Herman Susanto
Departemen Kebidanan Fakultas Kedokteran Universitas Padjadjaran

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Sekuens Gen Protein Kapsid Mayor L1 Human Papilomavirus 16 dari Isolat Klinik Asal Bandung Pradita, Anandayu; Sahiratmadja, Edhyana; Suhandono, Sony; Susanto, Herman
Majalah Kedokteran Bandung Vol 46, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Kanker serviks disebabkan oleh infeksi kronik human papillomavirus (HPV) dengan genotipe HPV-16 sebagai HPV tersering yang menginfeksi epitel serviks. Protein penyelubung virus yang disebut kapsid mayor (L1) mempunyai peranan penting dalam menginfeksi epitel serviks. Tujuan penelitian untuk mengisolasi dan menganalisis sekuens gen L1 HPV-16. Pengetahuan mengenai sekuens gen L1 dapat memberikan informasi yang berguna, salah satunya yaitu untuk pengembangan vaksin. Pada studi ini, deoxyribonucleic acid (DNA) virus diekstraksi dari sediaan biopsi pasien kanker serviks yang diambil pada bulan Juni sampai Oktober 2010 di Kebidanan dan Kandungan RS Dr. Hasan Sadikin Bandung. Gen diamplifikasi dengan polymerase chain reaction menggunakan primer spesifik. Infeksi HPV-16 pada jaringan kanker dikonfirmasi dengan menggunakan kit komersial untuk tes genotipe HPV. Fragmen L1 kemudian diklon dan diinsersikan ke dalam pJET1.2/L1-16, kemudian dipotong dengan enzim BamHI dan BgIII untuk kemudian divalidasi dan disekuensing. Hasil sekuensing menunjukkan amplikon gen L1 HPV-16 sebesar 1.595 pasang basa. Analisis dari dua amplikon gen L1 HPV-16 menggunakan software BIOEDIT dan Basic Local Alignment Search Tool menunjukkan kesamaan ho mologi 99% dan 97% dengan sekuens L1 HPV-16 asal Thailand yang terregistrasi pada GenBank. Simpulan, telah dilakukan kloning sekuens gen L1 HPV-16 dari dua isolat klinik Bandung. Hasil kloning HPV-16 pada penelitian ini memberikan informasi tentang variasi sekuens yang perlu dipertimbangkan bagi pengembangan vaksin terutama bagi daerah spesifik seperti penduduk asal Indonesia.Kata kunci: Human papillomavirus, kanker serviks, gen L1 HPV-16 Sequence of Human Papilomavirus 16 Major Capsid L1 Gene from Clinical Isolates in BandungCervical cancer is strongly associated with chronic human papillomavirus (HPV) infection. HPV-16 is the most prevalent genotype infecting cervical epithelium. The major coat protein of viral particle (L1) plays a key role in the infection process. Our study aimed to isolate the HPV-16 L1 gene and analyze its sequence. Samples used were samples collected from the Department of Obstetrics and Gynaecology, Dr. Hasan Sadikin General Hospital, Bandung during the period of June to October 2010. In this study, the HPV-16 L1 sequence was analyzed from the viral deoxyribonucleic acid (DNA) extracted from biopsy sample of cervical cancer patient biopsy samples.The HPV-16 L1 amplification was performed using the polymerase chain reaction with specific primer. The HPV infection in the cervical tissue was confirmed by commercial HPV genotyping test. The L1 fragment was cloned into plasmid and the insert of the recombinant clone pJET1.2/L1-16 was digested using BamHI and BgIII. The amplicon result showed HPV-16 L1 gene with a length of 1.595 base pairs. The sequence analysis of two samples using software BIOEDIT dan Basic Local Alignment Search Tool revealed a high level of sequence similarity to L1 HPV-16 from Thailand (99% and 97%) as registered in GenBank. In conclusion, the L1 HPV-16 gene from Bandung isolates revealed variations from published sequence. Knowledge on L1 gene sequence may give additional information to the development of vaccine. Further study on vaccine development is currently ongoing using this HPV-16 clone that may be specific to Indonesian population. Key words: Cervical cancer, human papillomavirus, L1 HPV-16 DOI: 10.15395/mkb.v46n3.317
Penurunan Nyeri Persalinan Primigravida Kala I Fase Aktif Pascapenghirupan Aromaterapi Lavender Tarsikah, -; Susanto, Herman; Sastramihardja, Herri S.
