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Research trends and clinical evidence: A comparison of surgical vs. conservative approaches for chronic pelvic pain syndrome – a systematic review and bibliometric analysis Saputra, I Gede Agus Rio; Pramana, Anak Agung Ngurah Gede Anggra; Marta, Kadek Fajar
Science Midwifery Vol 13 No 2 (2025): June: Health Sciences and related fields
Publisher : Institute of Computer Science (IOCS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35335/midwifery.v13i2.1945

Chronic Pelvic Pain Syndrome (CPPS) is a complex medical condition that affects patients' physical, emotional, and social quality of life. Its management involves two main approaches: surgical and conservative. However, there are significant differences in the effectiveness, risks, and long-term impacts of each approach. This study aims to evaluate the effectiveness of surgical and conservative approaches in managing CPPS through a systematic review and bibliometric analysis, focusing on pain reduction, improvement in quality of life, and risk of complications. This research employs the Systematic Literature Review (SLR) method, following the PRISMA guidelines to search, screen, and evaluate relevant literature from databases such as PubMed, Scopus, and the Cochrane Library. The quality of the relevant studies is assessed using standardized appraisal tools. Quantitative data are analyzed through bibliometric analysis to identify differences in effectiveness between surgical and conservative approaches. The results indicate that the surgical approach is more effective in reducing severe and refractory pain compared to conservative therapy, but it is associated with a higher risk of complications. Conversely, the conservative approach provides benefits for mild to moderate symptoms with minimal risk and lower cost. In the context of Indonesia, the conservative approach is more suitable to be implemented as the first-line treatment for CPPS, with surgical options considered for cases that do not respond to initial therapy.

Metastatic breast cancer during pregnancy: a case report Widi, Made Yudha Ganesa Wikantyas; Putra, Wayan Artana; Kusuma, Anak Agung Ngurah Jaya; Wiradnyana, Anak Agung Putra; Sanjaya, I Nyoman Hariyasa; Budiana, I Nyoman Gede; Mahayasa, Putu Doster; Marta, Kadek Fajar
Indonesian Journal of Perinatology Vol. 6 No. 1 (2025): (Available online: 1 June 2025)
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i1.73

Introduction: Breast cancer is the most prevalent malignancy among women and a notable comorbidity during pregnancy. Pregnancy-associated breast cancer (PABC) presents unique challenges due to physiological breast changes that complicate early diagnosis. This case report aimed to present a 31-year-old female with a diagnosis of bilateral breast tumors, pleural effusion, and multiple thoracic soft tissue tumors during her second pregnancy, highlighting the complexities and treatment considerations involved. Case presentation: A 31-year-old female patient, referred to Prof. Dr. I. G.N.G Ngoerah General Hospital, Denpasar, was in her second pregnancy at 20-21 weeks of gestation. She presented with bilateral breast lumps, worsening pain, and shortness of breath. Her obstetric history included a previous cesarean delivery and two abortions. Clinical examination revealed pleural effusion and multiple nodules suggestive of metastases. Biopsies confirmed tubular adenoma in the right breast and invasive breast carcinoma in the left breast. Ultrasound and chest x-ray findings indicated metastases to the liver and lungs. The patient was diagnosed with G4P1021 at 20 weeks of gestation with pregnancy-associated bilateral breast cancer and metastases. Conclusion: PABC diagnosis and treatment are fraught with challenges due to the need to balance maternal and fetal health. Delays in diagnosis, limited antenatal care, and the aggressive nature of PABC contribute to poor outcomes. This case underscores the necessity of early detection, prompt multidisciplinary intervention, and tailored treatment strategies to improve PABC patients' prognoses.

The Role of Microvascular Density (MVD) in Cervical Cancer: A Article Review Winata, I Gde Sastra; Aryana, Made Bagus Dwi; Marta, Kadek Fajar; Christyani, Fenyta
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 3 November 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i3.720

