Rustam Sunaryo
Faculty of Medicine, Sebelas Maret University

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KEMATIAN IBU SEBELUM DAN SELAMA PELAYANAN JAMINAN PERSALINAN (JAMPERSAL) DI RSUD DR. MOEWARDI SURAKARTA TAHUN 2009 - 2013 Sunaryo, Rustam; Hakimi, Mohammad; Suhadi, Agung
JURNAL KESEHATAN REPRODUKSI Vol 1, No 2 (2014)
Publisher : IPAKESPRO

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KEMATIAN IBU SEBELUM DAN SELAMA PELAYANAN JAMINAN PERSALINAN (JAMPERSAL) DI RSUD DR. MOEWARDI SURAKARTA TAHUN 2009 - 2013 Rustam Sunaryo1, Mohammad Hakimi2, Agung Suhadi3  ABSTRACT Background: Maternal mortality rate in Indonesia is considered to be one of the highest among South East Asia Countries. One of the main reason is access for health services cost, which leads to massive numbers of birth outside health facility. Some programs are initiated to address these issues in order to achieve Millenium Development Goals (MDG’s) with maternal mortality target of 102/100.000 live births on 2015. Jaminan Persalinan “JAMPERSAL” is one of government policy to reduce cost barrier.Objectives: To analyze the effect of Jampersal on reducing maternal mortality rate in Moewardi General Hospital, Surakarta.Methods: This was an observational Analysis with cross sectional design. Data were collected from all maternal mortality cases at Moewardi General Hospital from 1 st of January 2009 until 31stDecember 2013. Maternal mortality rate before and during Jampersal was taken into account for statistical analysis using Chi square Test.Results: Total number of births were significantly increasing, for about 3.5 times. Maternal mortality percentage was decreasing significantly during Jampersal, from 1.45% to 0.53% (p=0.000). The most frequent etiology of maternal death was preeclampsia/eclampsia (53.33% - 72.40%). For this cause, Jampersal also had a potential role on lowering case fatality rate from 5.95% to 3.64% (p=0.025, p<0.05)Conclusions: Jampersal has significantly reduce maternal mortality rate but on the other side increase number of birth in me hospital. The policy would be considerd as supportive for achieving MDG’s. Keywords: Jampersal, Maternal Mortality, cause of death  ABSTRAK Latar belakang: Angka kematian ibu di Indonesia masih menduduki tempat tertinggi di antara negara Asia Tenggara. Salah satu penyebabnya adalah biaya persalinan sehingga sebagian ibu melahirkan tidak di fasilitas kesehatan. Beberapa program dilakukan untuk mengatasi masalah ini agar dapat mencapai target Millenium Development Goals (MDG’s) dengan AKI 102/100.000 lahir hidup di 2015. Jaminan Persalinan “JAMPERSAL” merupakan salah satu kebijakan pemerintah untuk mengurangi hambatan biayaTujuan: Mengananlisis pengaruh Jampersal untuk menurunkan kematian ibu di RS Moewardi, Surakarta. Metode: Penelitian ini merupakan penelitian observasional dengan desain cross sectional. Data dikumpulkan dari semua kasus kematian ibu di RS Moewardi dari 1 Januari 2009 hingga 31 Desember 2013. Kematian ibu sebelum dan setelah dilaksanakannya Jampersal dihitung dan dianalisis dengan Chi square Test.Hasil: Jumlah total persalinan meningkat signifikan, sekitar 3,5 kali. Persentase kematian ibu menurun signifikan selama program Jampersal dilaksanakan, yaitu 1.45% hingga 0.53% (p=0.000). Penyebab kematian tersering adalah preeklampsia/eklampsia (53.33% - 72.40%). Jampersal menurunkan angka fatalitas kasus preeklamsia secara signifikan dari 5.95% menjadi 3.64% (p=0.025, p<0.05)Kesimpulan: Jampersal dapat menurunkan kematian ibu di rumah sakit secara signifikan tetapi di sisi lain meningkatkan jumlah persalinan. Kebijakan ini dianggap dapat mendukung tercapainya target MDGs. Kata kunci: Jampersal, Maternal Mortality, cause of death1 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UNS2 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM3 RSUD Wonosobo  
Hubungan Perokok Pasif dengan Tingkat Kejadian Kanker Serviks di RSUD Dr Moewardi Amar, Syahmi; Sunaryo, Rustam; Murti, Bhisma
Nexus Kedokteran Klinik Vol 1, No 2 (2012): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Background: Incidence of cervical cancer each year has increased and the risk of death from cervical cancer is also increased. Cigarette smoke is one of the risk factors associated with cervical cancer which contains chemicals such as nicotine and benzopiren. The content of these chemicals may increase the risk of cervical cancer by various mechanisms. The purpose of this study was to determine the incidence rate of cervical cancer associated with exposure to passive smokers is connected. Methods: This type of research is an case-control. Sample of this study were gynecologic cancer patients with a total sample of 60 people. Measuring instrument used was a validated questionnaire, and performed data analysis with multiple logistic regression analysis. Result: Found a statistically significant association between passive smoking with the incidence of cervical cancer. Passive smokers will have 11,5 ​​times the cervical cancer than non-passive smokers (p=0,001, OR = 11,5). Conclusion: Based on studies of passive smoking women would run the risk of cervical cancer will have 11,5 times higher than non-passive smokers. Key words: passive smoker, cervical cancer 
Hubungan antara Pemakaian Alat Kontrasepsi Dalam Rahim (AKDR) dan Kejadian Kanker Serviks di RSUD Dr. Moewardi Arta, Octava Prima; Sunaryo, Rustam; Murti, Bhisma
Nexus Kedokteran Klinik Vol 1, No 2 (2012): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.044 KB)

