Jurnal Kesehatan Reproduksi
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Pengaruh Metode Promosi Kesehatan Terhadap Pengetahuan dan Sikap Kader tentang Deteksi Dini Kanker Leher Rahim
Get PDFLatar Belakang: Kanker leher rahim adalah penyebab kematian wanita terbanyak kedua di Indonesia. Salah satu cara pencegahannya adalah dengan deteksi dini. Untuk mencapai cakupan deteksi dini yang baik perlu peningkatan pengetahuan masyarakat tentang bahaya, faktor risiko, pencegahan, dan deteksi dini.Tujuan Penelitian: Membandingkan efektivitas metode promosi kesehatan dalam meningkatkan pengetahuan dan sikap para kader kesehatan mengenai deteksi dini kanker leher rahim.Metode penelitian: Quasi eksperimental. Subyek adalah kader kesehatan Kecamatan Gedongtengen. Intervensi berupa penyuluhan dengan leaflet atau tanpa leaflet mengenai deteksi dini kanker leher rahim. Desain penelitian adalah pre-test dan post-test. Instrumen penelitian menggunakan kuisioner dengan 30 pertanyaan pengetahuan dan 19 pertanyaan sikap yang dinyatakan sahih dan andal melalui uji korelasi Perason. Uji statistik yang digunakan adalah uji Wilcoxon, Uji Mann Whitney, uji korelasi Pearson dan uji regresi linier berganda.Tempat penelitian: Kecamatan Gedongtengen, Daerah Istimewa YogyakartaHasil: Dari 128 responden, penyuluhan dengan atau tanpa leaflet meningkatkan pengetahuan dan sikap kader kesehatan secara bermakna (p =0,000), tetapi besar peningkatan ini tidak berbeda secara bermakna (p=0,175 dan p=0,740). Variabel luar yang berpengaruh dengan korelasi negatif pada peningkatan pengetahuan adalah penghasilan (p=0,006). Variabel luar yang berpengaruh pada peningkatan sikap dengan korelasi negatif adalah pendidikan (p=0,009).Kesimpulan: Penyuluhan dengan atau tanpa pemberian leaflet tidak berbeda untuk meningkatkan pengetahuan dan sikap kader kesehatan.Kata kunci: deteksi dini; kanker leher rahim; kader kesehatan; promosi kesehata
Hubungan Status ASI Eksklusif dan Pemberian Kolostrum dengan Kejadian Autisme pada Anak di Bawah 10 tahun
Get PDFBackground: The cause of autism until now is still not exactly known. One of the efforts in preventing the occurrence of autism is intervention early with giving colostrum and exclusive breastfeeding. The number of autism in Indonesia according to data released by the Central Bureau of Statistics in 2010 was estimated at 2.4 million people. Based on data from autism special school Bina Anggita Yogyakarta, recorded increase in the number of students from the beginning of the school in 2001 were 15 students, in 2009 the number increased to 32 students and in 2013 were 45 students.Objective: To determine the relationship between the status of exclusive breastfeeding and giving colostrum to the incidence of autism in children under 10 years.Methods: This research is a quantitative study with a matched case control study design. Subjects were children aged under 10 years who consisted of children with autism were 19 cases and 19 controls for normal children in Yogyakarta. The independent variable in this study in the provision of colostrum and exclusive breastfeeding, and dependent variable was autism. The counfounding variables are gastrointestinal infections, low birth weight and maternal age. Retrieval of data collected using a questionnaire. Univariable data analysis using frequency distribution, bivariate statistics using the McNemar test, multivariable analysis was not performed because the bivariate analysis, all variables are not significantly.Results: Of the five variables that were related to the occurrence of autism, five variables are not statistically significant and two variables that increase the risk of autism gastrointestinal infection (p=0,09 OR 3,5 CI 95%; 0,66-34,53) and low birth weight (p=0,17 OR 4 CI 95%; 0,39-196,9).Conclusions: There was no significant relationship between the giving of colostrum, exclusive breastfeeding and maternal age, but clinical gastrointestinal infection and low birth weight were risk factor of autism. Keywords: Colostrum, exclusive breastfeeding, autism