Introduction: The development, invasion and metastasis process of cervical cancer is closely related to the ability of cancer cells in the process of tumor oxygenation and the process of angiogenesis. Angiogenesis plays a very important role in the growth, metastasis and progression of tumor cells. Microvascular Density (MVD) is an examination that counts the number of microvasculature compared to the area of tissue analyzed by histology and immunohistochemistry. Method: This study reviewed literature by searching the Pubmed, ScienceDirect, and Cochran Library Database. The search query included “microvascular” and “cervical cancer”. The study was reviewed using the Preferred Reporting Item for Systemic Reviews and Meta-Analyses (PRISMA) standards. The scope of analysis was restricted to clinical trials conducted from 2011 to 2023Result: Currently, MVD examination is an examination that is often carried out to evaluate the process of intratumor angiogenesis in cancer. By knowing the MVD value in cancer sufferers, it is hoped that it can be considered in determining therapy and assessing the outcome of the course of cervical cancer which can be considered as a prognostic factor. Apart from that, it can complement the theory of other biomolecular prognostic factors that play a role in cervical cancer such as vascular endothelial growth factor (VEGF), Ki-67 protein, p53 tumor suppressor gene, oxygenation factors, especially hypoxia inducible factors-1α (HIF-1α), enzymes protease (matrix metalloproteinase), and cell adhesion molecules (E-Kadherin, catenin).Conclusion: The role of MVD in cervical cancer sufferers as an indicator of prognosis and success of therapy.Peranan Kepadatan Mikrovaskuler (MVD) pada Kanker Serviks: Sebuah Ulasan ArtikelAbstrakPendahuluan: Proses perkembangan, invasi dan metastasis kanker serviks erat kaitannya dengan kemampuan sel kanker dalam proses oksigenasi tumor dan proses angiogenesis. Angiogenesis memainkan peran yang sangat penting dalam pertumbuhan, metastasis, dan perkembangan sel tumor. Kepadatan Mikrovaskular (MVD) merupakan pemeriksaan yang menghitung jumlah mikrovaskular dibandingkan dengan luas jaringan yang dianalisis secara histologi dan imunohistokimia. Metode: Pencarian literatur dilakukan pada database PubMed dan ScienceDirect dan Cochrane Library. Pencarian dilakukan menggunakan istilah “mikrovaskular” dan “kanker serviks”. Penulisan sistematik review disesuaikan dengan pedoman Professed Reporting for Systematic Review and Meta-Analysis (PRISMA). Semua studi yang diinklusi merupakan uji klinis pada periode tahun 2011 – 2023.Hasil: Saat ini MVD merupakan pemeriksaan yang sering dilakukan untuk mengevaluasi proses angiogenesis intratumor pada kanker. Dengan mengetahui nilai MVD pada penderita kanker diharapkan dapat menjadi pertimbangan dalam menentukan terapi dan menilai luaran perjalanan penyakit kanker serviks yang dapat diperhitungkan sebagai faktor prognosis. Selain itu dapat melengkapi teori faktor prognostik biomolekuler lain yang berperan dalam kanker serviks seperti faktor pertumbuhan endotel vaskular (VEGF), protein Ki-67, gen penekan tumor p53, faktor oksigenasi, terutama faktor pemicu hipoksia-1 α (HIF-1 α), enzim protease (matrix metalloproteinase), dan molekul adhesi sel (E-Kadherin, catenin).Kesimpulan: MVD pada penderita kanker serviks berperan sebagai indikator prognosis dan keberhasilan terapiKata kunci: Kepadatan vaskular, kanker serviks, diagnosis

The Effect of Giving Human Umbilical Cord Mesenchymal Stem Cells (HUMSC) on the Expression of Collagen I in Menopause Model Mice Marta, Kadek Fajar; AAN Jaya Kusuma; Ida Bagus Aditya Mayanda; IB Yudhistira Anantasurya Vidhisvara; Juventius Anggoa
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 1 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i1.905

Background: Patients with pelvic floor dysfunction (PFD) who fail conservative treatment will undergo surgery. In recent years, various therapeutic approaches for PFD using stem cells have been investigated in vivo. One component of stem cells is the human umbilical cord mesenchymal stem cell (HUMSC). It is hoped that HUMSC can modify the collagen and elastin content in the extracellular matrix, leading to improvements in pelvic floor strength and PFD. Methods: This research is an experimental study with a randomized posttest-only controlled group design with the aim of determining the effect of giving HUMSC on the expression of Collagen I in a female mouse model of menopause. There are inclusion criteria, namely female Balb/c mice, healthy, never mated, aged 8 - 12 weeks, and body weight 18 - 22 grams. The research will be carried out with statistical analysis using SPSS; a p-value <0.05 is considered significant. Results: The results of the analysis of the distribution of sample means show that there are significant differences between the two groups. The treatment group had a higher mean expression of type I collagen compared to the control group. In addition, variation in the control group was lower compared with the treatment group, which could be interpreted as higher consistency in the response to HUMSC treatment. Conclusion: Human umbilical cord (HUMSC) has a positive impact on type I collagen expression in menopausal model mice.

