Heru Pradjatmo
Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta

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PENGETAHUAN DAN KETERAMPILAN BIDAN UNTUK SKRINING KANKER SERVIKS DENGAN METODE INSPEKSI VISUAL ASAM ASETAT (IVA) DI KALIMANTAN BARAT Mardiana, Mardiana; Dasuki, Djaswadi; Pradjatmo, Heru
JURNAL KESEHATAN REPRODUKSI Vol 2, No 1 (2015)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.6898

Abstract

Mardiana1, Djaswadi Dasuki2, Heru Pradjatmo2 ABSTRACT Background: Globally it is estimated that every two minutes a woman dies of cervical cancer and 500,000 women are diagnosed to have cervical cancer each year. In Indonesia, the incidence of cervical cancer is by 12.6 per 100,000 women with a mortality rate of 7 per 100,000. Screening method can reduce the incidence of cervical cancer if done cumulatively in 2012, the coverage of screening with a VIA method in Indonesia was 1.57%, whereas screening coverage with IVA in West Kalimantan Province was 1.06 %Objective: To assess midwives? knowledge and skills of screening practices with a VIA method in health centers Method: This was an observational study with a cross-sectional study, using quantitative and qualitative approaches. The study was conducted in health centers in the province of West Kalimantan. This study was conducted in September to October 2014. The subjects of research were midwives who served in health centers doing a VIA examination in West Kalimantan who met inclusion and exclusion criteria. The total sample of this study was 42 taken with purposive sampling. The variables of this study were the dependent variable, ie, the practice of screening skills with a VIA method, the independent variable, ie, knowledge, and the extraneous variables, ie, age, education, and years of service. Analysis of the data included univariable, bivariable, multivariable, and qualitative. The quantitative data analysis used the chi-square and logistic regression with a significance level of p <0.05 and an OR value with confidence interval (CI) of 95%.Result & Discussion: The mean value of midwives? knowledge was 26.0 from assessment scores of 0-30. A mean score of screening practice skills was 94.4 from 38-114. Of clinical assessment scores skill practice of competent midwives with good knowledge was higher than bad knowledge (OR= 6,98 CI 95% 1,21-40,33). After controlling education and years of service variables, good knowledge influenced screening clinical practice by 33%. Conclusion: Most of the midwives in West Kalimantan had good knowledge and skills to perform cervical cancer screening with a VIA method.Keywords: Knowledge, screening practice skills, VIA methods  ABSTRAKLatar Belakang: Di seluruh dunia diperkirakan setiap dua menit seorang wanita meninggal karena kanker servik dan sekitar 500.000 wanita di diagnosis kanker seviks setiap tahun. Di Indonesia insiden kanker serviks sebesar 12,6 per 100.000 perempuan dengan angka kematian sebesar 7 per 100.000. Metode skrining dapat menurunkan kejadian kanker serviks jika dilakukan secara kumulatif. Pada tahun 2012 cakupan skrining dengan metode IVA di Indonesia sebesar 1,57%, sedangkan cakupan skrining dengan metode IVA Propinsi Kalimantan Barat sebesar 1,06%.Tujuan: Menilai pengetahuan dan keterampilan praktek skrining bidan dengan metode IVA di puskesmas Metode: Jenis penelitian observasional dengan rancangan cross-sectional study, menggunakan pendekatan kuantitatif dan kualitatif. Penelitian dilakukan di puskesmas di Provinsi Kalimantan Barat. Penelitian ini dilaksanakan bulan September sampai dengan Oktober 2014. Subjek penelitian bidan yang melayani pemeriksaan IVA di puskesmas di Provinsi Kalimantan Barat yang memenuhi kriteria inklusi dan eksklusi. Total sampel penelitian ini 42 sampel dengan pengambilan sampel purposive sampling. Variabel penelitian ini yaitu: variabel terikat adalah keterampilan praktek skrining metode IVA, variabel bebas: pengetahuan, dan variabel luar: usia, pendidikan, dan lama bekerja. Analisis data meliputi: univariabel, bivariabel, multivariabel, dan kualitatif. Untuk analisis data kuantitatif meng-gunakan metode chi square dan logistic regresi dengan tingkat kemaknaan p < 0,05 dan nilai OR dengan Confidence Interval (CI) 95%.Hasil & Pembahasan: Nilai mean pengetahuan bidan sebesar 26,0 dari skor penilaian 0-30. Keterampilan praktik dengan nilai mean 94,4 dari skor 38-114. Keterampilan praktik klinik yang kompeten lebih tinggi pada bidan berpengetahuan baik daripada bidan berpengetahuan kurang (OR= 6,98 CI 95% 1,21-40,33). Pengetahuan baik setelah dikontrol variabel pendidikan dan lama bekerja berpengaruh terhadap keterampilan praktik skrining sebesar 33%.Kesimpulan: Sebagian besar bidan di Kalimantan Barat memiliki pengetahuan baik dan keterampilan yang kompeten untuk skrining kanker serviks dengan metode IVA. Kata Kunci: Pengetahuan, keterampilan praktek skrining, metode IVA 1 Dinas Kesehatan Provinsi Kalimantan Barat2 Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Gadjah Mada      Yogyakarta
Hubungan Asupan Cairan Ibu Hamil terhadap Indeks Cairan Amnion Fatmawati, Eny; Hadiati, Diah Rumekti; Pradjatmo, Heru
JURNAL KESEHATAN REPRODUKSI Vol 5, No 2 (2018)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (337.272 KB) | DOI: 10.22146/jkr.38549