Abstract

Background: One government program in an effort to deal with the increasing population is a national family planning program, in particular by the use of contraceptives. Intrauterine Device (IUD) is the one form of contraception is widely used in society but still not much information about the correct usage and side effects. Bacterial or viral infection is one of the side effects of IUD use, including Human Papilloma Virus (HPV) infection, the virus that causes cervical cancer. The purpose of this study to determine the incidence rate of cervical cancer associated with IUD use. Research Methods: This type of case-control study. Sample of this study were gynecologic cancer patients with a total sample of 60 people. Measuring instrument used was a validated questionnaire, and performed data analysis with multiple logistic regression analysis. Result: Found a statistically significant association between IUD users with the incidence of cervical cancer. IUD users will experience cervical cancer 12 times compared to non-IUD users (p = 0,001, OR=12,70). Conclusion: Based on research IUD users will experience a risk for cervical cancer 12,7 times higher than those not using an IUD. Keyword: Intrauterine Device, cervical cancer 
Hubungan antara Infeksi Menular Seksual dengan Kejadian Lesi Prakanker Serviks pada Ibu Rumah Tangga di Puskesmas Sangkrah Surakarta Dirk, Bela; Sunaryo, Rustam; Putranto, R.P. Andri
Nexus Kedokteran Komunitas Vol 2, No 2 (2013): Nexus Kedokteran Komunitas
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.115 KB)

Abstract

Background: The housewife is a group of women who are at risk for sexually transmitted infections. Sexually transmitted infections is one of the risk factors for pre-cancerous cervical lesions. This study aimed to determine the relationship between the incidence of sexually transmitted infections with cervical precancerous lesions on housewife in Sangkrah health center, Surakarta Methods: This study was a descriptive cross sectional analytic approach that was conducted in June-August 2012 in Sangkrah health center, Surakarta. Sampling was done by purposive sampling technique. In this study, researchers took a sample size of 53 samples. Research carried out by filling out the questionnaire, followed by a visual inspection test checks acetic acid (VIA) and the examination of sexually transmitted infections. Where is a sexually transmitted infection is gonorrhea, candidiasis and bacterial vaginosis. Data analysis using chi-square method. Results: This study shows the value of relationship to STI: a) Gonorrhea p = 0.299, CI95% = 0.236 to 71.357, and RR = 4.10, b) Candidiasis p = 0.160, CI95% = 0.236 to 71.357, and RR = 6.29, c) Bacterial Vaginosis p = 0.117, CI95% = 0.413 to 136,271 and RR = 7.50. From the results of these data revealed that there was no relationship between the incidence of sexually transmitted infections with pre-cancerous cervical lesions housewife in Surakarta but clinically meaningless to pose the risk of precancerous cervical lesions. But found a significant relationship between STI> 1 types and cervical precancerous lesions where p = 0.000, CI95% = 1.659 to 1507.303 and RR = 50.00.   Conclusions: There is no relationship between the incidence of sexually transmitted infections (Gonorrhoea, Candidiasis, and Bacterial Vaginosis) with pre-cancerous cervical lesions on housewife in Sangkrah Health Center Surakarta. Keywords: Sexually transmitted infection, Cervical Precancerous Lesions, Housevives, Surakarta.  
The association between pregnancy spacing and iron deficiency anemia at RSUD Dr. Moewardi Damayanti, Puspa; Sunaryo, Rustam; Murti, Bhisma
Nexus Kedokteran Klinik Vol 2, No 1 (2013): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