Majalah Kedokteran Bandung Vol 44, No 1 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Nyeri persalinan merupakan bagian pada proses normal yang tidak jarang menyebabkan stres fisiologis dan psikologis terhadap ibu yang berdampak pada ibu maupun janin. Sebagian besar persalinan (90%) disertai nyeri, bahkan sampai nyeri berat. Penanganan nonfarmakologi merupakan salah satu alternatif untuk mengurangi nyeri persalinan. Penelitian ini bertujuan untuk menganalisis efek analgesik penghirupan aromaterapi lavender pada nyeri persalinan primigravida kala I fase aktif. Rancangan yang digunakan adalah studi praeksperimental, satu kelompok diobservasi sebelum dan sesudah perlakuan terhadap 30 ibu bersalin di Rumah Bersalin (RB) Kasih Ibu Jatirogo kabupaten Tuban provinsi Jawa Timur sebagai sampel yang dipilih secara konsekutif. Pengukuran variabel menggunakan skala nyeri numerik. Dilakukan analisis univariabel kuantitatif untuk mengetahui nyeri sebelum dan sesudah perlakuan. Analisis kuantitatif bivariabel Wilcoxon signed ranks test digunakan untuk mengetahui pengurangan nyeri dengan tingkat kemaknaan p<0,05. Penelitian ini dilakukan periode 14 September–31 Oktober 2009. Hasil analisis univariabel menyatakan bahwa skor nyeri rata-rata sebelum perlakuan 7,3 (SD 1,1) dansesudah perlakuan 5,9 (SD 1,4). Hasil uji Wilcoxon signed ranks test menunjukkan pengurangan nyeri yang bermakna pascapenghirupan aromaterapi lavender (Z=-4,338; p=0,000). Simpulan, terdapat pengurangan nyeri persalinan pascapenghirupan aromaterapi lavender. [MKB. 2012;44(1):19–25].Kata kunci: Nyeri persalinan, penghirupan aromaterapi lavender Labor Pain Reduction in Primigravida Active Phase after Inhalation of Lavender AromatherapyLabor pain is part of a normal process, which often causes physiological and psychological stress to mother. These stress have impact to both mother and fetus. Largely (90%) labor comes with pain and in some cases severe pain. Non-pharmacological approach is one of alternatives to reduce labor pain. This research aims to analyse the analgesic effect of lavender aromatherapy inhalation on labor pain in primigravida in the active phase. The study was pra-experimental by observing one group before and after treatment. The group involved 30 parturients in RB Kasih Ibu Jatirogo district of Tuban, East Java. The sampling method was based on consecutive admission. The variables were measured by using numerical rating scales (NRS). Univariable quantitative analysis was applied to describe the pain before and after treatment. Wilcoxon signed ranks test bivariable quantitative analysis was used to investigate pain relief with significance level of p<0.05. The univariable analysis result revealed that mean pain score before treatment was 7.3 (SD 1.1) and after treatment 5.9 (SD 1.4). Wilcoxon signed ranks test result showed significant pain relief after lavender aromatherapy inhalation (Z=-4.338, p=0.000). The research shows that there is a reduction of labor pain after lavender aromatherapy inhalation. [MKB. 2012;44(1):19–25].Key words: Inhalation lavender aromatherapy, labor pain DOI:  http://dx.doi.org/10.15395/mkb.v44n1.210
Analisis Filogenetik Gen L1 Human Papillomavirus 16 pada Penderita Kanker Serviks di Bandung Fadhilah, Fitri Rahmi; Sahiratmadja, Edhyana K.; Safitri, Ratu; Maskoen, Ani Melani; Susanto, Herman
Majalah Kedokteran Bandung Vol 47, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Infeksi human papillomavirus (HPV) tipe high risk (hr) yang kronik dapat menyebabkan kanker serviks. Berbagai genotipe hrHPV telah teridentifikasi dan HPV-16 merupakan genotipe yang tersering menginfeksi serviks. Fragmen L1 HPV dapat digunakan untuk mengidentifikasikan asal usul HPV. Tujuan penelitian ini adalah mengeksplorasi asal usul HPV-16 dengan membuat pohon filogenetik. Metode penelitian yang digunakan adalah metode deskriptif analisis. Penelitian dilakukan di Laboratorium Genetika Molekuler Unit Penelitian Kesehatan, Fakultas Kedokteran Universitas Padjadjaran Bandung pada Februari hingga Agustus 