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A Randomized FiveYear Comparative Study of Two LevonorgestrelReleasing Implant Systems: Norplant® Capsules and Jadena® Rods Affandi, Biran; Ridwan, Rusdi S; Hoesni, R Hasan M; Tandjung, Thamrin; Ichsan, TM; Amran, Rizani; Manan, Heriyadi; Gunardi, Eka R; Pramana, Noor; Hadiyono, Suryo; Widohariadi, Widohariadi; Farid, Retno B; Taher, Mardiah
Indonesian Journal of Obstetrics and Gynecology Volume 4, No. 4, October 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To provide a randomized comparison between Jadena® and Norplant® in terms of efficacy and acceptability among Indonesian women. Method: This study was a phase IV, open label, randomized, multicenter study throughout Indonesia. Subjects were Indonesian adult women who were randomized to receive Jadena® or Norplant® as their contraceptive method. The subjects were recruited from 6 large cities in Indonesia, such as Medan, Palembang, Jakarta, Semarang, Surabaya, and Makassar. Result: Of 600 subjects, 301 women getting to Jadena® and 299 women to Norplant® were enrolled between August 1998 and February 1999. The mean age was 29.8 (SD 5.3) years old, ranging from 18 to 40 years old. We did not find the pregnancy during the study. Non-pregnancy probability at the end of one year was similar between Jadena® (0.920 (SD 0.016)) and Norplant® users (0.916 (SD 0.084)). The continuation rates of Jadena® at one and three-year were 95.3% and 66.8%; whereas, the continuation rates of Norplant® was 94.3% at year-1 and 70.2% at year-3. Conclusion: The new two rod levonorgestrel subdermal system (Jadena®) showed similar efficacy with the old six capsule levonorgestrel subdermal system (Norplant®) in term of birth control. Both implant systems also have similar tolerability profile. Jadena® is easier to insert and remove than Norplant®. Keywords: birth control, efficacy, implant

Serum Vascular Endothelial Growth Factor (VEGF) in DMPA Acceptors: Influence on Bleeding Occurrence Pratiwi, Ratih; Amran, Rizani; Said, Usman; Saleh, Irsan
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 1, January 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To analyze the relationship between levels of serum vascular endothelial growth factor (VEGF) and bleeding occurrence in depo medroxyprogesterone acetate (DMPA) acceptors. Method: We employed a cross‐sectional study on 70 DMPA acceptors with DMPA use of 3 to 6 months who presented for midwifery service in Palembang. Blood samples were obtained in order to assess levels of serum VEGF using ELISA (enzyme‐linked immunoabsorbent assay) method. Laboratory assessments were carried out in PRODIA laboratory in Jakarta. Result: We recruited 70 subjects into our study. After 3 to 6 months of using DMPA, as much as 26 subjects (37.1%) reported complaints of bleeding and 44 subjects (62.9%) reported no bleeding. The mean level of serum VEGF in DMPA acceptors with bleeding was 355 K 170 pg/ml, and 323 K 202 pg/ml in acceptors with no bleeding. We identified a significant association between duration of use and bleeding occurrence (p0.05). Conclusion: In our sample, we found an association between duration of DMPA use and presence of bleeding but VEGF levels was not found to be different in women experiencing abnormal uterine bleeding and those who did not. Keywords: bleeding, DMPA acceptor, serum VEGF

