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Perbandingan Gabapentin 600 mg dengan 1.200 mg per Oral Preoperatif terhadap Nilai Visual Analogue Scale dan Pengurangan Kebutuhan Petidin Pascaoperasi pada Modifikasi Mastektomi Radikal Ardi Zulfariansyah; A. Muthalib Nawawi; Tatang Bisri
Jurnal Anestesi Perioperatif Vol 1, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Gabapentin mempunyai efek antihiperalgesia, antialodinia, dan antinosiseptif. Penelitian ini bertujuan untuk menilai efek gabapentin 600 mg dan 1.200 mg per oral preoperatif terhadap nilai visual analogue scale (VAS) dan pengurangan kebutuhan petidin pascaoperatif. Penelitian dilakukan secara uji acak terkontrol buta ganda terhadap 38 orang pasien di Rumah Sakit Dr. Hasan Sadikin Bandung pada Mei–September 2010. Pasien dibagi menjadi dua kelompok yaitu kelompok gabapentin 600 mg dan gabapentin 1.200 mg. Penilaian skala nyeri dilakukan dengan menggunakan nilai VAS. Data hasil penelitian dianalisis menggunakan Uji Mann-Whitney dengan tingkat kepercayaan 95% dan dianggap bermakna bila nilai p<0,05. Hasil penelitian didapatkan nilai VAS saat diam dan saat mobilisasi berbeda bermakna (p<0,05). Kelompok gabapentin 1.200 mg lebih sedikit diberikan analgetik petidin tambahan (10,5% vs 15,8%), tetapi perbedaan tersebut tidak bermakna (p=0,631). Simpulan penelitian ini adalah gabapentin 1.200 mg per oral preoperatif lebih baik bila dibandingkan dengan 600 mg dalam mengurangi nilai VAS pasca operatif pada operasi modifikasi radikal mastektomi, namun tidak mengurangi kebutuhan petidin.Kata kunci: Gabapentin 600 mg, Gabapentin 1.200 mg, visual analogue scale, kebutuhan petidin The Comparison between 600 mg and 1,200 mg Gabapentin per Oral Preoperatively on Visual Analog Scale and Reduction of Postoperative Pethidine Requirement on Modified Radical MastectomyAbstract Gabapentin is a GABA analog which has the effect of anti hyperalgesia, anti allodynia, and anti nociceptive. This research was conducted in order to assess the effect of 600mg and 1,200 mg gabapentin given preoperatively to assess visual analogue scale (VAS) score and reduction of pethidine requirement. The study was done by conducting a double blind randomized controlled trial on 38 patients, aged 18–65 years, with ASA physical status I–II. Patients were divided into two groups: 600 mg gabapentin and 1,200 mg gabapentin group. The quality of pain was assessed using VAS score. The results were statistically analyzed using Mann-Whitney Test with 95% confidence interval and considered significant if p value <0.05. From the results, the VAS values obtained at rest and during mobilization were significantly different (p<0.05). The 1,200 mg gabapentin group received less additional pethidine (10.5% vs 15.8%), although no significant difference was shown (p=0.631). The conclusion of this study is that administration of 1,200 mg gabapentin per oral pre operatively is better when compared to 600 mg in reducing post operative visual analog scale score in modified radical mastectomy. However, it do not reduce the need for analgesic significantly.Key words: 600 mg Gabapentin, 1.200 mg Gabapentin, post operative pethidine requirement, visual analog scale DOI: 10.15851/jap.v1n3.196
Efek Penambahan Deksametason 5 mg pada Bupivakain 0,5% terhadap Mula dan Lama Kerja Blokade Sensorik Anestesia Epidural untuk Operasi Ortopedi Ekstremitas Bawah - Irwan; Erwin Pradian; Tatang Bisri
