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Risk Factors Early Postpartum Haemorrhage At Sukadana Hospital, District East Lampung

Abstract
Background: Early postpartum haemorrhage is still a leading cause of maternal mortality in Indonesia and in the district of East Lampung. Therefore it is necessary to investigate the risk factors associated with early postpartum haemorrhage in Sukadana hospital, East Lampung. At the end we hope that the incidence of bleeding can be identified and anticipated.
Objectives: To determine the risk factors associated with early post partum haemorrhage in Sukadana Hospital, District of East Lampung.
Design:  This was a case control study.
Method: The subject of this research was every vaginal delivery at East Lampung district  which suitable with the inclusion criteria. This research was conducted from October 2010 until March 2011, with 54 cases and 54 controls which have been matched by the education level. Bivariate and multivariate logistic regression were used for data analysis with α: 0,05 and 95% of confidence interval.
Results:  Proportion of elementary education and not school level was high (70,4%). Uterine atoni was the most prevalence cause for post partum haemorrhage (30 cases, 55,6%). Multivariate result for risk factor that significance for early postpartum haemorrhage was parity ≥3 with OR 3,32 (CI 95%; 1,15-9,6; p: 0,03). While preeclamsia and eclamsia, anemia, induction and stimulation Oxytocin 5 IU, premature rupture of membranes  were not significance statistically and clinically.
Conclusion:  Parity ≥ 3 are most dominant risk factor contribute to early        postpartum hemorrhage.
Keywords:  Early postpartum haemorrhage, risk factors, anemia.

Comparison of Changes in Content Squamous Cell Carcinoma Antigen Level at Weekly and Three Weekly Chemotherapy Protocol on Advanced Carcinoma of the Cervix Uteri

Abstract
Background: For the treatment of advanced carcinoma of the cervix uteri chemoradiation protocol performed weekly or three weekly. To determine the therapeutic response comparison of both protocols, need to check the tumor marker SCC antigen before and after chemotherapy.
Objective: To determine the ratio of SCC antigen changes before and after the third on the protocol of chemotherapy weekly and three weekly protocol at an advanced carcinoma of the cervix uteri.
Methods: The study was performed in RS Sardjito, study subjects were patients with advanced carcinoma of cervix uteri who received chemotherapy protocol weekly or three weekly. Examination of SCC antigen levels before and after the third chemotherapy.
Results: There were 30 cases, each of the 15 cases who received weekly protocol and the protocol of three weekly 15 cases. Most 46-55 years old (60.0%) in the weekly protocol and also 60.0% at three weekly protocol. Parity 3 or more, 73.3% and 66.7%. Elementary education level (33.3% and 73.3%). Class III of ward (73.3% and 66.7%). Histopathology of epidermoid carcinoma (40.0%) and squamous cell carcinoma (40.0%). Stage IIB (73.3%) and IIIA (40.0%). At the weekly protocol, the average (mean) SCC antigen levels before treatment (SCC Pre Ag) 8.080 ± 13.151 mg / L and SCC antigen after the weekly protocol (SCC Post Ag) 3.067 ± 3.465 mg / L, with changes (decreased levels) amounting to 5.013 ± 12.000 mg / L. While the protocol three weekly average SCC Pre Ag 17.610 ± 21.575 ug / L and Post SCC Ag is 8.074 ± 14.760 mg / L, with changes (decreased levels) for 9.536 ± 14.873 mg / L. With a paired t test individually on a weekly and three weekly protocol obtained: First, there is no change in a significant SCC antigen levels before and after the third on the protocol of chemotherapy weekly. Second, there is a change in a significant SCC antigen levels before and after the third chemotherapy on three weekly protocol. Test done together with the independent t test acquired conclusions: there is no change in a significant SCC antigen levels before and after the third chemotherapy between the weekly protocol and three weekly protocols.
Conclusion: there is no change in a significant SCC antigen levels before and after the third chemotherapy between the weekly protocol and three weekly protocols on advanced carcinoma of the cervix uteri.

Workshop on Systematic Review

Salah satu indikator tercapainya World Class Research University adalah jumlah publikasi internasional yang dihasilkan. Akan tetapi, data menunjukkan bahwa jumlah publikasi ilmiah yang dihasilkan para peneliti Indonesia masih rendah. Menurut data SCIMAGO Ranking Journal, posisi Indonesia (kurang dari 2.000 jurnal) masih jauh di bawah negara maju, bahkan masih di bawah negara-negara ASEAN (Thailand 13.000, Malaysia 8.800 jurnal). Data SCOPUS sampai dengan Januari 2009 menunjukan publikasi universitas-universitas di Indonesia juga masih perlu ditingkatkan. National University of Singapore telah mempublikasikan hampir 50.000 artikel, Chulalongkorn University Thailand 9.000 dan University Putra Malaysia 3.700. Indonesia diwakili oleh Universitas Indonesia (1.124), Institut Teknologi Bandung (1.100) dan UGM (690). Data sampai bulan Juni 2011 menunjukkan angka 1.915, 1.731 dan 1.058 untuk UI, ITB dan UGM. Salah satu kendala dalam mempublikasikan karya ilmiah adalah persyaratan penulisan artikel penelitian (original article) yang dirasakan cukup berat. Sementara itu, jenis publikasi lain seperti short communication, case report atau systematic review sudah mulai diterima secara luas. Dengan demikian ada peluang untuk meningkatkan jumlah publikasi ilmiah dengan melakukan diversifikasi penulisan, termasuk dengan systematic review. Pada beberapa institusi, systematic review bahkan sudah dipertimbangkan untuk syarat mendapat gelar doktor/PhD. Fakultas Kedokteran UGM telah mengembangkan systematic review sejak tahun 2005. Sampai saat ini sudah ada satu paper systematic review dan 2 protokol yang sudah dipublikasikan di Cochrane. 3 Paper ini merupakan paper pertama dari Indonesia, sehingga FK UGM merupakan leading institution dalam systematic review. FK UGM melihat perkembangan ini sebagai kesempatan yang perlu dimanfaatkan untuk ikut meningkatkan publikasi ilmiah untuk kalangan peneliti di Indonesia dengan melakukan Workshop on Systematic Review, dengan berkolaborasi dengan the Australasian Cochrane Centre, Melbourne, Australia. Tujuan 1.    Memberikan dasar, metode dan skill software penulisan Systematic Rewiew. 2.    Memfasilitasi pemilihan judul, input, penulisan Systematic Review. 3.    Melakukan proses submit manuskrip Systematic Review dan mengikuti proses review di jurnal. Fasilitator 1.       Steve McDonald, DipIPH, MLIS 2.       Prof. Dr. Mohammad Hakimi, PhD, SpOG (K) 3.       Dr. Setya Wandita, Mkes, SpA (K) 4.       Dr. Tunjung Wibobo, MPH, Mkes, SpA (K) 5.       Dr. Fauziah Natsir, SpA 6.       Dr. Ova Emilia, MMEdSc, PhD, SpOG (K) 7.       Dr. Detty Nurdiati, MPH, PhD, SpOG (K) 8.       Dr. Diah Rumekti, MSc, SpOG (K)

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