ABSTRACT Background: Pregnant women to be one of those most vulnerable to malnutrition, especially iron deficiency anemia and iron deficiency anemia coping is currently focused on the tablet of iron (Fe) in pregnant women. While pregnancy distance of less than 2 years old are at greatest risk for iron deficiency anemia. Methods: This analytic study was observational using case-control approach. A sample of 60 study subjects was selected by purposive sampling and fixed disease sampling from outpatients who visited Obstetric Clinics, RSUD Dr. Moewardi Surakarta. The data was collected by interview and some datas taken from the medical records. The data was analyzed using multiple logistic regression model on SPSS 20 for windows. Results : The pregnant women with pregnancy spacing ≥ 24 months at RSUD Dr. Moewardi have a greater risk for iron deficiency anemia 0,8 times larger than <24 months pregnancy spacing (OR=0,8 ; Cl 95% 0,17 s.d. 3,80; p=0,778). This analysis have control gestational age as a confounding factor, but not control the intake of nutrient. Conclusion: There is a weak and negative association, and not statistically significant between the gestational age with iron deficiency anemia.. Keywords: pregnancy spacing, iron deficiency anemia
Hubungan antara Faktor Risiko Perdarahan dengan Kejadian Perdarahan Postpartum di RSUD Dr. Moewardi Surakarta Tahun 2012 Amanda, Larissa; Sunaryo, Rustam; Widardo, .
Nexus Kedokteran Klinik Vol 3, No 1 (2014): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Background: Maternal mortality rate in Indonesia is relatively high compared to the other Asian countries. Postpartum hemorrhage is one of the major cause of maternal mortality. The increase in risk factors for hemorrhage in pregnancy and labor is known to contribute to the increase in cases of postpartum hemorrhage.  The objective of this research was to know the correlation between risk factors for hemorrhage and occurrence of postpartum hemorrhage in Dr. Moewardi Hospital Surakarta in 2012. Methods: This research used descriptive analytical study by the case control approach. Case group was patients with postpartum hemorrhage in Dr. Moewardi Hospital Surakarta in 2012. Sample of the case group was taken by purposive sampling. Control group was postpartum patients in Dr. Moewardi Hospital Surakarta in 2012 who didn’t experience of postpartum hemorrhage. Sample of the control group was randomly selected by simple random sampling from 45 patients who had spontaneus labor and 45 patients who had sectio caesarean which met the criteria of purposive sampling. This research was conducted by collecting data from 55 medical records of patients in case and control groups. The collected data were analyzed with Chi Square and logistic regression formulas. Results: The result of statistical analysis revealed significant diferrences between case and control groups for methods of labour with p values = 0,001 and r = 0,405. The results of statistical analysis for age, parity, anemia, birthweight and severe preeclampsia revealed no significant differences between case and control groups with each p values = 0,566, 0,423, 0,401 and 0,161. There were no eclampsia and polihidramnios patient in case and control groups. Conclusions: The results of this research revealed that there were a correlation between spontaneous labor with episiotomy, elective caesarean section, emergency caesarean section, assisted vaginal delivery with episiotomy and occurence of postpartum hemorrhage in Dr. Moewardi Hospital in 2012. Keywords: postpartum hemorrhage, risk factors for hemorrhage. 
KEMATIAN IBU SEBELUM DAN SELAMA PELAYANAN JAMINAN PERSALINAN (JAMPERSAL) DI RSUD DR. MOEWARDI SURAKARTA TAHUN 2009 - 2013 Sunaryo, Rustam; Hakimi, Mohammad; Suhadi, Agung
JURNAL KESEHATAN REPRODUKSI Vol 1, No 2 (2014)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.5345