2013. Isolat biopsi dari pasien kanker serviks disumbangkan oleh Departemen Kebidanan Fakultas Kedokteran Universitas Padjadjaran, Bandung. Isolasi DNA dibuat dari biopsi jaringan kanker serviks dan fragmen L1 diamplifikasi dengan desain primer sendiri. Infeksi dengan HPV-16 dikonfirmasi dengan Linear Array test (Roche). Sekuens urutan basa kemudian dimasukkan dalam program filogenetik (MEGA5). Hasil konstruksi menunjukkan isolat pasien kanker serviks dari Bandung berada dalam satu subgrup dengan HPV asal Asia dan Asia Timur. Simpulan, cluster HPV Indonesia berada pada galur Asia dan Asia Timur. [MKB. 2015;47(3):174–78]Kata kunci: Filogenetik, fragmen L1,  human papillomavirus 16 (HPV-16)Phylogenetic Analysis of Human Papillomavirus 16 L1 Gene from Cervical Cancer Patient in BandungAbstractChronic infection with high-risk (hr) human papillomavirus (HPV) can lead to cervical cancer. Various hrHPV genotypes have been identified and HPV genotype 16 is the most common genotypes that infect cervical cancer. HPV L1 fragment can identify the origin of HPV. The purpose of this study was to explore the origins of HPV-16 by making a phylogenetic tree. This study used analytical descriptive method and was  was conducted at the Laboratory of Molecular Genetics, Health Research Unit, Faculty of Medicine, Universitas Padjadjaran Bandung in the period of February to August 2013. Biopsy from cervical cancer patient was donated by the Department of Obstetrics, Faculty of Medicine, Universitas Padjadjaran, Bandung. Isolation of DNA was prepared from tissue biopsies of cervical cancer and L1 fragment was amplified with the specific primer. Infection with HPV-16 was confirmed by Linear Array test (Roche) design. The sequence then was constructed using the phylogenetic program (MEGA5). Results showed that the isolate from patient with cervical cancer from Bandung was in one subgroup with HPV from Asia and East Asia. In conclusion, cluster HPV of Bandung is in the same strain as the strain in Asia and East Asia. [MKB. 2015;47(3):174–78]Key words: Human papillomavirus 16 (HPV-16), L1 fragment, phylogenetic DOI: 10.15395/mkb.v47n3.598
Multiple human papilloma virus infections predominant in squamous cell cervical carcinoma in Bandung Sahiratmadja, Edhyana; Tobing, Maringan D.L; Dewayani, Birgitta M; Hernowo, Bethy S; Susanto, Herman
Universa Medicina Vol 33, No 1 (2014)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2014.v33.58-64

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BACKGROUND Persistent infection of high risk genotypes of human papilloma virus (hrHPV) has been established as the etiological cause for cervical cancer, and the most prevalent genotypes that infect the cervical tissue are HPV-16 and HPV-18. However, HPV genotype profile has been shown to differ according to geographical distribution across the globe. The present study aimed to determine the HPV genotype distribution in cervical cancer patients from Bandung, Indonesia. METHODS During the period of July – November 2010 viral DNA was extracted from randomly chosen cervical cancer biopsies and subjected to genotype determination using the diagnostic linear array genotyping test (Roche). The distribution of HPV genotypes was explored and the prevalence of HPV genotypes was mapped. RESULTS Of 96 cervical cancer tissue samples, 76 (79.2%) were histopathologically classified as squamous cell cervical carcinoma. Due to the high cost of HPV genotyping tests, only twenty-five samples were randomly genotyped. Almost 90% of the cervical cancer patients were multiply infected with HPV-16 in combination with HPV-18, HPV-45, or HPV-52. The HPV-16 genotype had the highest prevalence, all samples being infected with HPV-16. CONCLUSION The cervical cancer cases were predominantly infected by multiple hrHPVs with HPV-16 as the major genotype among other hrHPVs, supporting the carcinogenic role of this hrHPV. Therefore, screening for hrHPVs in the general population is urgently needed as a means of early detection of cervical cancer.