The Effect of Giving Human Umbilical Cord Mesenchymal Stem Cells (HUMSC) on the Expression of Collagen I in Menopause Model Mice Marta, Kadek Fajar; AAN Jaya Kusuma; Ida Bagus Aditya Mayanda; IB Yudhistira Anantasurya Vidhisvara; Juventius Anggoa
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 1 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i1.905

Background: Patients with pelvic floor dysfunction (PFD) who fail conservative treatment will undergo surgery. In recent years, various therapeutic approaches for PFD using stem cells have been investigated in vivo. One component of stem cells is the human umbilical cord mesenchymal stem cell (HUMSC). It is hoped that HUMSC can modify the collagen and elastin content in the extracellular matrix, leading to improvements in pelvic floor strength and PFD. Methods: This research is an experimental study with a randomized posttest-only controlled group design with the aim of determining the effect of giving HUMSC on the expression of Collagen I in a female mouse model of menopause. There are inclusion criteria, namely female Balb/c mice, healthy, never mated, aged 8 - 12 weeks, and body weight 18 - 22 grams. The research will be carried out with statistical analysis using SPSS; a p-value <0.05 is considered significant. Results: The results of the analysis of the distribution of sample means show that there are significant differences between the two groups. The treatment group had a higher mean expression of type I collagen compared to the control group. In addition, variation in the control group was lower compared with the treatment group, which could be interpreted as higher consistency in the response to HUMSC treatment. Conclusion: Human umbilical cord (HUMSC) has a positive impact on type I collagen expression in menopausal model mice.

Hypomethylation of the Promoter Region of the Vascular Endothelial Growth Factor (VEGF) Gene and It’s Low Expression in Placenta as a Risk Factor for Preeclampsia Bay, Godefridus Paulo; Kusuma, A.A.N Jaya; Darmayasa, I Made; Mahendra, I Nyoman Bayu; Mahayasa, Putu Doster; Marta, Kadek Fajar
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 3 November 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i3.923

Objective: This study aimed to determine the association between hypomethylation of VEGF gene promoter region and low VEGF expression in the placenta as a potential risk factor for preeclampsia.Methods: An observational case-control study was conducted involving pregnant women with preeclampsia and normotensive controls. Placental tissue samples were collected and analysed for DNA methylation status of the VEGF gene promoter using quantitative real-time PCR. VEGF expression levels in placental tissue were measured using ELISA. Results: Significant hypomethylation of the VEGF promoter region was observed in placenta samples from preeclamptic women compared to controls. This finding correlated with decreased VEGF expression. These results indicate that reduced VEGF expression due to promoter hypomethylation may impair placental vascularization, contributing to preeclampsia.Conclusions: Hypomethylation of the VEGF promoter and subsequent reduction in placental VEGF expression may serve as early biomarkers to predict preeclampsia. These results highlight the importance of epigenetic regulation in preeclampsia pathogenesis and suggest potential targets for early diagnosis and intervention.Hipometilasi Regio Promoter Gen Vascular Endothelial Growth Factor (VEGF) dan Ekspresi Vascular Endothelial Growth Factor (VEGF) yang Rendah pada Plasenta sebagai Faktor Risiko PreeklampsiaAbstrakTujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara hipometilasi pada daerah promoter gen VEGF dan rendahnya ekspresi VEGF di plasenta sebagai faktor risiko potensial terjadinya preeklampsia.Metode: Penelitian observasional dengan desain kasus-kontrol ini melibatkan ibu hamil dengan preeklampsia dan kontrol normotensif. Sampel jaringan plasenta dikumpulkan dan dianalisis untuk menentukan status metilasi DNA pada daerah promoter gen VEGF menggunakan quantitative real-time PCR. Tingkat ekspresi VEGF dalam jaringan plasenta diukur menggunakan metode ELISA.Hasil: Didapatkan hipometilasi yang signifikan pada daerah promoter gen VEGF pada jaringan plasenta ibu dengan preeklampsia dibandingkan kelompok kontrol. Temuan ini berkorelasi dengan penurunan ekspresi VEGF. Hasil tersebut menunjukkan bahwa penurunan ekspresi VEGF akibat hipometilasi promoter dapat mengganggu vaskularisasi plasenta, sehingga berperan dalam patogenesis preeklampsia.Kesimpulan: Hipometilasi pada daerah promoter gen VEGF dan penurunan ekspresi VEGF di plasenta dapat berfungsi sebagai biomarker awal untuk memprediksi terjadinya preeklampsia. Hasil ini menyoroti pentingnya regulasi epigenetik dalam patogenesis preeklampsia serta membuka peluang untuk diagnosis dini dan intervensi yang lebih tepat.Kata kunci: Preeklampsia, VEGF, Hipometilasi, Plasenta, Epigenetik

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