Serum Vascular Endothelial Growth Factor (VEGF) in DMPA Acceptors: Influence on Bleeding Occurrence Pratiwi, Ratih; Amran, Rizani; Said, Usman; Saleh, Irsan
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 1, January 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To analyze the relationship between levels of serum vascular endothelial growth factor (VEGF) and bleeding occurrence in depo medroxyprogesterone acetate (DMPA) acceptors. Method: We employed a cross‐sectional study on 70 DMPA acceptors with DMPA use of 3 to 6 months who presented for midwifery service in Palembang. Blood samples were obtained in order to assess levels of serum VEGF using ELISA (enzyme‐linked immunoabsorbent assay) method. Laboratory assessments were carried out in PRODIA laboratory in Jakarta. Result: We recruited 70 subjects into our study. After 3 to 6 months of using DMPA, as much as 26 subjects (37.1%) reported complaints of bleeding and 44 subjects (62.9%) reported no bleeding. The mean level of serum VEGF in DMPA acceptors with bleeding was 355 K 170 pg/ml, and 323 K 202 pg/ml in acceptors with no bleeding. We identified a significant association between duration of use and bleeding occurrence (p0.05). Conclusion: In our sample, we found an association between duration of DMPA use and presence of bleeding but VEGF levels was not found to be different in women experiencing abnormal uterine bleeding and those who did not. Keywords: bleeding, DMPA acceptor, serum VEGF

A Randomized FiveYear Comparative Study of Two LevonorgestrelReleasing Implant Systems: Norplant® Capsules and Jadena® Rods Affandi, Biran; Ridwan, Rusdi S; Hoesni, R Hasan M; Tandjung, Thamrin; Ichsan, TM; Amran, Rizani; Manan, Heriyadi; Gunardi, Eka R; Pramana, Noor; Hadiyono, Suryo; Widohariadi, Widohariadi; Farid, Retno B; Taher, Mardiah
Indonesian Journal of Obstetrics and Gynecology Volume 4, No. 4, October 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To provide a randomized comparison between Jadena® and Norplant® in terms of efficacy and acceptability among Indonesian women. Method: This study was a phase IV, open label, randomized, multicenter study throughout Indonesia. Subjects were Indonesian adult women who were randomized to receive Jadena® or Norplant® as their contraceptive method. The subjects were recruited from 6 large cities in Indonesia, such as Medan, Palembang, Jakarta, Semarang, Surabaya, and Makassar. Result: Of 600 subjects, 301 women getting to Jadena® and 299 women to Norplant® were enrolled between August 1998 and February 1999. The mean age was 29.8 (SD 5.3) years old, ranging from 18 to 40 years old. We did not find the pregnancy during the study. Non-pregnancy probability at the end of one year was similar between Jadena® (0.920 (SD 0.016)) and Norplant® users (0.916 (SD 0.084)). The continuation rates of Jadena® at one and three-year were 95.3% and 66.8%; whereas, the continuation rates of Norplant® was 94.3% at year-1 and 70.2% at year-3. Conclusion: The new two rod levonorgestrel subdermal system (Jadena®) showed similar efficacy with the old six capsule levonorgestrel subdermal system (Norplant®) in term of birth control. Both implant systems also have similar tolerability profile. Jadena® is easier to insert and remove than Norplant®. Keywords: birth control, efficacy, implant

Phytoestrogen Genistein and Black Cohosh and Marker of BMD in Menopausal Women Rizani Amran; Adenan Abadi; Theodorus Theodorus; Elvi Widiastuti
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 2 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (235.624 KB)