Epidermal growth factor polymorphism most prevalent in stage II cervical carcinoma Tjandraprawira, Kevin Dominique; Panigoro, Ramdan; Hidayat, Yudi Mulyana; Susanto, Herman; Sahiratmadja, Edhyana
Universa Medicina Vol 33, No 3 (2014)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2014.v33.192-198

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Background    Cervical cancer ranks second among female cancers worldwide and is widely associated with human papilloma virus (HPV) infection. However, HPV infection progression is influenced by various host factors. Epidermal growth factor (EGF) is a host factor important for proper epithelial proliferation and development, and may play a role in cervical cancer progression. A functional A61G polymorphism in the EGF gene has been hypothesized to alter EGF concentration in vivo with increasing guanine content associated with greater EGF level. However, a map of A61G polymorphism distribution is not available for any population, including Indonesia. This study aims to determine the distribution of EGF A61G polymorphism among cervical cancer patients at Dr. Hasan Sadikin General Hospital.MethodsA retrospective cross-sectional study was conducted between July-November 2010. Included were 61 cervical cancer patients of various stages at Dr. Hasan Sadikin hospital, who had previously undergone blood sample collection, DNA isolation and finally genotyping for EGF gene using Illumina BeadXpress®. Chi-square test was used to analyse the data. ResultsThe EGF A61G polymorphism was exhibited by 88.5% of patients (as genotypes A/G and G/G). The majority of patients with this polymorphism were of moderate severity (FIGO stage II and III, 42.6% and 38.1% respectively). Patients with the polymorphism but with the lightest severity (FIGO stage I) accounted for 22.2% of the population. ConclusionEGF A61G polymorphism affected the majority of cervical cancer patients and that once stratified, the patients showed intermediate severity in terms of their cancerous growth.
IFNG Polymorphism (+874 T>A) is not a risk factor for cervical cancer Maskoen, Ani Melani; Susanto, Herman; Surialaga, Samsudin; Sahiratmadja, Edhyana
Universa Medicina Vol 32, No 1 (2013)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2013.v32.29 - 36

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INTRODUCTION Cervical cancer cases are rising and many women are infected with human papillomavirus (HPV). Interferon gamma (IFN-ã) is one of the key regulatory cytokines that influence the HPV clearance. The production and the function of IFN-ã may impaired by the defect of the IFNG gene leading to the cervical malignant progression. This study aimed to examine the association between IFNG+874 T&gt;A polymorphism and cervical cancer in women METHODS In a case-control study design, consecutive untreated women with cervical cancer who showed for the first time in Hasan Sadikin Hospital Bandung were enrolled (n=98) and for controls women who came for PAP smear (n = 81). Controls were not matched in ages and ethnicities. DNA extracted from blood was amplified by amplification refractory mutation system - polymerase chain reaction method (ARMS – PCR) to detect IFNG+874 T&gt;A polymorphism. RESULTS The distribution of IFNG genotypes TT, TA and AA for women with cervical cancer who met the inclusion criteria (n= 64) and with negative intraepithelial lesion or malignancy (n=42) were 14.1%, 50.0%, 35.9% and 7.1%, 52.4%, 40.5%, respectively. No significant differences could be observed between both groups (p=0.64). Stratifying the cervical cancer women into a group of squamous cell carcinoma (n = 54) revealed no statistical different. CONCLUSION IFNG +874 T&gt;A polymorphismseems not to contribute in susceptibility to cervical cancer. Identification of other variants in IFNG gene signaling and its role in the development of cervical cancer diseases need to be further examined.