Jurnal Anestesi Perioperatif Vol 3, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Operasi ortopedi ekstremitas bawah dengan anestesia regional epidural memiliki kelemahan yaitu mula kerja yang lama. Penelitian ini bertujuan melihat efek penambahan 5 mg deksametason pada bupivakain 0,5% terhadap mula kerja dan lama kerja blokade sensoris. Penelitian prospektif eksperimental menggunakan uji klinis acak buta ganda pada 32 pasien dengan American Society of Anesthesiologist (ASA) I–II yang menjalani operasi ortopedi ekstremitas bawah dengan anestesi epidural di RSUP Dr. Hasan Sadikin Bandung pada Februari–Mei 2014. Pengambilan sampel dilakukan secara consecutive sampling dan random blok permutasi. Kelompok I, deksametason 5 mg ditambahkan ke dalam bupivakain 0,5% 15 mL. Kelompok II, bupivakain 0,5% ditambah NaCl 0,9% 15 mL. Hasil penelitian diuji secara statistika menggunakan uji-t dan Uji Mann-Whitney. Hasil penelitian menunjukkan mula kerja blokade sensorik kelompok I tidak lebih cepat, yaitu 13,56 menit dibanding dengan kelompok II, yaitu 14,31 menit (p=0,27). Lama kerja blokade sensorik kelompok I lebih lama, yaitu 399,81 menit dibanding dengan kelompok II, yaitu 227,43 menit (p=0,00). Simpulan, penambahan deksametason 5 mg pada bupivakain 0,5% 15 mL tidak mempercepat mula kerja blokade sensorik tetapi memperpanjang lama kerja blokade sensorik bupivakain 0,5% yang diberikan secara epidural.Kata kunci: Anestesi epidural, blokade sensorik, bupivakain, deksametason, lama kerja, mula kerjaEffect of Dexamethasone 5 mg Addition to Bupivacaine 0.5% on Onset and Duration of Sensory Blockade in Epidural Anesthesia for Lower Extremity Orthopedic SurgeryLower extremity orthopedic surgery performed with regional epidural anesthesia was still have weakness which is long onset of time. This study was conducted to determine the onset time and duration time of sensory blockade epidural anesthesia  between the use of dexamethasone 5 mg addition to 0.5% bupivacaine for lower limb orthophedic surgery. The study was using randomized controlled blind method on 32 ASA I–II patients undergoing lower limb orthopedic surgery under epidural anesthesia. Consecutive sampling and random allocation of block of permutation groups was applied. In group I, dexamethasone 5 mg was added to bupivacaine 0.5% 15 mL while in group II NaCl 1 mL was added to bupivacaine 0.5% 15 mL. The results were statistically tested using t-test and Mann-Whitney test. It was shown that the onset time of sensory blockade was not significantly faster when dexamethasone was added in bupivacaine 0.5%, 13.56 minutes versus 14.31 minutes (p=0.27). The duration time of sensory blockade in dexamethasone in bupivacaine 0.5% group was longer 399.81 minutes, compared to the bupivacaine 0.5% group, 227.43 minutes (p=0.00). In conclusions, the addition of dexamethasone 5 mg to bupivacaine 0.5% 15 mL does not produced faster onset time. However, the duration sensory blockade time is longer than bupivacaine 0,5% 15 mL is usedKey words: Bupivacaine, dexamethasone, duration time, epidural anesthesia, onset, sensory blockade DOI: 10.15851/jap.v3n2.577
Perbandingan Kombinasi Bupivakain 0,5% Hiperbarik dan Fentanil dengan Bupivakain 0,5% Isobarik dan Fentanil terhadap Kejadian Hipotensi dan Tinggi Blokade Sensorik pada Seksio Sesarea dengan Anestesi Spinal Ahmado Okatria; Ezra Oktaliansah; Tatang Bisri
Jurnal Anestesi Perioperatif Vol 4, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Anestesi spinal mejadi teknik pilihan untuk seksio sesarea karena lebih aman dan efisien dibanding dengan anestesi umum. Anestesi spinal pada wanita hamil menyebabkan hipotensi lebih berat dan cepat. Hipotensi berhubungan dengan ketinggian blokade simpatis yang dipengaruhi oleh barisitas anestetik lokal. Tujuan penelitian ini adalah membandingkan kejadian hipotensi dengan tinggi blokade sensorik antara kombinasi bupivakain 0,5% hiperbarik 12,5 mg dan fentanil 25 µg dengan bupivakain 0,5% isobarik 12,5 mg-fentanil 25 µg pada anestesi spinal untuk seksio sesarea. Penelitian dilakukan di Central Operating Theatre (COT) Rumah Sakit Dr. Hasan Sadikin Bandung selama bulan April‒Mei 2015 dengan uji klinis acak tersamar ganda terhadap 40 pasien yang menjalani seksio sesarea dengan status fisik American Society of Anesthesiologist (ASA) II. Kejadian hipotensi dan tinggi blokade sensorik dinilai setelah pemberian anestesi spinal. Data penelitian dianalisis menggunakan