Hubungan Kadar Interferon Gamma (IFN-γ) Pada Cairan Asites Dan Darah Dengan Grade Karsinoma Ovarium
Get PDFLatar Belakang: Kanker ovarium dapat digolongkan berdasarkan grade, yang dibagi menjadi low grade dan high grade. IFN-γ memiliki efek anti-tumor dan juga pro-tumor. Penelitian tentang kadar IFN-γ pada asites dan darah serta hubungannya dengan grade belum banyak dilakukan.Tujuan: Mengetahui hubungan kadar interferon gamma (IFN-γ) dengan grade karsinoma ovarium pada cairan asites dan darah.Metode: Penelitian cross sectional dengan sampel asites dan darah dari pasien karsinoma ovarium yang dilakukan operasi di RSUP Dr. Sardjito.Hasil dan Pembahasan: Pada sampel asites rata-rata pada low grade sebesar 0,57 pg/ml, pada high grade sebesar 0,68 pg/ml, pada sampel darah rata-rata pada low grade sebesar 0,74 pg/ml, pada high grade sebesar 0,84 pg/ml. Namun perbedaan rata-rata tersebut tidak signifikan (asites, p=0,780; darah, p=0,861). Pada cairan asites dan darah, rata-rata pada asites sebesar 0,66 pg/ml, pada darah 0,81 pg/ml, namun perbedaan rata-rata tersebut tidak signifikan (p=0,568).Kesimpulan: Tidak terdapat perbedaan rata-rata yang signifikan antara kadar interferon-gamma (IFN- γ) cairan asites dan darah pada karsinoma ovarium low grade dan high grade. Tidak terdapat perbedaan rata-rata yang signifikan antara kadar interferon-gamma (IFN- γ) pada cairan asites dan darah karsinoma ovarium. Kata Kunci: asites, darah, grade, interferon gamma (IFN-γ), karsinoma ovariu
Perbedaan Kadar Interferon Gamma Cairan Asites Pada Subtipe Histopatologi Serosa dan Non-Serosa Kanker Ovarium Tipe Epitel
Get PDFLatar Belakang: Karsinoma ovarium dapat dibedakan menjadi subtipe serosa dan non-serosa, dimana subtipe serosa memiliki prognosis yang lebih baik. IFN-γ dapat memiliki aktivitas pro-tumor maupun anti-tumor. Penelitian tentang kadar IFN-γ asites serta hubungannya dengan subtipe serosa dan non-serosa belum banyak dilakukan.Tujuan: Mengetahui perbedaan rata-rata kadar IFN-γ cairan asites pada subtipe serosa dan non-serosa karsinoma ovarium.Metode: Penelitian cross sectional selama periode September – Desember 2018. Pengambilan sampel asites dilakukan di kamar operasi RSUP Dr. Sardjito dan pengujian sitokin menggunakan Human IFN-γ ELISA Kit dilakukan di Laboratorium Biologi Molekuler FKKMK Universitas Gadjah Mada.Hasil dan Pembahasan: Pada 11 sampel subtipe serosa didapatkan rata-rata kadar IFN-γ sebesar 0,46 pg/ml, sedangkan pada 7 sampel non-serosa didapatkan rata-rata 0,97 pg/ml, namun perbedaan rata-rata tersebut tidak signifikan secara statistik (p=0,104).Simpulan: Tidak terdapat perbedaan rata-rata kadar IFN-γ dalam cairan asites pada subtipe serosa dan non-serosa karsinoma ovarium.Kata Kunci: interferon gamma (IFN-γ), karsinoma ovarium, asites, subtipe histopatolog
Studi Literatur Perbedaan Ekspresi Messenger Ribonucleid Acid (mRNA) Reseptor Androgen Setelah Pemberian Testosteron antara Penis dan Kelenjar Prostat Tikus Wistar Jantan (Rattus Norvegicus) Pascakastrasi
Get PDFBackground: Aging process (andropause) in men will cause a decrease in testosterone hormones, in other that decrese of androgen receptor (testosteron and dhyhidrtestosterone) in target organ, can be seen from AR mRNA expression. Andropause finaly impact of male reproductive organ, so given testosterone hormone therapy is important to restore the condition. Giving testosterone hormone causes increase the expression of AR mRNA in the prostate gland and penis, but in these two organs there is a different increase.Objective: to know the difference of expression AR mRNA after administration of testosterone between prostate gland and penis.Method: This article used literature review from database of intisari sains medis.Results and Discussion: AR mRNA expression in the prostate gland is smaller than the penile tissue, due to the prostate gland in addition to the 5α reductase enzyme there are also many aromatase enzymes. In the normal prostate gland the amount of 5α reductase is small, so the addition of testosterone is converted to DHT but also in aromatization to estrogen. Therefore, fewer androgen receptors are found compared to the tissue of the penis, in addition expression of AR mRNA in the preputial penis is higher than the prostate gland.Conclusion: Penile tissue is more responsive to testosterone and improves the function and maintenance of tissue especially in old. Keywords: androgen receptor mRNA; testosterone; penis and prostat