Background: In Indonesia, phytoestrogens can be found in the market as supplement to resolve climacteric complaint and osteoporosis. This phytoestrogens has not been proven scientifically to have benefit in overcoming the climacteric complaints and osteoporosis in menopausal women. Therefore, it is important to have clinical test searching data for knowing the increase of bone mineral density (BMD).Methods: The design was comparison clinical test in the form of “add on” with double blind in Hospital of Mohammad Hoesin Palembang started in August 2010 until February 2011 putting subjects into fitoestrogen and placebo groups randomly. T-score of spine and femur were measured using done densitometry before and after 6 months supplementation.Results: In the beginning of study, it was found that the average of spine T-score in the group of phytoestrogens was -1.455±0.264 after 6 months it increased to -1.295±0.223 with change 0.160±0.153 (p=0.001).Whereas in placebo group the average of spine T-score at the beginning of the study was -1.295±0.223 becoming -1.560±0.414 with decrease of -0.100±0.273 (p=0.118). Femur T-score level, of phytoestrogens group at the beginning of the study was -1.415±0.215, after 6 months it became -1.270±0.141 with change of 0.145±0.170 (p=0.001). In placebo group, the average of femur T-score was -1.475±0.202 becoming -1.595±0.421 with of decrease -0.120±0.33 (p=0.124). The status of spine and femur T-score BMD both in, phytoestrogens and placebo group was osteopenia at the beginning of the study. After 6 months, spine T-score in phytoestrogens group did not change, and in placebo group, 2 subject showed osteoporosis with spine T-score and femur T-score -2.7 and -2.75(±0.212).Conclusions: The administration of phytoestrogens is able to maintain bone mineral density and prevent the occurrence of osteoporosis.Keywords: Phytoestrogens, BMD, T-score, menopauseABSTRAK Fitoestrogen genistein dan black cohosh dan penanda BMD pada perempuan menopauseLatar belakang: Di Indonesia, fitoestrogen beredar di pasaran sebagai suplemen untuk mengatasi keluhan klimakterik dan osteoporosis. Fitoestrogen ini belum terbukti secara ilmiah bermanfaat untuk mengatasi keluhan klimakterik maupun osteoporosis pada perempuan menopause. Oleh karena itu uji klinik ini dilakukan untuk mencari data guna mengetahui meningkatnya gambaran BMD.Metode: Desain adalah uji klinik berpembanding dalam bentuk add on, secara tersamar ganda di RS Dr. Mohammad Hoesin Palembang bulan Agustus 2010 sampai dengan Februari 2011 pada subyek yang dibagi dalam kelompok fitoestrogen dan placebo secara acak. Variabel yang diukur adalah skor T tulang vertebra dan femur menggunakan bone densitometer sebelum dan setelah 6 bulan mendapat suplemen.Hasil: Pada awal penelitian rerata T-skor tulang belakang kelompok fitoestrogen -1,455±0,264 setelah 6 bulan menjadi -1,295±0,223 dengan perubahan 0,160 ± 0,153 (p=0,001). Sedangkan kelompok plasebo rerata T-skor tulang belakang pada awal penelitian -1,295±0,223 menjadi -1,560±0,414 dengan penurunan -0,100±0,273 (p=0,118). Pada kadar T-skor femur, di awal penelitian kelompok fitoestrogen -1,415±0,215 setelah 6 bulan menjadi -1,270±0,141 dengan besaran perubahan 0,145±0,170 (p=0,001). Pada kelompok plasebo rerata T-skor femur pada awal penelitian -1,475±0,202 menjadi -1,595±0,421 dengan perubahan -0,120±0,33 (p=0,124). Status BMD T-skor tulang belakang dan femur di awal penelitian, kelompok fitoestrogen dan kelompok plasebo adalah osteopeni. Setelah 6 bulan kemudian, pada kelompok fitoestrogen tidak terdapat perubahan status BMD sedangkan pada kelompok plasebo terdapat 2 orang yang densitas mineral tulangnya mengalami perubahan menjadi osteoporosis dengan rerata T-skor tulang belakang -2,70 dan T-skor femur -2,750 ± 0,212.Simpulan: Pemberian fitoestrogen dapat mempertahankan densitas mineral tulang dan mencegah terjadinya osteoporosis.

Effects of Metformin Therapy on Anti-Mullerian Hormone (AMH) Levels in Polycystic Ovary Syndrome Patients with Insulin Resistance at Palembang Fatimah Usman; Rizani Amran; Heriyadi Manan; Zulkarnain Zulkarnain
Majalah Kedokteran Sriwijaya Vol 52, No 1 (2020): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v52i1.11424

