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Mochtar, Arufiadi Anityo
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KEJADIAN FISTULA UROGENITAL PADA PEREMPUAN DI RSUP DR. KARIADI SEMARANG Mukti, Ngesti Anggita; Mochtar, Arufiadi Anityo; Wiyati, Putri Sekar
DIPONEGORO MEDICAL JOURNAL (JURNAL KEDOKTERAN DIPONEGORO) Vol 7, No 1 (2018): JURNAL KEDOKTERAN DIPONEGORO
Publisher : Faculty of Medicine, Diponegoro University, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (389.12 KB) | DOI: 10.14710/dmj.v7i1.19378

Abstract

Latar Belakang: Fistula urogenital adalah hubungan abnormal antara saluran reproduksi wanita dan saluran kemih yang dapat mengakibatkan kebocoran urin. Fistula urogenital dapat menimbulkan dampak fisik maupun psikososial.Tujuan:Mengetahui angka kejadian serta karakteristik umum, faktor obstetri dan faktor ginekologi kejadian fistula urogenital pada perempuan di RSUP Dr. Kariadi Semarang.Metode: Penelitian deskriptif retrospektif. Data diambil dari data rekam medis pasien dengan fistula urogenital di RSUP Dr. Kariadi Semarang Periode Tahun 2013 – 2016. Analisis statistik dilakukan secara deskriptif dimana hasil penelitian disajikan dalam bentuk tabel distribusi dan frekuensi untuk setiap karakteristiknya.Hasil: Kejadian fistula urogenital pada perempuan di RSUP Dr. Kariadi Semarang selama periode 2013 – 2016 adalah sebanyak 36 kasus. Karakteristik umum pasien fistula urogenital, berdasarkan jenis fistula sebagian besar adalah fistula vesikovaginal ( 97,2%) dan sebagian besar terdiagnosis pada usia lebih dari 35 tahun (86,1 %). Status rujukan pasien terbanyak adalah bukan merupakan pasien rujukan (66,7%). Sebagian besar  pasien mengeluhkan munculnya keluhan inkontinensia urin adalah antara satu bulan sampai satu  tahun (50%).  Faktor ginekologi yang paling banyak menyebabkan fistula adalah operasi  histerektomi total (30,6%).Faktor obstetri terbanyak yang menyebabkan timbulnya fistula adalah persalinan dengan seksio sesarea (11,1%) dengan karakteristik maternal multipara, menikah pada usia diatas 18 tahun dan tingkat pendidikan terakhir yang ditempuh adalah SD.Kesimpulan: Kejadian fistula urogenital pada perempuan di RSUP Dr. Kariadi Semarang, sebagian besar disebabkan oleh faktor ginekologi, yaitu operasi histerektomi total.
Pregnancy Associated Plasma Protein-A (PAPP-A) as a Marker to Distinguish Normotensive with Early 2nd Trimester and Late 3rd Trimester Onset of Preeclampsia Simangunsong, Ragam Pesona; Kristanto, Herman; Iskandar, Mirza; Thaufik, Syarief; Pramono, Besari Adi; Mochtar, Arufiadi Anityo
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.979

Abstract

Introduction: Preeclampsia is a hypertensive condition that occurs after 20 weeks of gestation accompanied by target organ damage. Complications of preeclampsia can cause intrauterine fetal growth retardation, and placental hypoperfusion, even in the most serious situations, namely termination of pregnancy and death of the fetus and/or mother. Pregnancy-associated plasma protein-A (PAPP-A) is a high molecular weight glycoprotein that is produced in the placenta and secreted into the maternal bloodstream. However, based on several studies that have been conducted, there is uncertainty in the results of assessing PAPP-A levels obtained in pregnant women in the second and third trimesters. Aim: Proving differences in PAPP-A levels in the second and third trimesters in the incidence of early-onset preeclampsia and normotensive pregnancy. Methods: An analytic observational study with a cross-sectional approach was carried out in the delivery room of RSUP Dr. Kariadi Semarang, Halmahera Health Center, Ngesrep Health Center, Bulu Health Center, and private midwife practice in Semarang City. The subjects of the study were six 2nd-trimester preeclampsia patients, fourteen 3rd-trimester preeclampsia patients, and twenty normotensive pregnancy patients who met the inclusion and exclusion criteria. Data were analyzed using Mann Whitney with a significance of p<0.05 Results: There was a significant difference in PAPP-A levels (p<0.001) between the preeclampsia and normotensive pregnancy groups, whereas PAPP-A levels were higher in the preeclampsia group. There were significant differences in PAPP-A levels (p<0.001) between the 2nd-trimester preeclampsia, 3rd-trimester preeclampsia, and normotensive pregnancies, where the highest PAPP-A levels were found in the 2nd-trimester preeclampsia group. Conclusion: There was a significant difference in PAPP-A levels between the second and third trimesters of early-onset preeclampsia compared to normotensive pregnancies, where PAPP-A levels were higher in the second and third trimesters of early-onset preeclampsia. Elevated PAPP-A levels in the second and third trimesters are associated with an increased risk of early-onset preeclampsia.
Comparison Between Placenta Accreta Index and Tovbin Score as A Predictor of Placenta Accreta Spectrum Disorders (PASD) Dinata, Willy Angga; Hafiz, Alini; Mochtar, Arufiadi Anityo; Dewantiningrum, Julian; Wiyati, Putri Sekar; Cahyanti, Ratnasari Dwi
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.980