Pengaruh Konseling Antenatal terhadap Tingkat Penerimaan IUD Pasca Salin:Non RCT
Get PDFBackground: Postpartum period is a period where a woman has a great motivation to use a contraceptive. The present data showed that the use of IUD was only about 7,75% of all mixed contraceptive use. Counseling carried out during the antenatal care period continued during early labor is believed be able to increase its acceptance.
Objective: To compare the effect of antenatal counseling continued during the early labor versus counseling in the early labor only on the acceptance of postpartum IUD use.Method: The study was carried out in Sardjito Hospital and several Puskesmas in the province of Yogyakarta during six months period from January to June 2015. A non-randomized controlled trial (quasi experimental design) was used. Pregnant women meeting the inclusion and exclusion criteria that are counseled during their antenatal visit continued during their early labor were assigned as the exposed group. Those who are counseled during the early labor only were assigned to the control group. Counseling was done using a specific designed card introduced by BKKBN. The main outcome of interest is the real insertion of postpartum IUD. Chi square test, relative risk and logistic regression were used for statistical analysis.Result and Discussion: A total of 144 subjects were recruited consisting of 72 subjects as the exposed group and 72 as the control. Both groups were comparable in terms of age, parity, education, mode of delivery, and history of previous IUD use. The rate of IUD insertion on the exposed group was 52.8% compared to 26.4% in the control (RR 2.00; 95% CI 1.28-3.12). Other factors contributing to the acceptance of postpartum IUD were mode of delivery and previous IUD use. Logistic regression showed that the most dominant factor contributing to the acceptance of postpartum IUD was history of previous IUD use, (OR 8,42; 95% CI 1,68–42,27) followed by mode of delivery (OR 4.96; 95% CI 1.86–13.26), while timing of counseling was the third (RR 2.93; 95% CI 1.36–6.32).Conclusion: Counseling carried out during ANC continued in the period of early labor increased significantly the acceptance of postpartum IUD. Other factors contributing to the acceptance of IUD use were history of previous IUD use and mode of delivery.Key words: Postpartum IUD; Time of Counseling; Antenatal Care; Rate of Acceptance; IUD pasca salin; waktu konseling
Kualitas Hidup Satu Tahun Pasien Kanker Serviks yang telah Dilakukan Histerektomi Radikal di RSUP DR. Sardjito Yogyakarta
Get PDFLatar 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 radika
Perbedaan Pola Menyusui Bulan Pertama Ibu Melahirkan Seksio Sesarea Dibandingkan Melahirkan Normal di Rumah Sakit Sayang Bayi
Get PDFBackground: exclusive breastfeeding should be provided until 6 months of age, but the fact proves that the pattern of breastfeeding has decreased. The pattern of the first month lactation is a critical period for the survival of the subsequent breastfeeding, so it is necessary to make efforts to maintain the duration of breastfeeding because the success of the first month breastfeeding will increase mothers’ confidence to continue breastfeeding.Objective: To determine differences in the pattern of the first month breastfeeding in mothers who gave birth by cesarean section compared to