Paclitaxel-carboplatin chemotherapy induced hematologic toxicities among epithelial ovarian cancer patients Charles, Afandi; Dewayani, Birgitta M.; Sahiratmadja, Edhyana; Winarno, Gatot N.A.; Susanto, Herman
Universa Medicina Vol 35, No 3 (2016)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2016.v35.165-170

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BackgroundEpithelial ovarian cancer (EOC) is one of the most common cancers diagnosed in Indonesian women. A combination of paclitaxel and carboplatin is used to treat EOC as standard chemotherapy which is known to have hematologic toxicities. This study aimed to investigate the effect of combined paclitaxel-carboplatin chemotherapy on hematologic status in EOC patients managed at Dr. Hasan Sadikin General Hospital, Bandung, West Java.MethodsAll patients with confirmed pathological diagnosis of EOC at Dr. Hasan Sadikin General Hospital in the period of 2013 to 2014 were registered. Only patients with complete hematologic data before and after chemotherapy were collected and compared using the paired non-parametric Wilcoxon and McNemar tests. ResultsIn total there were 147 patients with EOC (median age 46 ± 12 years), with the most dominant pathological diagnosis of mucinous (32.7%) and serous (29.3%) types. Only 33 patients had hematologic data before the initiation of chemotherapy. There was a significant decrease after chemotherapy including hemoglobin level (12.0 vs 10.9 g/dL, p=0.013), erythrocyte count (4.53 vs 3.74 million/mL, p&lt;0.001), leukocyte count (7,700 vs 4,000/mm3 p&lt;0.001) and platelet count (343,000 vs 215,000/mm3, p&lt;0.001). Interestingly, anemia cases after chemotherapy were predominant (87.9%) compared with erythopenia, leukopenia, thrombocytopenia i.e. 39.4%, 57.6%, and 27.3% respectively. ConclusionsThis study confirmed the hematologic toxicities after paclitaxel-carboplatin chemotherapy in EOC patients treated in Hasan Sadikin General Hospital, West Java. The hemoglobin concentration may serve as prognostic factor. Further studies directed to other factors such as genetic factor for polymorphisms may be encouraged to explore the decrease of the hematologic indices.
Methylenetetrahydrofolate Reductase C677T Distribution among Cervical Cancer Patients at Dr. Hasan Sadikin General Hospital Maskoen, Ani Melani; Kurniawan, Cynthia; Susanto, Herman; Sahiratmadja, Edhyana
Majalah Kedokteran Bandung Vol 48, No 4 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (207.831 KB) | DOI: 10.15395/mkb.v48n4.754

Abstract

Cervical cancer is the second most common cancer among women in the world. Persistent infection with high risk human papillomavirus (HPV) is one of the necessary causes of cervical cancer development. However, host genetic factors may also play a role in cervical cancer carcinogenesis. Methylenetetrahydrofolate reductase enzyme, encoded by the MTHFR gene, regulates folate metabolism which is important for genetic expression and stability. Single nucleotide polymorphism (SNP) C677T in MTHFR gene may produce a thermo-labile enzyme, resulting in a reduced enzyme activity. The aim of this study was to explore the SNP C677T of MTHFR gene and the susceptibility to cervical cancer among cancer patients visiting Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. This descriptive quantitative study involved cervical cancer patients recruited in 2010 and their control group. Genomic DNA was extracted from patients’ blood. MTHFR C677T genotype was performed using BeadXpress Reader Illumina® and some samples were re-genotyped for confirmation using conventional PCR-RFLP. The distribution of MTHFR C677T genotype in cervical cancer patients was 71.6%, 25.4%, and 3%, and 44%, 36%, and 20% in control group for CC, CT, and TT, respectively. This yielded a statistical significant difference of CC