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Introduction: Adequate amniotic fluid volume is a requirement for intra uterine fetal development and good pregnancy outputs / neonatal. Adequate intake of fluid in pregnant women can increase both the amniotic fluid index on oligohydramniotic or normoamniotic, but the scientific basis for the adequacy of the recommended daily fluid have not clear yet. Furthermore, the fluid intake counseling in addition to nutrition for pregnant women is neededObjective: To determine the fluid intake in pregnant women and the mean difference of  amniotic fluid index on adequate fluid intake compared to less fluid intake.Methods: This research used prospective observational cohort study, conducted against the third semester pregnant women in Puskesmas Mergangsan and Tegalrejo Yogyakarta during July until September 2014. The subjects who met the inclusion criteria were divided into adequate and less fluid intake groups. The correlation between fluid intake and amniotic fluid index was analyzed using t-test and linear regression.Result and Discussion: The total subjects who met the criteria were 27 people, consist of 12 people in adequate fluid intake group and 15 people in less fluid intake group. The mean of subject’s fluid intake 2078 ml (enough), while the mean of amniotic fluid index (AFI) 12,76 cm (normoamniotic).The result showed that there was a significant difference (3,50 cm (IK 95%; 1,5-5,48); P < 0,05) between the mean of AFI from adequate fluid intake group compared to less fluid intake group . Simple linear regression test showed the effect of fluid intake for AFI namely 31,7%; with the amount of predicted AFI = 10,686 + 3,545 x fluid intake – 1,015 x age – 1,317 x education + 0,314 x occupation (ARS= 44,5%). External variables (age, education, and occupation) had no significant effect for AFI .Conclusion : The mean preview of fluid intake in the third semester pregnant women in Yogyakarta was adequate. Moreover, there was a AFI signifficant difference between adequate fluid intake compared to less fluid intake.  Keywords: fluid intake; amniotic fluid index; AFI
HUBUNGAN ANTARA ENDOMETRIOSIS FERTILITY INDEX (EFI) DAN KEBERHASILAN FERTILISASI IN VITRO (FIV) Amelia, Adelina; Dasuki, Djaswadi; Pradjatmo, Heru
JURNAL KESEHATAN REPRODUKSI Vol 1, No 2 (2014)
Publisher : IPAKESPRO