Abstract

KEMATIAN IBU SEBELUM DAN SELAMA PELAYANAN JAMINAN PERSALINAN (JAMPERSAL) DI RSUD DR. MOEWARDI SURAKARTA TAHUN 2009 - 2013 Rustam Sunaryo1, Mohammad Hakimi2, Agung Suhadi3  ABSTRACT Background: Maternal mortality rate in Indonesia is considered to be one of the highest among South East Asia Countries. One of the main reason is access for health services cost, which leads to massive numbers of birth outside health facility. Some programs are initiated to address these issues in order to achieve Millenium Development Goals (MDG?s) with maternal mortality target of 102/100.000 live births on 2015. Jaminan Persalinan ?JAMPERSAL? is one of government policy to reduce cost barrier.Objectives: To analyze the effect of Jampersal on reducing maternal mortality rate in Moewardi General Hospital, Surakarta.Methods: This was an observational Analysis with cross sectional design. Data were collected from all maternal mortality cases at Moewardi General Hospital from 1 st of January 2009 until 31stDecember 2013. Maternal mortality rate before and during Jampersal was taken into account for statistical analysis using Chi square Test.Results: Total number of births were significantly increasing, for about 3.5 times. Maternal mortality percentage was decreasing significantly during Jampersal, from 1.45% to 0.53% (p=0.000). The most frequent etiology of maternal death was preeclampsia/eclampsia (53.33% - 72.40%). For this cause, Jampersal also had a potential role on lowering case fatality rate from 5.95% to 3.64% (p=0.025, p<0.05)Conclusions: Jampersal has significantly reduce maternal mortality rate but on the other side increase number of birth in me hospital. The policy would be considerd as supportive for achieving MDG?s. Keywords: Jampersal, Maternal Mortality, cause of death  ABSTRAK Latar belakang: Angka kematian ibu di Indonesia masih menduduki tempat tertinggi di antara negara Asia Tenggara. Salah satu penyebabnya adalah biaya persalinan sehingga sebagian ibu melahirkan tidak di fasilitas kesehatan. Beberapa program dilakukan untuk mengatasi masalah ini agar dapat mencapai target Millenium Development Goals (MDG?s) dengan AKI 102/100.000 lahir hidup di 2015. Jaminan Persalinan ?JAMPERSAL? merupakan salah satu kebijakan pemerintah untuk mengurangi hambatan biayaTujuan: Mengananlisis pengaruh Jampersal untuk menurunkan kematian ibu di RS Moewardi, Surakarta. Metode: Penelitian ini merupakan penelitian observasional dengan desain cross sectional. Data dikumpulkan dari semua kasus kematian ibu di RS Moewardi dari 1 Januari 2009 hingga 31 Desember 2013. Kematian ibu sebelum dan setelah dilaksanakannya Jampersal dihitung dan dianalisis dengan Chi square Test.Hasil: Jumlah total persalinan meningkat signifikan, sekitar 3,5 kali. Persentase kematian ibu menurun signifikan selama program Jampersal dilaksanakan, yaitu 1.45% hingga 0.53% (p=0.000). Penyebab kematian tersering adalah preeklampsia/eklampsia (53.33% - 72.40%). Jampersal menurunkan angka fatalitas kasus preeklamsia secara signifikan dari 5.95% menjadi 3.64% (p=0.025, p<0.05)Kesimpulan: Jampersal dapat menurunkan kematian ibu di rumah sakit secara signifikan tetapi di sisi lain meningkatkan jumlah persalinan. Kebijakan ini dianggap dapat mendukung tercapainya target MDGs. Kata kunci: Jampersal, Maternal Mortality, cause of death1 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UNS2 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM3 RSUD Wonosobo  
Hubungan antara Infeksi Menular Seksual dengan Kejadian Lesi Prakanker Serviks pada Ibu Rumah Tangga di Puskesmas Sangkrah Surakarta Dirk, Bela; Sunaryo, Rustam; Putranto, R.P. Andri
Nexus Kedokteran Komunitas Vol 2, No 2 (2013): Nexus Kedokteran Komunitas
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.115 KB)