vs CT+TT (p 0.014 with OR 3.22 and CI 95% 1.24 – 8.33). Taken together, this result indicates that T allele has a protective effect against cervical cancer development. Further studies to confirm this effect in bigger population is warranted. [MKB. 2016;48(4):216–21]Key words: Cervical cancer, MTHFR C677T, polymorphism, Bandung Distribusi C677T gen Methylenetetrahydrofolate Reductase pada Pasien Kanker Serviks di Rumah Sakit Dr. Hasan Sadikin BandungKanker serviks menduduki peringkat kedua sebagai kanker yang paling sering ditemukan pada wanita di dunia. Infeksi persisten oleh human papillomavirus (HPV) tipe risiko tinggi merupakan salah satu penyebab utama kanker serviks. Selain itu, factor genetic juga turut berperan dalam proses perkembangan kanker serviks. Enzim methylenetetrahydrofolate reductase yang disandi oleh gen MTHFR berfungsi meregulasi metabolism folat. Polimorfisme C677T pada gen MTHFR dapat membuat produksi enzim menjadi termolabil sehingga terjadi penurunan aktivitas. Distribusi folat yang abnormal dapat mengganggu proses metilasi, sintesis, dan perbaikan DNA yang dikaitkan dengan perkembangan kanker serviks. Tujuan penelitian ini adalah mengetahui distribusi polimorfisme C677T gen MTHFR pada pasien kanker serviks di Rumah Sakit Umum Dr. Hasan Sadikin Bandung, Indonesia. Penelitian deskriptif kuantitatif ini melibatkan pasien kanker serviks yang diinklusi tahun 2010 dan sebagai control adalah wanita yang datang untuk pemeriksaan PAPsmear. DNA genomic diisolasi dari darah pasien dan dihibridisasi dengan menggunakan system BeadXpress Reader Illumina® untuk menentukan jenis genotipenya. Genotipe beberapa sampel dikonfirmasi dengan metode PCR-RFLP. Hasil distribusi polimorfisme C677T gen MTHFR dengan genotipe CC, CT, dan TT pada pasien kanker serviks adalah 71,6%, 25,4%, dan 3% dan pada kontrol adalah 44%, 36%, and 20%. Hasil ini menunjukkan perbedaan yang signifikan antara pasien kanker serviks dan kontrolnya, dengan genotipe CC vs CT+TT menunjukkan nilai p=0,014 (OR 3.22 dan IK 95% 1,24–8,33). Simpulan, alel T menunjukkan efek yang protektif pada perkembangan kanker serviks. Penelitian harus dilanjutkan untuk membuktikan efek protektif alel pada kanker serviks.[MKB. 2016;48(4):216–21]Kata kunci: Kanker serviks, MTHFR C677T, polimorfisme, Bandung
Phylogeny of HPV-16 and HPV-18 Multiple Infection of a Patient with Cervical Cancer from Dr. Hasan Sadikin General Hospital, Bandung: A Case Report Lestari, Vera Amalia; Rini, Ika Agus; Pradini, Gita Widya; Sahiratmadja, Edhyana; Susanto, Herman
The Indonesian Biomedical Journal Vol 10, No 3 (2018)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v10i3.383

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BACKGROUND: From all of human papillomaviruses (HPV) genotypes capable of causing cervical cancer, it is estimated that 70 percent are HPV-16 and HPV-18. HPV-16 can infect the tissues in single infection or together with other high-risk types of HPV, and the most common is with HPV-18. The origin of HPV can be identified by its phylogenetic tree. The aim of this study was to determine the phylogeny of HPV-16 and HPV-18 multiple infection in cervical cancer, whether both HPVs were from the same origin.METHODS: Cervical tissue biopsies (n=33) were obtained from Hasan Sadikin Hospital in the period of September to November 2016. HPV genotyping test was performed to confirm the HPV-16 and HPV-18 multiple infection. L1 gene of both HPV-16 and HPV-18 were sequenced for phylogenetic analysis.RESULTS: Phylogenetic analysis of L1 HPV-16 and HPV-18 showed the closest relationship with sequence from China and Thailand, respectively.CONCLUSION: HPV-16 and HPV-18 multiple infection of a cervical cancer patient from Dr. Hasan Sadikin General Hospital Bandung showed a very close L1 phylogeny relationship with isolate from Asian region.KEYWORDS: HPV-16, HPV-18, multiple infection, cervical cancer, Bandung