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Adelina Amelia1, Djaswadi Dasuki2, Heru Pradjatmo3Background: Endometriosis is a gynecological disease that is found in 25-30% of infertile women. The most widely used staging system of endometriosis in IVF is the revised American Fertility Society (r-AFS) which has limited predictive ability for pregnancy after surgery. The Endometriosis Fertility Index (EFI) is used to predict fecundity after endometriosis surgery.Objective: To assess the relationship between EFI and the outcomes of IVF.Methods: The study was retrospective cohort. Subjects of study were endometriosis patients who underwent IVF in Infertility Clinic of Permata Hati, Dr. Sardjito Hospital, Yogyakarta in 2012 that met inclusion and exclusion criteria. Subjects were devided into two groups: high EFI and low EFI. ROC curve was used to obtain the cut-off point.Chi-square and logistic regression statistics analysis were used.Results and Discussion: A total of 54 cycles from 54 couples who underwent IVF were included. Cut off point for EFI is 6. There is no difference in the outcomes of IVF between high and low EFI (OR 15,135; 95% CI 0,830-276,00; p=0,067), but high EFI increased the outcome of IVF 15 times better than low EFI. The outcome of IVF was influenced by type of the embryo transfer (OR 0,126; 95% CI 0,028-0,566).Conclusion: High EFI did not affect the outcomes of IVF both rated at biochemical pregnancy, clinical pregnancy and live birth. The outcomes of IVF was influenced by type of the embryo transfer. The cause of female infertility and stage of the endometriosis increased EFI score but did not affect the outcomes of IVF. Keyword: endometriosis, infertility, endometriosis fertility index, in vitro fertilization ABSTRAK Latar Belakang: Endometriosis adalah salah satu penyakit ginekologi yang ditemukan pada 25-50% wanita infertil. Sistim klasifikasi yang digunakan untuk menentukan derajat atau stadium endometriosis dalam FIV yaitu The revised American Fertility Society (r-AFS) yang memiliki keterbatasan dalam memprediksikan kehamilan setelah pembedahan. Endometriosis Fertility Index ( EFI) adalah sistim klasifikasi endometriosis terbaru yang dapat digunakan untuk memprediksikan kehamilan setelah pembedahan.Tujuan: Menilai hubungan antara Endometriosis Fertility Index (EFI) dan keberhasilan Fertilisasi In Vitro (FIV). Metode: Studi kohor retrospektif. Subyek penelitian adalah pasien endometriosis yang menjalani program FIV di Klinik Permata Hati RSUP Dr. Sardjito Yogyakarta pada tahun 2012 yang memenuhi kriteria inklusi dan terlepas dari kriteria ekslusi. Subyek dibagi menjadi 2, kelompok EFI tinggi dan EFI rendah. Nilai titik potong EFI didapat dari kurva ROC. Uji statistik yang digunakan adalah Chi-square dan regresi logistik.Hasil dan Pembahasan: Sebanyak 54 siklus dari 54 pasangan yang menjalani fertilisasi in vitro(FIV) disertakan dalam penelitian sesuai dengan kriteria inklusi dan eksklusi. Nilai titik potongditetapkan EFI=6. Tidak terdapat perbedaan secara statistik terhadap keberhasilan FIV antara EFI tinggi dan rendah (OR 15,135; IK 95% 0,830-276,00; p=0,067) tetapi secara klinis skor EFI tinggi meningkatkan keberhasilan FIV 15 kali dibanding skor EFI rendah. Keberhasilan FIV dipengaruhi oleh jenis embrio yang ditransfer (OR 7,020; IK 95% 1,309-37,660; p=0,023).Kesimpulan: Skor EFI tinggi tidak mempengaruhi keberhasilan dalam program FIV baik dinilai pada kehamilan biokimia, kehamilan klinik, maupun kelahiran bayi hidup. Faktor yang mempengaruhi adalah jenis embrio yang ditransfer. Faktor penyebab infertilitas wanita dan stadium endometriosis meningkatkan skor EFI tetapi tidak mempengaruhi keberhasilan FIV.Kata kunci: endometriosis, infertilitas, endometriosis fertility index,fertilisasi in vitro. 1,2,3 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM
PENGARUH PEMBERIAN ASAM TRANEKSAMAT TERHADAP JUMLAH PERDARAHAN PASCASALIN PADA KELAHIRAN VAGINAL Chilmawati, Laili; Pradjatmo, Heru; Siswosudarmo, H.R.
JURNAL KESEHATAN REPRODUKSI Vol 1, No 2 (2014)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (162.604 KB)