Abstract

Background : The incidence of  Placenta Accreta Spectrum Disorders (PASD) in developed countries has reportedly increased 10-fold in the last 50 years. The significant increase was followed by an increase in the number of caesarean section from 12.5% to 23.5% in the last 10 years. Maternal morbidity related to PASD events reaches 7% in intraoperative and postoperative actions, while the morbidity reaches 60%. In cases of late diagnosis, maternal mortality with placenta accreta reaches 30%. Efforts to prevent maternal morbidity and mortality can be carried out by early detection at antenatal care visits. The Placenta Accreta Index (PAI) and Tovbin scoring systems based on the results of ultrasound examination can be used to screening for placenta accreta. Objective: To analyze the comparison of the accuracy of the PAI and Tovbin scoring systems in predicting the incidence of Placenta Accreta Spectrum Disorder (PASD). Method: The study used an analytic observational with a cross sectional design. Sampling was done by consecutive sampling method. There were 35 subjects who met the inclusion and exclusion criteria. PAI and Tovbin scoring were performed on each selected subject. The accuracy of the PAI and Tovbin scoring systems was confirmed by establishing a diagnosis based on PASD histopathology. Results: The PAI scoring system in predicting PASD has a sensitivity value of 79.31%, a specificity of 83.33%, a positive predictive value (NDP) of 95.83%, a negative predictive value (NDN) of 45.45%, an accuracy of 80.00%. While the Tovbin scoring system obtained a sensitivity value of 86.21%, specificity of 83.33%, NDP of 96.15%, NDN of 55.56%, accuracy of 85.71 %. Conclusion: In the comparison of scoring systems, it was found that the Tovbin scoring system has almost the same sensitivity and accuracy and the same specificity in predicting Placenta Accreta Spectrum Disorder (PASD).
Effectiveness of Kelly Plication Method on Clinical Improvement in Stress Urinary Incontinence Patients Notohatmodjo, Puspitasari; Pramono, Besari Adi; Mulyantoro, Inu; Kristanto, Herman; Purnaningtyas, Dewi Astri; Mochtar, Arufiadi Anityo; Mulyantoro, Erwinanto
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.1032

Abstract

BACKGROUND: Patients with pelvic organ prolapse (POP) usually present with POP, but stress urinary incontinence (SUI) is also found during history taking and physical examination. As a result, the complaint of SUI is persistent despite POP surgery. Therefore, SUI found along with POP and undergoing surgery can be performed Kelly plication method. OBJECTIVES: To examine the effectiveness of Kelly's plication method on clinical changes and quality of life of patients suffering from SUI. METHODS: A single cohort prospective one-group pretest-posttest design conducted at RSUP Dr. Kariadi Teaching Hospital Semarang involving 31 research subjects. All subjects were measured preoperative IIQ-7 questionnaire and pad test. Then, all subjects will undergo Kelly method surgery. Postoperative evaluation will be conducted 3 months later, including measurement of the IIQ-7 questionnaire and pad test. All data will be analyzed with univariate and bivariate analysis using paired t-test and Wilcoxon test. RESULTS:  The effectiveness rate of Kelly's plication method was 58.06% in this study. Most of the subjects were aged 50-59 (38.7%) years and had experienced menopause (87.1%). Correlation analysis of baseline data on the degree of preoperative SUI showed that the degree of POP correlated SUI. The Pad test and IIQ-7 questionnaire test showed a significant decrease in postoperative measurements in the treatment group (p: <0.001 & p: <0.001). CONCLUSIONS: Kelly's plication method is effective in treating SUI.
The Effect of Moringa oleifera Extract on Histopathological of Mice Testes Exposed by Monosodium Glutamate Handoyo, Regenio Akira; Saraswati, Indah; Mochtar, Arufiadi Anityo; Armalina, Desy; Miranti, Ika Pawitra
Jurnal Kedokteran Diponegoro (Diponegoro Medical Journal) Vol 12, No 6 (2023): JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL)
Publisher : Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dmj.v12i6.37311