Anti-Mullerian Hormone is useful in examining folliculogenesis and ovarian abilities. Previous research found that follicular fluid and serum in PCOS women containing high AMH levels. As therapy in PCOS with insulin resistance, metformin, an insulin sensitizer agent can be given. The efficacy of metformin therapy in inducing ovulation is more due to the local action of metformin on the ovaries rather than the systemic improvements that result both metabolically and hormonally. We conducted this study to evaluate the levels of Anti-Mullerian Hormone (AMH) in women with polycystic ovarian syndrome (PCOS) with insulin resistance before and after metformin therapy. An analytic observational study with cross-sectional design. Seventy PCOS women with insulin resistance, taking metformin for 3 months, were enrolled in this study. Serum levels of AMH was assessed before and after treatment, and the difference between them was analyzed with student t-test. Diagnosis of PCOS is made based on Rotterdam criteria and insulin resistance by HOMA-IR calculation. This study was conducted at the Fertility and Reproductive Endocrinology Polyclinic of Dr. Mohammad Hoesin Palembang hospital and Imaya clinic. The mean age of PCOS patients with insulin resistance ranges from 25-30 years, with a mean age of 28.61±3.883. The mean AMH levels prior metformin therapy was 7.6957±0.6001 ng/ml; mean AMH after therapy was 7.5914±0.57678 ng/ml; and there are significant differences (p <0.001). The mean AMH levels in all patients were 0.10429. Based on body mass index (BMI), a total of 52 respondents (74.29%) met the criteria for obesity and 18 respondents (25.71%) nonobese. There is a relationship between AMH levels and the number of follicles (p <0.01), with an OR of 1.5. AMH levels decreased significantly after metformin therapy in PCOS patients with insulin resistance.

Hubungan Polycystic Ovary Syndrome(PCOS)dengan Infertilitas di Praktik Swasta Dokter ObstetriGinekologi Palembang Riska Mareta; Rizani Amran; Veny Larasati
Majalah Kedokteran Sriwijaya Vol 50, No 2 (2018): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v50i2.8552

Sindrom Ovarium Polikistik (SOPK) merupakan salah satu kelainan endokrin dan metabolik yang sering terjadi pada wanita usia reproduksi. SOPK merupakan kumpulan gejala dari amenorrhea, oligomenore, infertilitas, obesitas, hirsutisme, acne, alopesia, dan akantosis nigrikan. Dari seluruh perempuan usia reproduksi yang tersebar di dunia, sebanyak 4-18% diantaranya mengalami SOPK. SOPK menyebabkan 5-10% wanita usia reproduktif menjadi infertilitas. Oleh karena itu, penelitian ini dilakukan untuk mengetahui hubungan antara SOPK dan infertilitas.Penelitian menggunakan metode observasional analitik dengan desain potong lintang. Sampel diambil dari data sekunder di Praktik Pribadi Dr. dr. Rizani Amran, SpOG(K) periode Agustus 2014-Juli 2017. Teknik pengambilan sampel menggunakan metode konsekutif. Data di analisis menggunakan uji Kai-kuadrat.Dari 249 orang (79,6%) SOPK, 77,8% amenorrhea/oligomenorrhea, 92,2% obesitas, 99% hirsutisme dan 89,6% infertilitas. Uji Kai-kuadrat menunjukkan nilai p = 0,000 (p-value < 5%) dan nilai PR = 8,572.Terdapat hubungan yang sangat bermakna antara SOPK dan infertilitas.Orang yang mengalami SOPK berisiko 8,572 kali lebih besar untuk mengalami infertilitas dari pada orang yang tidak mengalami SOPK.

Abnormal Uterine Bleeding in Adolescent Kms Yusuf Effendi; Rizani Amran; Iskandar Zulqarnain; Heriyadi Manan; Adnan Abadi; Fatimah Usman; Awan Nurtjahyo; Cindy Kesty; Siti Chodijah; Selly Rizany
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 1 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v6i1.431

Abnormal uterine bleeding (AUB) is defined as the abnormal bleeding from the uterine corpus in term of duration, volume, frequency and/or regularity. This condition occurs in 37% of adolescents and may affect the quality of life and increased hospitalization. Etiology is divided into structural and non-structural causes, known as PALM-COEIN. The most common etiology in adolescents is anovulatory menstruation due to immature hypothalamus-hypophysis axis. Diagnostic evaluation should include investigation in the etiology of AUB, anemia signs, and hemodynamic status. Treatment of AUB consists of hormonal and non-hormonal therapy. Therapy in adolescent is given based on the severity of bleeding, grading of anemia, and hemodynamic stability. Follow-up is required after therapy. Understanding AUB in adolescents can help clinicians deliver appropriate and comprehensive treatment. This review was aimed to explain about definition, epidemiology, etiology, pathophysiology, diagnosis, and treatment of abnormal uterine bleeding in adolescent.