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PENGARUH PEMBERIAN ASAM TRANEKSAMAT TERHADAP JUMLAH PERDARAHAN PASCASALIN PADA KELAHIRAN VAGINALLaili Chilmawati1 , Heru Pradjatmo2, H.R. Siswosudarmo3 ABSTRACT Background: Maternal mortality is the great problem in developing countries and postpartum hemorrhage is the main cause. Obstetrics intervention and uterotonics agents have been used to control postpartum hemorrhage, but the use of hemostatic agent is still in the study.Objective: To compare the effect of tranexamic acid on postpartum hemorrhage and its potential side effects compared with placebo in vaginal deliveryMethods: A Double blindrandomized controlled Trial (RCT). We conducted a total of 198 subjects who met the inclusion criteria were recruited. The treatment group was those who got one gram tranexamic injection and the the control group those who got placebo. Independent sample t-test, chi-square and linear regression were used for statistical in treatment group analysis.Results and Discussion: A total of 198 subjects met the inclusion criteria, consisting of 99 subjects and 99 in the control group. No significant difference was found on the amount of postpartum hemorrhage (102.13±67.34 ml vs.110.58±73.57 ml;p=0.40), nor on the difference of hemoglobin level (0.99±1.13 g/dLvs.1.05 ± 0.93 g/dLp=0.66), and of hematocrit level (4.06 ± 3.73 vs.4.58±4.18%;p=0.36). The use of other uterotonics gave the significant difference at the decrease of hemoglobin level (p=0,02). Side effect of nausea and vomiting at tranexamic acid group didn’t differ from placebo (p=1,00).Conclusion: There was no difference between the use of tranexamic acid and placebo in terms of number of bleeding the decrease of haemoglobin and hematocrit. Keywords: tranexamic acid; postpartum hemorrhage; hemoglobin and hematocryte level, vaginal delivery. ABSTRAK Latar belakang: Kematian ibu merupakan masalah yang besar di negara sedang berkembang. Perdarahan pascasalin merupakan penyebab paling utama kematian ibu. Intervensi obstetrik dan obat-obat uterotonika telah digunakan secara optimal untuk mengatasi perdarahan pascasalin, tetapi obat hemostatik masih dalam kajian.Tujuan: Mengetahui pengaruh asam traneksamat terhadap jumlah perdarahan pascasalin pada persalinan vaginal dan efek samping yang mungkin terjadi.Metode Penelitian: Metode penelitian ini adalah Randomized Controlled Trial (RCT). Subyek penelitian adalah pasien dengan persalinan vaginal yang memenuhi kriteria inklusi dan eksklusi. Kelompok penelitian adalah mereka yang mendapat injeksi asam traneksamat 1 gram intravena sedang kelompok control adalah mereka yang mendapat plasebo. Independent t-test, chi-square dan regresi linier digunakan untuk analisis statistika.Hasil dan Pembahasan: Sebanyak 198 subyek memenuhi memenuhi kriteria kelayakan, terdiri atas 99 subyek masuk ke dalam kelompok perlakuan dan 99 subyek yang masuk dalam kelompok kontrol. Tidak didapatkan perbedaan secara bermakna pada jumlah perdarahan kala IV (102,13±67,34 ml vs 110,58±73,57 ml, p=0,40), penurunan kadar hemoglobin (0,99±1,13 g/dLvs.1,05±0,93 g/dL, p=0,66) dan penurunan kadar hematokrit (4,06±3,73 vs.4,58±4,18%, p=0,36). Penggunaan uterotonika lain memberikan perbedaan secara signifikan terhadap penurunan kadar hemoglobin (p=0,02). Kadar hemoglobin awal dan kadar hematokrit awal memberikan perbedaan secara signifikan terhadap penurunan kadar hematokrit (p=0,006 dan 0,01). Kejadian efek samping mual dan muntah pada pemberian asam traneksamat tidak berbeda dibandingkan dengan plasebo (p=1,00).Kesimpulan: Jumlah perdarahan kala IV, penurunan kadar hemoglobin dan penurunan kadar hematokrit tidak berbeda antara kelompok yang mendapat asam traneksamat dibanding yang mendapat placebo. Kata kunci: asam traneksamat, perdarahan pascasalin, kadar hemoglobin, hematokrit. 1 PPDS 1 Obstetri dan Ginekologi, Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM2,3 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM
PRESERVASI FERTILITAS PADA PENDERITA KANKER Pradjatmo, Heru
JURNAL KESEHATAN REPRODUKSI Vol 2, No 3 (2015)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (255.114 KB) | DOI: 10.22146/jkr.12656