uji-t, Mann-Whitney, dan chi-kuadrat. Hasil penelitian bermakna jika nilai p<0,05. Kejadian hipotensi antara kelompok hiperbarik dan isobarik adalah 75% vs 100% (p=0,017). Tinggi blokade sensorik rata-rata antara kedua kelompok di T6 vs T4 (p=0,000). Kejadian hipotensi dan blokade sensorik lebih tinggi pada kombinasi bupivakain 0,5% isobarik 12,5 mg dan fentanil 25 µg dibanding dengan bupivakain 0,5% hiperbarik 12,5 mg dan fentanil 25 µg.Kata kunci: Anestesi spinal, bupivakain hiperbarik, bupivakain isobarik, seksio sesareaComparison between Combination of Hyperbaric 0.5% Bupivacain with Fentanyl and 0.5% Isobaric Bupivacain with Fentanyl Use on Incidence of Hypotension and Sensoric Blockade Level in Caesarian Section with Spinal AnesthesiaSpinal anesthesia technic has been the technic of choice for caesarean section due to its safety and efficiency compared to general anesthesia. Spinal anesthesia in pregnancy causes hypotension in a heavier and more rapid manner. Hypotension is associated with the height of the sympathetic block influenced by the baricity of the local anesthetics. This study aimed to compare hypotension incidence and sensory blockade height between combination of 12.5 mg 0.5% hyperbaric bupivacaine with 25 µg fentanyl and 12.5 mg 0.5% isobaric bupivacaine with fentanyl 25 µg in spinal anesthesia for caesarean section. The study was performed at the central operating theatre (COT) of Dr. Hasan Sadikin General Hospital during April‒May 2015 using double blind randomized control trial method on 40 patients underwent caesarean section with American Society of Anesthesiologist (ASA) II physical status. The hypotension incidence and sensory blockade height were assessed after spinal anesthesia and measured by t-test, Mann Whitney, and Chi-square tests. Significancy was declared when p value <0.05. The hypotension incidence between the hyperbaric and isobaric groups were 75% vs. 100% (p value=0.017). The mean sensory blockade height was at T6 vs. T4 (p value=0.000). The hypotension incidence and sensory blockade are significantly higher in isobaric 12.5 mg 0.5% bupivacainewith 25 µg fentanyl compared to those in 12.5 mg hyperbaric 0.5% bupivacaine with fentanyl 25 µg.Key words: Caesarean section, hyperbaric bupivacaine, isobaric bupivacaine, spinal anesthesia  DOI: 10.15851/jap.v4n2.820
Perbandingan antara Sevofluran dan Enfluran terhadap Kontraksi Uterus, Jumlah Perdarahan, dan Skor APGAR pada Seksio Sesarea Elektif RR. Pramada Resvita; Ike Sri Redjeki; Tatang Bisri
Jurnal Anestesi Perioperatif Vol 3, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Anestetika volatil memiliki sifat fisikokimia yang berbeda-beda yang akan memberikan pengaruh berbeda juga terhadap kontraksi uterus,  jumlah perdarahan dan skor APGAR. Tujuan penelitian ini adalah menilai perbedaan pengaruh antara sevofluran dan enfluran terhadap kontraksi uterus, jumlah perdarahan, dan skor APGAR. Penelitian ini adalah randomized controlled trial (RCT) pada 36 pasien seksio sesarea elektif di Rumah Sakit Melinda pada Juni–Agustus 2011. Pasien dibagi dalam dua kelompok: kelompok I (sevofluran) dan kelompok II (enfluran). Analisis data hasil penelitian dilakukan dengan melakukan uji-t,  Fisher’s Exact Test, dan Uji Mann-Whitney. Hasil penelitian menunjukkan bahwa kontraksi uterus lebih baik pada kelompok sevofluran (p<0,05) dan jumlah perdarahan lebih sedikit pada kelompok sevofluran (p<0,05). Tidak didapatkan perbedaan yang signifikan untuk skor APGAR (p>0,05). Simpulan penelitian ini adalah kontraksi uterus pada seksio sesarea dengan sevofluran lebih baik dibandingkan dengan enfluran dan jumlah perdarahan lebih sedikit pada sevofluran. Skor APGAR pada kedua kelompok tidak menunjukkan perbedaan.Kata kunci: Enfluran, jumlah perdarahan, kontraksi uterus (LAS), seksio sesarea, sevofluran, skor APGARComparison between Sevoflurane and Enflurane Effects on Uterine Contraction, Amount of Bleeding, and APGAR Score