Postpartum Anxiety Factors Involved in Subjects Undergoing Cesarean Section as Analyzed by Zung Self Rating Anxiety Scale Rahmat, Akbar; Saputra, Lucky; Pramatirta, Akhmad Yogi; Sabarudin, Udin; Krisnadi, Sofie Rifayani; Susanto, Herman; Effendi, Jusuf Sulaeman
Indonesian Journal of Obstetrics & Gynecology Science Volume 1 Nomor 1 Maret 2018
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

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Abstract

AbstractObjective: postpartum mother who underwent cesarean section may experience anxiety. The risk factors associated with anxiety include age, education and income level, parity, social and cultural factors, delivery methods, as well as the history of pregnancy.Methods: This study used analytic, cross-sectional method. Postpartum mother (n=194) were recruited for this study. All participants consented to fill a questionnaire, to determine the subject’s parameters and anxiety levels. Severity of postpartum anxiety was determined based on the Zung Self-rating Anxiety Scale (SAS). Results: Postpartum anxiety (SAS ≥45) were mostly found in the group experiencing emergency cesarean section (71.13%) compared to the group with scheduled cesarean section (32.1%) (p<0.001). Forty-seven subjects (82.5%) women aged <20 years old experienced postpartum anxiety, while 32.1% women aged ≥20 years old were found to have similar condition (p<0.001). Subjects with lower education levels had a higher prevalence of postpartum anxiety than those with higher education levels (73.4% vs 12.9%, p<0.001). Different income levels  had 47.2% and 46.3% prevalence of postpartum anxiety respectively, but not statistically significant. Conclusion: there was a correlation between anxiety score on women who experienced an emergency and scheduled cesarean section with age and education level.Keywords: Cesarean section, age, education levels, income levels, parity, Zung Self-rating Anxiety ScaleBeberapa Faktor yang Memengaruhi Kecemasan Pasien yang Menjalani Seksio Sesarea dengan Pemeriksaan Zung Self Rating Anxiety ScaleAbstrakTujuan: Kondisi pascaseksio sesarea dapat menimbulkan kecemasan ibu. Faktor yang dapat mempengaruhi timbulnya kecemasan antara lain usia, tingkat pendidikan, tingkat pendapatan, paritas, faktor sosial budaya, faktor jenis persalinan, dan riwayat persalinan yang lalu. Metode: Penelitian ini menggunakan metode analitik cross-sectional. Wanita pasca seksio sesarea yang memenuhi kriteria penelitian (n=194) dengan kuesioner. Tingkat kecemasan dinilai berdasarkan derajat Zung Self-rating Anxiety Scale (SAS).Penelitian dilakukan di RSUP Dr. Hasan Sadikin Bandung, RSUD Ujung Berung, RSKIA Kota Bandung, RSUD Soreang Kabupaten Bandung dari bulan Maret sampai dengan April 2017.Hasil: Penelitian ini menunjukan bahwa kecemasan postpartum (SAS ≥45) lebih banyak ditemukan pada pasien yang menjalani operasi sesar darurat (71,13%) dibandingkan dengan pasien yang telah dijadwalkan terlebih dahulu (32,1%) (p <0,001). Empat puluh tujuh pasien (82,5%) wanita usia <20 tahun mengalami kecemasan pasca melahirkan, sementara 32,1% wanita berusia ≥ 20 tahun ditemukan memiliki kondisi yang sama (p <0,001). Tingkat pendidikan ≤ SLTP memiliki prevalensi kecemasan lebih tinggi dibandingkan > SLTA (73,4% vs 12,9%, p <0,001). Tingkat pendapatan yang berbeda (lebih rendah dari UMR, sama atau lebih tinggi dari UMR) memiliki prevalensi pasca melahirkan sebesar 47,2% dan 46,3%, namun tidak signifikanberbeda  secara statistik. Simpulan: Terdapat perbedaan tingkat kecemasan pasca seksio sesarea pada kelompok  seksio sesarea segera dibandingkan terencana dengan usia dan tingkat pendidikan.Kata kunci: Seksio sesarea, usia, tingkat pendidikan, tingkat pendapatan, paritas, Zung Self-rating Anxiety Scale