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PRESERVASI FERTILITAS PADA PENDERITA KANKER*Heru Pradjatmo1ABSTRACTBackground: Young women who survive from cancer as candidates to face reproductive problemsassociated with cytotoxic cancer therapy. Side effects that alter the quality of life becomes unacceptable.Advances in reproductive medicine enables previously infertile women can obtain offspring.Objective: To recognize the effort that can be done to prevent adverse effects on fertility patients due tocancer therapyMethod: Literature studyResult and Discussion: In general, women age 40 years or less with cancer who received chemotherapy tobe likely ovarian function will cease. Studies show that many technique performed before chemotherapyallows women to have babies would be greater. Women prior to treat chemotherapy should be consultedto physicians in the field of reproductive and endocrinology for fertility preservation methods to deal withoncologist who take care the patient. All methods that can be performed should be included in counselingand all counseling and treatment including possible complications should be documented and recorded.Keywords : infertility, chemotherapy, adverse effect, preservationABSTRAKLatar Belakang: Perempuan muda yang survive dari penyakit kanker menjadi kandidat menghadapimasalah reproduksi berkaitan dengan terapi kanker yang bersifat sitotoksik. Sehingga efek samping yangmerubah kualitas kehidupan menjadi tidak dapat diterima. Kemajuan dalam kedokteran reproduksimemungkinkan wanita yang sebelumnya infertil akibat prngobatan penyakit kanker sekarang dapatmemperoleh keturunan.Tujuan: Untuk memahami upaya yang dapat dilakukan untuk mencegah terjadinya efek samping terhadapfertilitas penderita akibat terapi kanker.Metode: Studi literaturHasil dan Pembahasan: Secara umum perempuan penderita kanker sampai umur 40 tahun yangmendapat kemoterapi kemungkinan dapat berhenti fungsi ovariumnya. Studi menunjukkan bahwabeberapa teknik yang dilakukan sebelum kemoterapi memungkinkan wanita memperoleh keturunan lebihbesar. Seharusnya sebelum terapi dikonsulkan ke dokter dibidang reproduksi untuk metode preservasifertilitas dengan kesepakatan ahli onkologi yang menangani. Semua metode yang dapat dilakukan harusdimasukkan dalam konseling. Semua konseling dan pengobatan termasuk komplikasi yang mungkin terjadiseharusnya di dokumentasikan dan dicatat.Kata Kunci: infertilitas, khemoterapi, efek samping, preservasi1 Bagian Obstretika & Ginekologi Fakultas Kedokteran UGM/RSUP Dr. Sardjito Yogyakarta* Dipresentasikan pada seminar in vitro maturation (IVM) in vitro fertilization andlaparoskopic surgery, Yogyakarta, 8-9 November 2013
KUALITAS HIDUP SATU TAHUN PASIEN KANKER SERVIKS YANG TELAH DILAKUKAN HISTEREKTOMI RADIKAL DI RSUP DR. SARDJITO YOGYAKARTA Fuadi, Afif; Pradjatmo, Heru; Kusumanto, Ardhanu
JURNAL KESEHATAN REPRODUKSI Vol 6, No 3 (2019)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.49348

