSUD dr. Zainoel Abidin Banda Aceh sejak berlakunya BPJS (periode 1 Januari 2014-31 Desember 2016). Penelitian ini bersifat deskriptif-observasional dengan desain retrospective study dan teknik total sampling.Pengambilan data dimulai dari bulan Maret-April 2017. Sebanyak 3656 data dikumpulkan dari data sekunder rekam medik. Hasil penelitian menunjukkan terdapat 1669 kasus persalinan pervaginam (45,65%) dan 1987 kasus seksio sesarea (54,35%). Indikasi terbanyak yang menyertai seksio sesarea adalah ketuban pecah dini (32,06%), malpresentasi (8,91%), dan oligohidramnion (8,61%). Kesimpulan dari penelitian ini adalah angka seksio sesarea di RSUD dr. Zainoel Abidin sejak berlakunya BPJS (1 Januari 2014-31 Desember 2016) mencapai 54,35%, angka ini meningkat 41,06% dari tahun 2011-2013 dengan indikasi terbanyak merupakan ketuban pecah dini (32,06%). Kata kunci: Seksio sesarea, BPJS, RS rujukan tersier  Abstract. Caesarean section is an operative procedure whereby the fetusesare delivered through an incision on the abdominal and uterine walls where normal  deliveries are not possible through maternal and neonatal indication. The incidence of caesarean section in the world is rising year after years particularly in developing countries. The rising of caesarean section rate is seen in BPJS era started since January 1st, 2014, especially in dr. Zainoel Abidin Hospital which is a tertiary referral hospital in Province Aceh.  The purpose of this study was to find out the profile of caesarean section in dr. Zainoel Abidin Hospital since the promulgation of BPJS (period January 1st, 2014- December 31st, 2016). This was a descriptive-observational study with retrospective design and total sampling technique. The data were obtained in March-April 2017. Three thousands six hundreds and fifty six secondary data from medical record were enrolled in this study. The finding showed that there were one thousand six hundreds and sixty nine vaginal deliveries (45,65%) and one thousand nine hundreds and eighty seven (54,35%) caesarean sections. The most frequent causes to caesarean sections were premature rupture of membranes (32,06%), malpresentation (8,91%), and oligohydramnion (8,61%). The conclusion of this study were the incidence of caesarean sections in dr. Zainoel Abidin Hospital since the promulgation of BPJS (January 1st, 2014-December 31st, 2016) was 54,35%, this number is increased by 41,06% than the year of 2011-2013 with the most frequent cause is premature rupture of membranes (32,06%). Keywords: Caesarean section, BPJS, Tertiary referral hospital
PROFILE OF CESAREAN SECTIONS SINCE THE BPJS ERA: PROFIL SEKSIO SESAREA PADA ERA BPJS Andalas, Mohd.; R. Maharani, Cut; Jannah, Raudhatul; Harisah, Siti; Haekal, Muhammad; Ichsan
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 1 January 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (188.686 KB) | DOI: 10.32771/inajog.v8i1.1028

Abstract

  Objective: to find out the profile of caesarean section in dr. Zainoel Abidin Hospital since the BPJS era. Methods: This study was a descriptive-observational with retrospective design. The data were obtained in March-April 2017. We collected 3656 data from medical record period January 1st, 2014- December 31st, 2016. Results: The finding showed there were 1669 vaginal deliveries (45,65%) and 1987 caesarean sections (54,35%). The most frequent causes to caesarean sections were induction failure (49,77%), cephalopelvic disproportion (14,33%), pregnancy induced hypertension (11,21%), malpresentation (8,91), and antepartum haemorrhage (4,33%). Conclusion: The incidence of caesarean sections in dr. Zainoel Abidin Hospital since the BPJS era was 54,35%, increased by 13,29% than the year of 2011-2013 (41,06%) with the most frequent cause is induction failure (49,77%). Keywords: Antepartum haemorrhage, BPJS, Caesarean section, Induction failure, Pregnancy induced hypertension, Tertiary referral hospital.   Abstrak Tujuan: Mengetahui profil persalinan seksio sesarea di RSUD dr. Zainoel Abidin Banda Aceh pada era BPJS. Metode: Penelitian deskriptif-observasional dengan desain studi retrospektif. Pengambilan data dimulai dari bulan Maret-April 2017. Sebanyak 3656 data dikumpulkan dari rekam medik periode 1 Januari 2014- 31 Desember 2016. Hasil: Terdapat 1669 kasus persalinan pervaginam (45,65%) dan 1987 kasus seksio sesarea (54,35%). Indikasi terbanyak yang menyertai seksio sesarea adalah gagal induksi (49,77%), cephalopelvic disproportion (14,33%), hipertensi dalam kehamilan (11,21%), malpresentasi (8,91%), dan perdarahan antepartum (4,33%). Kesimpulan: Angka seksio sesarea di RSUD dr. Zainoel Abidin meningkat 13,29% sejak berlakunya BPJS (1 Januari 2014-31 Desember 2016) mencapai 54,35% dibandingkan tahun 2011-2013 (41,07%) dengan indikasi terbanyak gagal induksi (49,77%). Kata kunci: Perdarahan Antepartum, BPJS, Seksio sesarea, Gagal Induksi, Hipertensi dalam kehamilan, RS Rujukan Tersier.