in Elective Caesarean SectionAbstractDifferent volatile agents with different physicochemical properties affect uterine contraction, amount of bleeding, and APGAR score in different ways. The objective of this study was to evaluate the effects of different volatile agents, i.e., sevoflurane and enflurane, on  uterine contraction, amount of bleeding, and APGAR score. A randomized controlled trial (RCT) was conducted on 36 patients undergoing elective caesarean section. These patients were randomly divided into two groups, group I (sevoflurane) and group II (enflurane). The data were analyzed using t-test, Mann-Whitney, and fisher exact tests. The result of this study showed that there was a significant difference in the strength of uterine contraction among the sevoflurane group and the enflurane group (p<0.05) and also a significant difference in the amount of bleeding among the two groups (p<0.05), with better results seen ion the sevoflurane group. However, there was no significant difference found oin the APGAR score among the two groups. It is concluded in this study that sevoflurane gives better results in terms of uterine contraction with less bleeding compared to the enflurane group. No difference is found in the APGAR score in sevoflurane and enflurane groups.Key words: Amount of bleeding,  APGAR score, caesarean section, enflurane, sevoflurane, uterine contraction (LAS) DOI: 10.15851/jap.v3n1.381  
Multimodal Analgesic Effect on Proinflammatory and Anti-inflammatory Cytokines Serum Muhammad Ramli Ahmad; Tatang Bisri
International Journal of Integrated Health Sciences Vol 2, No 1 (2014)
Publisher : Faculty of Medicine Universitas Padjadjaran

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Objective: To investigate the effect of combination epidural bupivacaine and intravenous parecoxib analgesia on  immune response in patients who underwent open reduction and internal fixation of the lower limb under epidural anesthesia.  Methods: This research was conducted using the randomized, placebo-controlled double blind trial method on 52 patients who were randomly divided into 2 groups: the Parecoxib group which received 40 mg intravenous parecoxib for 30 minutes before incision and the control group which received an equal volume of 0.9% normal saline. Both groups received epidural anesthesia and postoperative epidural 0.125% bupivacaine analgesia continously. Venous blood samples were obtained before parecoxib administration, 2 and 24 hours after the surgery. The data were analyzed using Mann Whitney U and Independent t tests (p<0.05).     Results: There was a significant difference between the two groups (p<0.05) in IL-1β, IL-6, IL-10 levels and proinflammatory to anti-inflammatory ratio, 2 hours after surgery.    Conclusions: Multimodal analgesic combination of 40 mg IV parecoxib and 0.125% bupivacaine epidural analgesia have the effect to alter and stabilize the  systemic immune response.    Keywords: Cytokines, epidural analgesia, interleukins, immune response, parecoxib, tissue damage DOI: 10.15850/ijihs.v2n1.272
Gravida 7 para 4 abortus 2 (G7P4A2) for multiple repeat caesarean section: general or neuroaxial anesthesia Dewi Yulianti Bisri; Tatang Bisri
ACTA Medical Health Sciences Vol. 2 No. 1 (2023): ACTA Medical Health Sciences
Publisher : ACTA Medical Health Sciences

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A caesarean section (CS) is a surgical procedure that has several risks, such as uterine rupture, infection, bleeding, thrombosis, and damage to the bladder, ureters, or intestines. Compared to primary CS, multiple repeat caesarean sections (MRCS) are associated with additional risks, including placenta previa, abnormal placental invasion, difficulty in surgical dissection, longer surgeries, and greater amounts of bleeding. A woman, age 40 years, G7P4A2, gravida aterm, weight 64.4 kg, height 150 cm, Mallampati score 1, open mouth >3 cm, thyromental