Serum Vascular Endothelial Growth Factor (VEGF) in DMPA Acceptors: Influence on Bleeding Occurrence Ratih Pratiwi; Rizani Amran; Usman Said; Irsan Saleh
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 1, January 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To analyze the relationship between levels of serum vascular endothelial growth factor (VEGF) and bleeding occurrence in depo medroxyprogesterone acetate (DMPA) acceptors. Method: We employed a crossâ€sectional study on 70 DMPA acceptors with DMPA use of 3 to 6 months who presented for midwifery service in Palembang. Blood samples were obtained in order to assess levels of serum VEGF using ELISA (enzymeâ€linked immunoabsorbent assay) method. Laboratory assessments were carried out in PRODIA laboratory in Jakarta. Result: We recruited 70 subjects into our study. After 3 to 6 months of using DMPA, as much as 26 subjects (37.1%) reported complaints of bleeding and 44 subjects (62.9%) reported no bleeding. The mean level of serum VEGF in DMPA acceptors with bleeding was 355 K 170 pg/ml, and 323 K 202 pg/ml in acceptors with no bleeding. We identified a significant association between duration of use and bleeding occurrence (p0.05). Conclusion: In our sample, we found an association between duration of DMPA use and presence of bleeding but VEGF levels was not found to be different in women experiencing abnormal uterine bleeding and those who did not. Keywords: bleeding, DMPA acceptor, serum VEGF

A Randomized FiveYear Comparative Study of Two LevonorgestrelReleasing Implant Systems: NorplantÂ® Capsules and JadenaÂ® Rods Biran Affandi; Rusdi S Ridwan; R Hasan M Hoesni; Thamrin Tandjung; TM Ichsan; Rizani Amran; Heriyadi Manan; Eka R Gunardi; Noor Pramana; Suryo Hadiyono; Widohariadi Widohariadi; Retno B Farid; Mardiah Taher
Indonesian Journal of Obstetrics and Gynecology Volume 4, No. 4, October 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To provide a randomized comparison between JadenaÂ® and NorplantÂ® in terms of efficacy and acceptability among Indonesian women. Method: This study was a phase IV, open label, randomized, multicenter study throughout Indonesia. Subjects were Indonesian adult women who were randomized to receive JadenaÂ® or NorplantÂ® as their contraceptive method. The subjects were recruited from 6 large cities in Indonesia, such as Medan, Palembang, Jakarta, Semarang, Surabaya, and Makassar. Result: Of 600 subjects, 301 women getting to JadenaÂ® and 299 women to NorplantÂ® were enrolled between August 1998 and February 1999. The mean age was 29.8 (SD 5.3) years old, ranging from 18 to 40 years old. We did not find the pregnancy during the study. Non-pregnancy probability at the end of one year was similar between JadenaÂ® (0.920 (SD 0.016)) and NorplantÂ® users (0.916 (SD 0.084)). The continuation rates of JadenaÂ® at one and three-year were 95.3% and 66.8%; whereas, the continuation rates of NorplantÂ® was 94.3% at year-1 and 70.2% at year-3. Conclusion: The new two rod levonorgestrel subdermal system (JadenaÂ®) showed similar efficacy with the old six capsule levonorgestrel subdermal system (NorplantÂ®) in term of birth control. Both implant systems also have similar tolerability profile. JadenaÂ® is easier to insert and remove than NorplantÂ®. Keywords: birth control, efficacy, implant

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