Abstract

Background: Monosodium glutamate (MSG) consumption in excess can have an impact on a man's fertility and lead to infertility. MSG has the potential to produce free radicals, which can harm cells. Antioxidants can fight off free radicals. Exogenous antioxidants are required to maintain equilibrium since there will be an imbalance if the body produces more free radicals than endogenous antioxidants. Exogenous antioxidants flavonoids are present in the leaves of the Moringa plant (Moringa oleifera L). It is thought that flavonoids have 4-5 times more antioxidant potential than vitamins. Objectives: To evaluate how moringa leaf extract affects the histopathological profile of MSG-exposed mouse testes. Methods: Only the posttest was used as a control group in this study. 25 male mice were used as the sample, and they were split up into five groups. The treatment group 1 (P1) received 6 g/day of MSG exposure + 300 mg/kg BW/day of moringa leaf extract, the treatment group 2 (P2) received 6 g/day of MSG exposure + 600 mg/kg BW/day of moringa leaf extract, and the treatment group 3 (P3) received 6 g/day of MSG exposure + 1200 mg/kg BW/day of moringa leaf extract. The control group (K-) received only standard feed. The mice were put to death after 30 days. The testes were removed for histological examination using hematoxylin-eosin staining, and the Johnsen scoring criteria were applied to their evaluation. Results: The data were not significant according to the Shapiro-Wilk test in the P3 group (MSG 6 g/day + Moringa Extract 1200 mg/kg BW/day). The Kruskal-Wallis test revealed that there was no significant difference between the seminiferous tubules according to the treatment group (p = 0.117). Conclusion: Moringa oleifera leaf extract protects the histopathological picture of the testes of male mice compared to the group given monosodium glutamate. 
Factors Associated With Recurrence Of Epithelial Ovarian Cancer In RSUP Dr. Kariadi Semarang Kurube, Isabela Marsialina; Ambari, Ediwibowo; Iskandar, Teuku Mirza; Tjahjanto, Hary; Dewantiningrum, Julian; Mochtar, Arufiadi Anityo; Trisetiyono, Yuli
Diponegoro International Medical Journal Vol 3, No 2 (2022): December 2022
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v3i2.15448

Abstract

Introductions: Epithelial ovarian cancer accounts for 90% of all ovarian malignancies. More than 70% of patients will experience a relapse even after receiving operative therapy and chemotherapy. There are several prognostic factors that influence the recurrence of ovarian cancer. In Indonesia, especially at Dr. Kariadi Hospital, Semarang, the data as mentioned above is still very limited.objective: Knowing the disease-free survival rate, optimizing surgery and factors related to the incidence of recurrence in epithelial ovarian cancer patients at Dr. Kariadi Hospital SemarangMethods: This study is a retrospective cohort study with survival analysis. Data were collected through medical records, with the study population are patients with a diagnosis of epithelial ovarian cancer who were treated at Dr. Kariadi Hospital Semarang in period January 2018-December 2019. Furthermore, patients who had been remission were observed for signs of disease recurrence for 2 years period.Results: There were 361 patients with epithelial ovarian cancer who underwent primary treatment at Dr. Kariadi Hospital, Semarang in  2018-2019. Furthermore, there were observations of recurrence in 148 patients who achieved remission. Of these 76 patients (51.4%) experienced recurrence, while 72 patients not relapse. From 148 epithelial ovarian cancer patients who underwent cytoreduction surgery at Dr. Kariadi Hospital, Semarang, 113 patients (76.4%) achieved optimal operation with a residu less than 2 cm, while 35 patients (23.6%) were not optimal with a residu more than 2 cm. FIGO stage (HR 2.44) and tumor residu (HR 2.15) were shown to be significant factors associated with the recurrence of epithelial ovarian cancer.Conclusion: Overall disease-free survival in epithelial ovarian cancer at Dr. Kariadi Semarang were 74.8% (6 months), 57.1% (1 year), 42.5% (18 months), and 37.4% (2 years). Tumor residual factors and FIGO stage were shown to be significant prognostic factors influencing the recurrence of epithelial ovarian cancer. 
Effect Of Vitamin D Administration On Interleukin 6 (IL-6) Levels In Peritoneal Fluid In Endometrioma Patients Setyasworo, Singgeh; Mochtar, Arufiadi Anityo; Erwinanto, Erwinanto; Kristanto, Herman; Tjahjanto, Hary; Trisetiyono, Yuli
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 3 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i3.1031