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Latar Belakang: Kanker serviks merupakan kanker paling banyak ketiga yang ditemukan pada seorang wanita. Secara keseluruhan lebih dari 85% terjadi pada negara-negara berkembang. Insidensi rata-rata paling tinggi di wilayah Sub Sahara Afrika, Amerika Latin dan Karibia, Melanesia dan Asia Barat, Australia/Selandia Baru. Variasi geografis yang besar mencerminkan ketersediaan skrining yang memungkinkan untuk mendeteksi lesi prakanker dan prevalensi terjadinya infeksi Human Papillomavirus (HPV). Modalitas skrining dan strategi pengobatan telah berevolusi, dengan kemajuan terapi saat ini yang meliputi tindakan pembedahan, kemoterapi dan radiasi, penderita kanker serviks dihadapkan pada efek samping pasca pengobatan lengkap. Sehingga dapat menyebabkan penurunan kualitas hidup mereka.Tujuan: Mengetahui kualitas hidup satu tahun pasien kanker serviks yang telah dilakukan histerektomi radikal.Metode: Penelitian kuantitatif dengan pendekatan cross sectional dengan cara melakukan wawancara dengan pasien saat periksa di poli onkologi menggunakan instrumen dari EORTC QLQ C30 versi 3.Hasil dan Pembahasan: Rata-rata penderita kanker serviks berusia 45-55 tahun yaitu 21 orang (37,5%), tidak menopause, dengan paritas antara 1-2 dan indeks massa tubuh normal. Jenis histopatologi terbanyak adalah karsinoma sel skuamosa dan grade sedang. Sebagian besar tidak terdapat keterlibatan kelenjar getah bening, lymphovascular space invation (LVSI) dan tidak dilakukan kemoterapi adjuvan. Kualitas hidup pasien kanker serviks termasuk dalam katagori baik dengan nilai rata-rata status kesehatan global >87,5% dan pada domain skala fungsi dan gejala >90%. Hanya saja terdapat hubungan yang bermakna yang ditunjukkan pada variable usia dengan nilai p=0,020 dan RR=0,545 dan keterlibatan kelenjar gertah bening dengan nilai p=0,008.Kesimpulan: Pada penelitian ini kualitas hidup pasien kanker serviks yang telah dilakukan histerektomi radikal di RSUP Dr. Sardjito sangat baik.Kata Kunci: Kanker serviks; Kualitas Hidup; Histerektomi radikal
PENGETAHUAN DAN KETERAMPILAN BIDAN UNTUK SKRINING KANKER SERVIKS DENGAN METODE INSPEKSI VISUAL ASAM ASETAT (IVA) DI KALIMANTAN BARAT Mardiana, Mardiana; Dasuki, Djaswadi; Pradjatmo, Heru
JURNAL KESEHATAN REPRODUKSI Vol 2, No 1 (2015)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (197.687 KB)