those by vaginal delivery in Rumah Sakit Sayang Bayi (Baby Friendly Hospital)Method: Type of research is comparative observational with a prospective cohort design using a quantitative approach. The research was conducted in Baby Friendly Hospital of RSUD (General Hospital) Mataram City. Total sample 120 consisted of 60 mothers giving birth the caesarean section and 60 mothers vaginal delivery. The independent variable of giving birth by Cesarean Section and vaginal delivery, dependent variable pattern the first month of breastfeeding and external variables age, parity, employment, the incidence of antepartum and postpartum. The sampling technique using consecutive sampling. Analysis of the data used is univaribel, bivariate using Chi-square and Fisher's exact test and multivariable logistic regression and stratification testResult and Discussion: There was no significant correlation between the mode of delivery and the patterns of the first month breastfeeding by including a variable of employment with a value of OR (95% CI) = 1.6 (0.63 to 4.17) and there was a decrease in the value of OR (95% CI ) from 2.5 (1.05 to 5.94) to 1.6 (0.63 to 4.17); there was also no significant correlation when involving the variable of the incidence of ante partum and post partum with the value of OR (95% CI) = 1.7 (0.45 to 6.26) and OR (95% CI) = 2.3 (0.96 to 5.53), respectively.Conclusion: : There is no difference patterns of breastfeeding mothers first month who gave birth cesarean section compared to normal birth. Caesarean section would affect the pattern of the first month breastfeeding if cesarean section deliveries occurred at housewives and mothers who did not experience the incidence of ante partum. Keywords: pattern of breastfeeding; vaginal deliveries; caesarean section; breast milk;
Hubungan Kadar CA-125 Praoperatif terhadap Prognosis Survival Penderita Kanker Ovarium Epitelial di RSUP Dr.Sardjito
Get PDFBackground: CA-125 level increases in 50% of patients with stage I, 90% of patients with stage II, 92% of patients with stage III and 94% of patients with stage IV ovarian cancer. CA-125 level were not a diagnostic tool to detect ovarian cancer, however it was useful to monitor the progressive of disease and as a prognostic marker.Objectives: The aim of this study is to prove whether CA-125 level before surgery in ovarian cancer patients at Dr. Sardjito Hospital as well as a factor that correlates to the survival prognosis of those patients.Method: This research used cohort retrospective study at Dr. Sardjito Hospital Yogyakarta.Result and Discussion: As much as 71 ovarian cancer patients which had been included in this research with inclusion and exclusion criteria. Subjects were divided into two groups. One group was for patients with low CA-125 level (≤35 U/ml) as much as 18 subjects and another group was for patients with high CA-125 level (>35 U/ml) as much as 53 subjects. The result of a bivariate analysis with an independent survival analysis (Cox’s Regression) was the stage of disease (p=0.005, HR 4.827, CI 95% 1.623 – 14.355) and residual tumour (p=0.029, HR 2.605, CI 95% 1.101 – 6.161) were a survival prognosis factor. Multivariate analysis with a survival analysis (Cox’s Regression) shows CA-125 level (p=0.031, HR 4.131, CI 95% 1.143 – 14.933) and menarche (p=0.003, HR 4.989, CI 95% 1.736 – 14.342) were significantly related with survival prognosis in EOC (Epithelial Ovarian Cancer) patients at Dr. Sardjito Hospital.Conclusion: CA-125 level affects the survival rate of epithelial ovarian cancer patients in Dr. Sardjito Hospital. Besides the level of CA-125, there are other factors that affect the survival rate of epithelial ovarian cancer patients which is the stage of cancer, residual operation and age of menarche.Keywords: CA-125 level, EOC, prognosis, survival
Hubungan Asupan Cairan Ibu Hamil terhadap Indeks Cairan Amnion
Get PDFIntroduction: 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; AF