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All Journal Indonesian Journal of Cardiology Medica Hospitalia Diponegoro International Medical Journal (DIMJ)
Erwinanto, Erwinanto
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Dentistry Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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Differences of Dyspareunia in Primipara with 2nd Degree Perineal Laceration Sutured with Rapide Polyglactin 910 and Chromic Catgut Threads Wibowo, Satrio Arief; Trisetiyono, Yuli; Kristanto, Herman; Wiyati, Putri Sekar; Tjahjanto, Hary; Erwinanto, 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.v11i1.968

Abstract

BACKGROUND: Dyspareunia is persistent or recurrent pain during sexual intercourse. Perineal laceration, spontaneous or episiotomy, is one of the most common causes. Perineal lacerations that occur must be treated through suturing. Chromic catgut is a natural thread that is often used in medical practice, but this thread have a higher inflammatory response compared to Rapide Polyglactin 910. AIMS: To analyze the difference in the incidence of dyspareunia in primipara with 2nd degree perineal lacerations sutured with Rapide Polyglactin 910 and Chromic catgut threads METHOD: True experimental research with randomized controlled trial-single blinded method. The research was conducted at dr. Kariadi Semarang, RA Kartini Hospital and dr. Soeselo from August 2022 to February 2023. The research subjects were primipara with 2nd degree perineal lacerations which were divided into 2 groups, namely 45 subjects in the Chromic catgut group and 45 subjects in the Rapide Polyglactin 910 group. Evaluation of dyspareunia after 3 months was carried out using the Female Sexual Function Index (FSFI) RESULT:  Subjects sutured using Chromic catgut had a 2.7 times greater risk of experiencing dyspareunia when compared to using Rapide Polyglactin 910 (OR=2.7; 95% CI=1.1-6.6). A significant confounding factor was found, namely the act of episiotomy (p=0.047; OR=9.56; 95% CI=1.86 - 48.97). After controlling for these variables, the subjects who were sewn using Chromic had a significant risk (p=0.002, OR=5.39; 95% CI=1.76-16.50) CONCLUSION: Subjects with Chromic catgut have a higher risk of experiencing dyspareunia than using Rapide Polyglactin 910 threads after 3 months of suturing.
Incident Rate of Vesicovaginal Fistula at Dr. Kariadi General Hospital Semarang in 2022 Zunaidhi Bahar, Rully; Arya Putra, Aditya; Agung Nugroho, Eriawan; Wiryawan Cahyono, Chemmy; Erwinanto, Erwinanto; Santosa, Ardy; Sindhu Wibisono, Dimas; Daniswara, Nanda; Rais Addin, Sofyan
Diponegoro International Medical Journal Vol 4, No 2 (2023): December 2023
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v4i2.17873

Abstract

Background: Vesicovaginal fistula (VVF) is an abnormal connection between the vesicourinaria and the vagina which causes urine to continuously leak through the vagina. The etiology of VVF fistulas has changed from being obstetric to being more hysterectomy related. While management is as early as possible appropriately and prevents further complications that can occur. Aim: Analyzing the comparison of the characteristics of patients with VVF at Dr. Kariadi General Hospital Semarang in 2022.Methods: The study design in this study was a retrospective descriptive observational study. Results: During the period from 3 January to 30 December 2022, 20 patients were found with VVF. Based on the data obtained, the average age of the patients was 39.4 years. Parity in the study subjects consisted of 2 nulliparas (10%), 5 primiparas (25%) and 13 multiparas (65%). Types of fistulas in patients included 14 fistulas after gynecological surgery (70%), 4 fistulas after caesarean section (20%), 1 fistula after radiotherapy (5%) and 1 fistula after trauma (5%). Conclusion: VVF incident in Dr. Kariadi General Hospital Semarang in 2022 were 20 cases with the majority of fistula types after gynecological surgery as many as 14 cases.  
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.
Dyslipidemia management among patients with high and very high cardiovascular risk in Indonesia: a multi-center registry Ng, Sunanto; Santoso, Anwar; Sukmawan, Renan; Erwinanto, Erwinanto; Adam, Erika; Desandri, Dwita Rian; Zahra, Rita; Wicaksono, Sony Hilal; Putra, Magma Purnawan; Heriansyah, Teuku; Tiksnadi, Badai Bhatara; Pintaningrum, Yusra
Jurnal Kardiologi Indonesia Vol 46 No 2 (2025): April - June, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1880

Abstract

Background Indonesia, the world's largest archipelago, faces significant challenges in equitable healthcare delivery due to its geographical and infrastructural disparities. Atherosclerotic Cardiovascular Disease (ASCVD) remains the leading cause of mortality, with over 659,000 deaths recorded in 2019. Effective dyslipidemia management is crucial for preventing adverse ASCVD events. Unfortunately, the lack of implementation of an updated national lipid management registry might hinder optimal strategy for the adverse events. This study evaluated dyslipidemia cholesterol management practices among high- and very high-risk patients across the country. Methods The study recruited 322 patients from eight centers across six provinces in Indonesia between May 2022 and March 2023. Patients were stratified based on the ASCVD risk and followed over three visits. Baseline clinical characteristics, lipid profiles, and treatment regimens were analyzed. Descriptive statistics summarized continuous and categorical variables, and low-density lipoprotein cholesterol (LDL-C) achievement was assessed. Results Of the 322 patients, 98.8% were very high-risk, with only 4.9% achieving <55 mg/dL and 21.2% achieving <70 mg/dL. Moderate-intensity statins were the most prescribed (51.2%), followed by high-intensity (36.6%). LDL-C reduction was most pronounced in private insurance patients, achieving a mean LDL-C of 69.8 mg/dL at the third visit compared to 98.9 mg/dL in National Health Insurance (Jaminan Kesehatan Nasional/JKN) participants. Missed visit rates increased over time, with 57.5% of patients missing the third visit, predominantly among JKN participants and low-income groups. Conclusion Majority of the population failed to achieve the recommended target of LDL-C levels. Dyslipidemia management in Indonesia remains suboptimal, with disparities driven by socioeconomic factors. Improved policies addressing medication availability, national lipid registry establishment, and equitable healthcare access are essential to enhance lipid management and reduce the burden of ASCVD in Indonesia.
Co-Authors Adam, Erika Agung Nugroho, Eriawan Anwar Santoso Ardy Santosa Arya Putra, Aditya Badai Bhatara Tiksnadi Desandri, Dwita Rian Hary Tjahjanto Herman Kristanto Mochtar, Arufiadi Anityo Nanda Daniswara, Nanda Pintaningrum, Yusra Putra, Magma Purnawan Putri Sekar Wiyati Rais Addin, Sofyan Renan Sukmawan Setyasworo, Singgeh Sindhu Wibisono, Dimas Sunanto Ng Teuku Heriansyah, Teuku Udjaja, Claudio Wibowo, Satrio Arief Wicaksono, Sony Hilal Wiryawan Cahyono, Chemmy Yuli Trisetiyono, Yuli ZAHRA, RITA Zunaidhi Bahar, Rully