Abstract

Mardiana1, Djaswadi Dasuki2, Heru Pradjatmo2 ABSTRACT Background: Globally it is estimated that every two minutes a woman dies of cervical cancer and 500,000 women are diagnosed to have cervical cancer each year. In Indonesia, the incidence of cervical cancer is by 12.6 per 100,000 women with a mortality rate of 7 per 100,000. Screening method can reduce the incidence of cervical cancer if done cumulatively in 2012, the coverage of screening with a VIA method in Indonesia was 1.57%, whereas screening coverage with IVA in West Kalimantan Province was 1.06 %Objective: To assess midwives’ knowledge and skills of screening practices with a VIA method in health centers Method: This was an observational study with a cross-sectional study, using quantitative and qualitative approaches. The study was conducted in health centers in the province of West Kalimantan. This study was conducted in September to October 2014. The subjects of research were midwives who served in health centers doing a VIA examination in West Kalimantan who met inclusion and exclusion criteria. The total sample of this study was 42 taken with purposive sampling. The variables of this study were the dependent variable, ie, the practice of screening skills with a VIA method, the independent variable, ie, knowledge, and the extraneous variables, ie, age, education, and years of service. Analysis of the data included univariable, bivariable, multivariable, and qualitative. The quantitative data analysis used the chi-square and logistic regression with a significance level of p &lt;0.05 and an OR value with confidence interval (CI) of 95%.Result &amp; Discussion: The mean value of midwives’ knowledge was 26.0 from assessment scores of 0-30. A mean score of screening practice skills was 94.4 from 38-114. Of clinical assessment scores skill practice of competent midwives with good knowledge was higher than bad knowledge (OR= 6,98 CI 95% 1,21-40,33). After controlling education and years of service variables, good knowledge influenced screening clinical practice by 33%. Conclusion: Most of the midwives in West Kalimantan had good knowledge and skills to perform cervical cancer screening with a VIA method.Keywords: Knowledge, screening practice skills, VIA methods  ABSTRAKLatar Belakang: Di seluruh dunia diperkirakan setiap dua menit seorang wanita meninggal karena kanker servik dan sekitar 500.000 wanita di diagnosis kanker seviks setiap tahun. Di Indonesia insiden kanker serviks sebesar 12,6 per 100.000 perempuan dengan angka kematian sebesar 7 per 100.000. Metode skrining dapat menurunkan kejadian kanker serviks jika dilakukan secara kumulatif. Pada tahun 2012 cakupan skrining dengan metode IVA di Indonesia sebesar 1,57%, sedangkan cakupan skrining dengan metode IVA Propinsi Kalimantan Barat sebesar 1,06%.Tujuan: Menilai pengetahuan dan keterampilan praktek skrining bidan dengan metode IVA di puskesmas Metode: Jenis penelitian observasional dengan rancangan cross-sectional study, menggunakan pendekatan kuantitatif dan kualitatif. Penelitian dilakukan di puskesmas di Provinsi Kalimantan Barat. Penelitian ini dilaksanakan bulan September sampai dengan Oktober 2014. Subjek penelitian bidan yang melayani pemeriksaan IVA di puskesmas di Provinsi Kalimantan Barat yang memenuhi kriteria inklusi dan eksklusi. Total sampel penelitian ini 42 sampel dengan pengambilan sampel purposive sampling. Variabel penelitian ini yaitu: variabel terikat adalah keterampilan praktek skrining metode IVA, variabel bebas: pengetahuan, dan variabel luar: usia, pendidikan, dan lama bekerja. Analisis data meliputi: univariabel, bivariabel, multivariabel, dan kualitatif. Untuk analisis data kuantitatif meng-gunakan metode chi square dan logistic regresi dengan tingkat kemaknaan p &lt; 0,05 dan nilai OR dengan Confidence Interval (CI) 95%.Hasil &amp; Pembahasan: Nilai mean pengetahuan bidan sebesar 26,0 dari skor penilaian 0-30. Keterampilan praktik dengan nilai mean 94,4 dari skor 38-114. Keterampilan praktik klinik yang kompeten lebih tinggi pada bidan berpengetahuan baik daripada bidan berpengetahuan kurang (OR= 6,98 CI 95% 1,21-40,33). Pengetahuan baik setelah dikontrol variabel pendidikan dan lama bekerja berpengaruh terhadap keterampilan praktik skrining sebesar 33%.Kesimpulan: Sebagian besar bidan di Kalimantan Barat memiliki pengetahuan baik dan keterampilan yang kompeten untuk skrining kanker serviks dengan metode IVA. Kata Kunci: Pengetahuan, keterampilan praktek skrining, metode IVA 1 Dinas Kesehatan Provinsi Kalimantan Barat2 Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Gadjah Mada      Yogyakarta
MicroRNA-21 as a biomarker for ovarian cancer detection Kartika, Aprilia Indra; Chasanah, Siti Nur; Fitriawan, Akbar Satria; Tanjung, Dewi Sahfitri; Trirahmanto, Addin; Pradjatmo, Heru; Aryandono, Teguh; Haryana, Sofia Mubarika
Indonesian Journal of Biotechnology Vol 23, No 1 (2018)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (120.369 KB) | DOI: 10.22146/ijbiotech.35692

Abstract

Ovarian cancer is a lethal disease. One of the problems faced by patients with ovarian cancer is the lack of symptoms in its early stages, which results in it only being detected when it is at an advanced stage. Therefore, there is an urgent need for biomarkers that can predict ovarian cancer precisely. The purpose of this study was to determine the expression of microRNA-21 as a predictive biomarker candidate in both early- and advanced-stage ovarian cancer. This was a cross-sectional study using the blood plasma of 21 healthy control subjects and 37 blood plasma samples from patients with ovarian cancer. Blood plasmas were collected, from which the RNA was isolated. Based on the RNA, the cDNA was synthesized and run through qPCR, the results of which were analyzed using the Livak method. The results showed an upregulation of microRNA-21 in the advanced stage by 2.14 fold compared with the early stage, and 6.13 fold compared with the healthy controls (p < 0.05). The upregulation of microRNA-21 in early-stage ovarian cancer was 2.86 fold compared with the healthy control subjects (p < 0.05). In addition, there was an increase in the expression of microRNA-21 in ovarian cancer by 4.14 fold compared with the healthy controls (p < 0.05). Based on these results, it can be concluded that the expression of microRNA 21 upregulated with the severity of the disease.
Hubungan Response Time Seksio Sesarea Emergensi Kategori 1 dengan Luaran Perinatal di RSUP Dr.Sardjito Gunawan, Tri; Attamimi, Ahsanudin; Pradjatmo, Heru
JURNAL KESEHATAN REPRODUKSI Vol 5, No 1 (2018)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (418.237 KB) | DOI: 10.22146/jkr.37997