distance > 3 fingers, neck circumference 33 cm, former caesarean section 4 times, would have her caesarean section and sterilization at Melinda Woman Hospital Bandung-Indonesia. A caesarean section was performed under general anesthesia, induction with propofol, atracurium, and sevoflurane, and maintenance anesthesia with N2O/O2-sevoflurane. Induction-delivery time: 16 minutes, uterine incision 50 seconds, baby born with 1-minute Apgar score was 9 and 5-minute Apgar score was 10. Analgetic fentanyl is given after birth at a dose of 1.5 mcg/kgBw intravenously. There were no caesarean-section complications. Postoperatively, the patient was treated in the wards. Due to concerns about heavy bleeding, which would require massive transfusions, anesthesia was performed under general anesthesia due to the fact that massive transfusions make patient uncomfortable because of various complications of massive transfusion DOI : 10.35990/amhs.v2n1.p38-45 REFERENCE Cook JR, Jarvis S, Knight M, Dhanjal MK. Multiple repeat caesarean section in the UK: incidence and consequences to mother and child. A national, prospective, cohort study. BJOG. 2013;120(1):85–91. doi:10.1111/1471-0528.12010. [PubMed][Google Scholar] Rashid M, Rashid RS. Higher order repeat caesarean sections: how safe are five or more? 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Effect of antioxidants on kidney damage repair in - diabetes-induced animal: a literature study Astri Pradini; Dian Anggraeny; Tatang Bisri; Diana Akmalia
ACTA Medical Health Sciences Vol. 2 No. 1 (2023): ACTA Medical Health Sciences
Publisher : ACTA Medical Health Sciences

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Diabetes mellitus is a disease characterized by hyperglycemia. Chronic hyperglycemia indiabetes mellitus can cause various complications, one of which is diabetic nephropathy,which affects the kidney. Chronic hyperglycemia causes an increase in free radicals and adecrease in antioxidant activity resulting in oxidative stress conditions. This study aims to determine kidney damage caused by oxidative stress and the role of antioxidants in reducingthis damage through literature studies. The literature used comes from Google search results such as PubMed, Google Scholar, ResearchGate, and ScienceDirect. From the search results, ten journals meeting the inclusion and exclusion criteria were selected for review and comparison so that a conclusion could be drawn. The results of this literature study have demonstrated that biochemical parameters, such as increased levels of creatinine, urea, malondialdehyde (MDA), and decreased antioxidant enzymes, as well as kidney histological parameters, such as changes in the shape of tubules, glomeruli, and increased kidney expression, are indicators of kidney damage caused by oxidative stress. The mechanism of antioxidants in reducing kidney damage is through DNA cutting, binding to phenolic OH groups, down-regulation of the oxidase expression of nitrogen oxides 4 nicotinamide adenine dinucleotide phosphate (Nox4 NADPH), antioxidant enzyme systems, activation of the activated protein kinase pathway - silent mating type information regulation 2 homolog 1- peroxisome proliferator-activated receptor-γ coactivator 1α (AMPK-SirT1- PGC-1 α), protein glycation reactions, and inhibition of protein 53 (P53) so that erythroid nuclear factor 2-related factor 2 (Nrf2) can activate antioxidant gene transcription. 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Awake Craniotomy Can be Done Humanly? Tatang Bisri
Jurnal Komplikasi Anestesi Vol 1 No 1 (2013): Volume 1 Number 1 (2013)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v1i1.5533

Abstract