Abstract

Background: The housewife is a group of women who are at risk for sexually transmitted infections. Sexually transmitted infections is one of the risk factors for pre-cancerous cervical lesions. This study aimed to determine the relationship between the incidence of sexually transmitted infections with cervical precancerous lesions on housewife in Sangkrah health center, Surakarta Methods: This study was a descriptive cross sectional analytic approach that was conducted in June-August 2012 in Sangkrah health center, Surakarta. Sampling was done by purposive sampling technique. In this study, researchers took a sample size of 53 samples. Research carried out by filling out the questionnaire, followed by a visual inspection test checks acetic acid (VIA) and the examination of sexually transmitted infections. Where is a sexually transmitted infection is gonorrhea, candidiasis and bacterial vaginosis. Data analysis using chi-square method. Results: This study shows the value of relationship to STI: a) Gonorrhea p = 0.299, CI95% = 0.236 to 71.357, and RR = 4.10, b) Candidiasis p = 0.160, CI95% = 0.236 to 71.357, and RR = 6.29, c) Bacterial Vaginosis p = 0.117, CI95% = 0.413 to 136,271 and RR = 7.50. From the results of these data revealed that there was no relationship between the incidence of sexually transmitted infections with pre-cancerous cervical lesions housewife in Surakarta but clinically meaningless to pose the risk of precancerous cervical lesions. But found a significant relationship between STI> 1 types and cervical precancerous lesions where p = 0.000, CI95% = 1.659 to 1507.303 and RR = 50.00.   Conclusions: There is no relationship between the incidence of sexually transmitted infections (Gonorrhoea, Candidiasis, and Bacterial Vaginosis) with pre-cancerous cervical lesions on housewife in Sangkrah Health Center Surakarta. Keywords: Sexually transmitted infection, Cervical Precancerous Lesions, Housevives, Surakarta.  
Hubungan Perokok Pasif dengan Tingkat Kejadian Kanker Serviks di RSUD Dr Moewardi Amar, Syahmi; Sunaryo, Rustam; Murti, Bhisma
Nexus Kedokteran Klinik Vol 1, No 2 (2012): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.042 KB)

Abstract

Background: Incidence of cervical cancer each year has increased and the risk of death from cervical cancer is also increased. Cigarette smoke is one of the risk factors associated with cervical cancer which contains chemicals such as nicotine and benzopiren. The content of these chemicals may increase the risk of cervical cancer by various mechanisms. The purpose of this study was to determine the incidence rate of cervical cancer associated with exposure to passive smokers is connected. Methods: This type of research is an case-control. Sample of this study were gynecologic cancer patients with a total sample of 60 people. Measuring instrument used was a validated questionnaire, and performed data analysis with multiple logistic regression analysis. Result: Found a statistically significant association between passive smoking with the incidence of cervical cancer. Passive smokers will have 11,5 ??times the cervical cancer than non-passive smokers (p=0,001, OR = 11,5). Conclusion: Based on studies of passive smoking women would run the risk of cervical cancer will have 11,5 times higher than non-passive smokers. Key words: passive smoker, cervical cancer 
Hubungan antara Pemakaian Alat Kontrasepsi Dalam Rahim (AKDR) dan Kejadian Kanker Serviks di RSUD Dr. Moewardi Arta, Octava Prima; Sunaryo, Rustam; Murti, Bhisma
Nexus Kedokteran Klinik Vol 1, No 2 (2012): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.044 KB)

Abstract

Background: One government program in an effort to deal with the increasing population is a national family planning program, in particular by the use of contraceptives. Intrauterine Device (IUD) is the one form of contraception is widely used in society but still not much information about the correct usage and side effects. Bacterial or viral infection is one of the side effects of IUD use, including Human Papilloma Virus (HPV) infection, the virus that causes cervical cancer. The purpose of this study to determine the incidence rate of cervical cancer associated with IUD use. Research Methods: This type of case-control study. Sample of this study were gynecologic cancer patients with a total sample of 60 people. Measuring instrument used was a validated questionnaire, and performed data analysis with multiple logistic regression analysis. Result: Found a statistically significant association between IUD users with the incidence of cervical cancer. IUD users will experience cervical cancer 12 times compared to non-IUD users (p = 0,001, OR=12,70). Conclusion: Based on research IUD users will experience a risk for cervical cancer 12,7 times higher than those not using an IUD. Keyword: Intrauterine Device, cervical cancer