Abstract

Background: Caesarean section is often applied as a preventif efoort against the continued effects of perinatal asphyxia. The cesarean section (SC) in pregnant woman can be performed in a planned manner with various indications or performed by emergency (emergency) on maternal or fetal indications and or both.Objective: To study the association of response time in category I emergency caesarean section with perinatal outcomes in Dr. Sardjito hospital and the average response time of category 1 emergency cesarean section in Dr. Sardjito hospital.Method: This study uses retrospective cohort. Category 1 CS with an indication of fetal accordance with the inclusion criteria was recorded from 1st January 2012 until 31th July 2016, then we find the response time mean as the cut off point of this study to compare with their perinatal outcomes.Result and Discussion: There were 155 cases out of 386 of emergency CS category 1 met the inclusion criteria during the period 1st January 2012 to 31th July 2016. From the data obtained, the average response time of category 1 emergency CS was 115±52 minutes (35 - 360 minutes). We found no significant differences in perinatal outcomes in the group’s response time ≥115 minutes with a value of p>0.05 on the Apgar score, CPAP, infant mortality, ventilator, NICU care, MAS and HIE than those category 1 emergency CS with a response time <115 minutes. From multivariate analysis, general anaesthesia was statistically significant against perinatal outcomes Apgar score <7 at 5 minutes with (p=0.044). Prematurity in the multivariate analysis was statistically significant against perinatal outcomes Apgar score ≤3 at 1 minute with (p=0.040), Apgar score <7 at 5 minutes with (p=0.025) and the use of CPAP with (p=0.009).Conclusions: Response time category 1 emergency cesarean section in this study did not affect perinatal outcomes. General anesthesia effect on perinatal outcomes Apgar score <7 at 5 minutes, whereas the prematurity effect on perinatal outcomes Apgar score ≤3 at 1 minute, Apgar score <7 at 5 minutes and the use of CPAP.Keywords: category 1 emergency caesarean section, response time, fetal distress
Status gizi sebagai faktor prognosis penderita karsinoma endometrium Pradjatmo, Heru; Pahlevi, Deyna Primavita
Jurnal Gizi Klinik Indonesia Vol 10, No 1 (2013): Juli
Publisher : Minat S2 Gizi dan Kesehatan, Prodi S2 IKM, Fakultas Kedokteran UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (216.475 KB) | DOI: 10.22146/ijcn.18838

Abstract

Background: In Indonesia, endometrial cancer is the third gynaecologic cancer after cervical and ovarian cancers. Various factors affect the survival of the patients, however, which factors affect the survival of endometrial carcinoma patients in Dr. Sardjito Hospital remain unclear. A research is therefore needed in order to determine the survival and the prognostic factors.Objective: To investigate the prognostic factors that affect the survival of endometrial carcinoma patients who had been admitted to Dr. Sardjito Hospital.Method: The study design was retrospective cohort. The subjects were patients with endometrial carcinoma who were treated in Dr. Sardjito Hospital from 1st of January 2006 until 31st of December 2011. Kaplan-Meier analysis was performed to analyze several factors that influenced the survival of the patients. The differences of survival were analyzed with log rank test while the prognostic factors influencing the survival were analyzed using Cox regression.Results: 68 endometrial carcinoma patients were recruited as the subjects for the study. The median survival of endometrial carcinoma patients 52 months for those on early stage and 17 months on advanced stage (p≤0.01). The prognostic factors affecting survival that has been found statistically and clinically significant was the stage of the disease (p=0.002; HR=6.175; 95% CI=1.1980 to 19.25). Meanwhile, the nutritional status of patients with low, normal, and high BMIs score showed increased survival rate as indicated by the HR values of 1; 0.768; and 0.311 respectively.Conclusion: The prognostic factor that was clinically and statistically significant influenced the survival was the stage of the disease, while the nutritional status of patients was found clinically significant as the prognostic survival of the patients.