“Humanly” atau berperikemanusiaan, berarti dapatkah awake craniotomy (AC) dilakukan dengan penuh rasa kemanusiaan. Tindakan yang penuh rasa kemanusiaan saat pembedahan yang dilihat dari sudut pandang anestesi pada saat dilakukan operasi otak dengan teknik awake adalah pasien bebas dari rasa sakit, cemas dan tetap nyaman selama dilakukan tindakan pembedahan walaupun pasiennya tetap sadar. Anestesi untuk AC bervariasi dari anestesi lokal ke anestesi umum dengan pasien harus bangun intraoperatif selama dilakukan mapping language dan reseksi tumor. Awake craniotomy dengan menggunakan obat anestesi lokal dan sedasi termonitor untuk operasi tumor intrakranial yang mengenai eloquent cortex merupakan suatu teknik yang dapat diterima. Dengan teknik ini dapat dilakukan mapping intraoperatif yang menyebabkan dapat dilakukan reseksi tumor yang lebih radikal serta meminimalkan morbiditas dengan memelihara jaringan yang berfungsi. AC adalah suatu prosedur yang mengagumkan yang tidak bisa dipercaya pada saat pertama kali. Prosedur sama dengan kraniotomi standar, dengan satu perbedaan bahwa pasien bangun selama pemetaan korteks dan reseksi tumor, pasien mampu berbicara dan bergerak normal, akan tetapi pasien tidak bangun sepanjang pembedahan, bisa tidur dalam 1–2 jam pertama, namun tidak ada rasa nyeri selama bangun. Awake craniotomy mempunyai dua keuntungan dibandingkan dengan pembedahan biasa dengan anestesi umum yaitu 1) memberikan kesempatan mapping cortex dan subcortex untuk mengurangi morbiditas neurologis dan memaksimalkan luasnya operasi, 2) untuk menghindari morbiditas akibat anestesi umum dan lebih cepat keluar dari rumahsakit. Tidak ada penelitian randomized controll yang telah dilakukan untuk mendukung pernyataan tadi, akan tetapi, pendukung teknik ini yakin akan menguntungkan untuk pasien. Obat yang diberikan selama prosedur harus mampu memberikan level sedasi dan analgesia yang adekuat untuk pengangkatan tulang kepala, tapi harus tidak mempengaruhi testing fungsional dan elektrokortikografi.
Characterisctics, Clinical Features, And Management Of Fibroadenoma Mammae Patients At Dustira Hospital Cimahi Ris Kristiana; Salsha Regina Syakyra; Endah Hamidah; Endry Septiadi; Fitriardi Sejati; Tatang Bisri
Jurnal EduHealth Vol. 16 No. 01 (2025): Jurnal EduHealt, Edition January - March, 2025
Publisher : Sean Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Fibroadenoma mammae (FAM) is the most common benign breast tumor that occurs at the age of 14-35 years. About 10% of the female population has FAM. FAM manifests as solitary masses that are easily movable, well-defined, with a smooth surface. The aim of this study was to determine the characteristics, clinical features, and management of FAM patients at Dustira Hospital using secondary data from medical records. A total of 68 FAM patients were selected as samples during the period 2018-2023. The research variables consisted of the number of cases, age, body mass index(BMI), location, topography, size, quantity, and management of FAM. Univariate analysis was used in this study and the results were presented in narrative and tabular forms. The results of the study showed that the highest number of FAM cases occurred in 2018, reaching 28 (41.1%). Characteristics of FAM patients included 49 individuals (72%) in the 16-30 age group, 32 individuals (47%) with normal body mass index. Clinical features of FAM were found in 31 individuals (45.6%) on the right breast, 24 individuals (35.3%) in the upper medial quadrant, with a size of 3-5 cm in 24 individuals (35.3%), and 49 individuals ( 72.1%) limited solitary masses. Management included surgery in all 68 individuals (100%), with 67 individuals (98.5%) underwent excision, while 1 individual (1.5%) underwent incision. Age and BMI are suspected to play a role in FAM formation related to estrogen hypersensitivity and mutations in the mediator complex subunit 12 (MED12). Lesion size is influenced by estrogen exposure. Management of fibroadenoma depends on the patient's preferences and clinical conditions. Women at risk or suspecting breast masses are advised to perform self-breast examination (BSE) and efficiently consult with healthcare professionals.