Abstract

BACKGROUND: An endometrioma is a cyst that occurs when endometrial tissue grows on the epithelium of the ovary. Vitamin D is a steroid hormone that can be extracted from commonly available foods and can be synthesized by humans when exposed to sunlight. Vitamin D deficiency has been reported to be associated with various pathologies, including endometrioma. Vitamin D has been reported to have anti-angiogenic effects that may inhibit the growth of endometriotic implants.   AIM: Proving the effect of vitamin D administration on interleukin 6 (IL-6) levels in peritoneal fluid in patients with endometrioma. METHOD:  Experimental research with two group, post-test only design with single blind that carried out at Central General Hospital (RSUP) Dr. Kariadi Semarang. The research subject was 50 patients with endometrioma on ovary. The definite diagnosis of endometrioma is made based on histopathological examination of tissue samples after the patient undergoes surgery. Patients will be divided into 2 groups, namely the vitamin D3 supplementation group and placebo. The intervention was carried out by providing vitamin D3 50,000 IU/week for a month. Evaluation of serum vitamin D levels were obtained using venous blood samples immediately when the patient was undergoing surgery. Interlukin-6 levels were obtained using peritoneal fluid samples obtained when the patient underwent surgery. Statistical analysis was carried out using the Independent T Test, Mann-Whitney U, Dependent T Test and Wilcoxon. Results are significant if p <0.05. Statistical analysis was carried out using SPSS edition 26. RESULT:  Peritoneal fluid interleukin-6 (IL-6) levels between the vitamin D supplementation group and the placebo group did not show a significant difference (p=0.554). CONCLUSION: Vitamin D supplementation in endometrioma patients is not associated with peritoneal fluid interleukin-6 (IL-6) levels.
Perineal Laceration in primipara in Association with Perineal length, Fetal Head Circumference, and Fetal Weight Udjaja, Claudio; Erwinanto, Erwinanto; Kristanto, Herman; Tjahjanto, Hary; Trisetiyono, Yuli; Mochtar, Arufiadi Anityo
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 3 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i3.1117

Abstract

BACKGROUND : Perineal laceration is one of the risk and complication of spontaneous labour resulting intervention in short-term and long-term quality of life. Lack of research in Indonesia on perineal length Lack of research on perineal length in Indonesia, fetal birth weight and fetal head circumference and its impact on spontaneous labour and perineal laceration gave rise to the idea of research in order to minimize the occurrence of complications from perineal laceration in spontaneous labour.OBJECTIVES : To know find out the association between perineal length, fetal head circumference, and fetal weight with degree of perineal laceration in primiparous women.METHODS : Observational cross sectional multi-center study conducted between August 2023 until October 2023 in which all subject that delivered vaginally within inclusion criteria was measured. All data will be further analized to determine the significant predictor of perineal tear.RESULTS : Based on this study The result of this study has indicated that there is no significant association of perineal length with the degree of spontaneous primiparous perineal laceration. While there is an association of fetal head circumference and fetal weight with the degree of spontaneous primiparous perineal laceration in aterm pregnancy. Based on further analysis, fetal head circumference greater than 325 mm increases the risk of severe perineal laceration 4.4 times (PR=4,4; 95% CI=1,4-13,9) and Fetal weight greater than 3097.5 grams increases the risk of 2.7 times (PR=2,7; 95% CI=1,1-6,4) the occurrence of severe perineal laceration.CONCLUSION : There is an association of fetal head circumference and fetal weight with the degree of spontaneous primiparous perineal laceration.
Co-Authors Besari Adi Pramono Desy Armalina Dewi Astri Purnaningtyas Dinata, Willy Angga Ediwibowo Ambari Erwinanto, Erwinanto Hafiz, Alini Handoyo, Regenio Akira Hary Tjahjanto Herman Kristanto Ika Pawitra Miranti Indah Saraswati Julian Dewantiningrum Kurube, Isabela Marsialina MIRZA ISKANDAR, MIRZA Mukti, Ngesti Anggita Mulyantoro, Erwinanto Mulyantoro, Inu Notohatmodjo, Puspitasari Putri Sekar Wiyati Ratnasari Dwi Cahyanti, Ratnasari Dwi Setyasworo, Singgeh Simangunsong, Ragam Pesona Syarief Thaufik, Syarief Teuku Mirza Iskandar, Teuku Mirza Udjaja, Claudio Yuli Trisetiyono, Yuli