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All Journal SAINS MEDIKA : JURNAL KEDOKTERAN DAN KESEHATAN BALI MEDICAL JOURNAL (BMJ) Medicina E-Jurnal Medika Udayana Indonesian Journal of Cancer The Indonesian Biomedical Journal Indonesian Journal of Obstetrics & Gynecology Science Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Batoboh : Jurnal Pengabdian Pada Masyarakat ISM (Intisari Sains Medis) : Jurnal Kedokteran Journal of Community Development Indonesian Journal of Perinatology Perwira Journal of Science and Engineering (PJSE) Indonesian Journal of Cancer Perwira Journal of Community Development (PJCD)

Nyoman Bayu Mahendra

Gynecologic Oncology Division, Obstetrics And Gynecology, Faculty Of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia

Author-ID : 241649

Agriculture, Biological Sciences & Forestry Arts Humanities Automotive Engineering Biochemistry, Genetics & Molecular Biology Civil Engineering, Building, Construction & Architecture Computer Science & IT Economics, Econometrics & Finance Education Electrical & Electronics Engineering Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Social Sciences Other

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Tingginya rasio neutrofil terhadap limfosit serum darah ibu sebagai faktor risiko persalinan preterm spontan Tjokorda Gde Agung Suwardewa; I Nyoman Bayu Mahendra; Anak Agung Gede Putra Wiradnyana; Made Bagus Dwi Aryana; I Gde Sastra Winata; I Wayan Megadhana; Daniel Hadinata Susanto
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Introduction: Preterm delivery is still a major problem in pregnancy and causes 70% of all perinatal deaths. The immaturity of the organ systems of preterm infants increases neonatal morbidity and mortality compared to term infants. The incidence of preterm delivery at Sanglah Hospital in 2015 was 285 cases out of 1198 births or 23.7%. Inflammation is thought to be the cause of 40% cases of preterm labor and as much as 70-80% of spontaneous preterm births has a significant relationship with the incidence of infection in the vagina and cervix. The physiological immune response to inflammation is characterized by an increase in the number of circulating neutrophils and a decrease in the number of lymphocytes. There is a controversy regarding the relationship between an increase of neutrophils to lymphocytes ratio in maternal serum and the threatened preterm delivery. This study aims to determine that a high neutrophils to lymphocytes ratio in maternal blood serum is a risk factor for spontaneous preterm delivery. Method: This research was an analytic case control study with 56 samples, and divided into two groups, 28 preterm delivery samples as a case group and 28 preterm pregnancy samples as a control group. This research was conducted at the Obstetric and Gynecology Outpatient clinic as well as the delivery room at Sanglah Hospital Denpasar in the period of November 2020 to April 2021. Result: Analysis results of this study found a statistically significant difference (p = 0.003) between the case and control groups. The group of patients with high maternal neutrophil to lymphocyte serum ratio had a chance of preterm labor 5.6 times higher compared to the group of patients with low maternal neutrophil to lymphocyte serum ratio (OR = 5.6; CI 95% = 1.74-18.42; p=0.003). Conclusion: The conclusion of this study is that the high maternal neutrophils to lymphocytes serum ratio is a risk factor for 5.6 times the occurrence of spontaneous preterm labor. Pendahuluan: Persalinan preterm masih menjadi masalah utama pada ibu hamil dan menyebabkan 70% dari seluruh kasus kematian perinatal. Imaturitas sistem organ tubuh bayi prematur meningkatkan morbiditas dan mortalitas neonatal dibandingkan dengan bayi lahir cukup bulan. Angka kejadian persalinan preterm di RSUP Sanglah pada tahun 2015 sebesar 285 kasus dari 1198 kelahiran atau sebesar 23,7%. Inflamasi diduga sebagai penyebab dari 40% kasus persalinan preterm dan sebanyak 70-80% persalinan preterm spontan mempunyai hubungan bermakna dengan kejadian infeksi pada vagina dan serviks. Respon imun fisiologis terhadap inflamasi ditandai oleh peningkatan jumlah neutrofil yang beredar dan penurunan jumlah limfosit. Terdapat kontroversi hubungan antara peningkatan rasio neutrofil terhadap limfosit serum darah ibu dan ancaman persalinan preterm, sehingga penelitian ini bertujuan untuk mengetahui bahwa tingginya rasio neutrofil terhadap limfosit serum darah ibu merupakan faktor risiko persalinan preterm spontan. Metode: Penelitian ini merupakan penelitian analitik dengan rancangan kasus kontrol dengan jumlah sampel sebanyak 56 sampel, dan dibagi menjadi dua kelompok, yaitu 28 sampel persalinan preterm sebagai kelompok kasus dan 28 sampel kehamilan preterm sebagai kelompok kontrol. Penelitian ini dilakukan di Poliklinik Obstetri dan Ginekologi serta kamar bersalin IGD RSUP Sanglah Denpasar periode November 2020 hingga April 2021. Hasil: Hasil analisis dari penelitian ini didapatkan perbedaan yang signifikan secara statistik (p = 0,003) antara kelompok kasus dan kontrol. Kelompok pasien dengan nilai rasio neutrofil terhadap limfosit serum darah ibu yang tinggi memiliki kemungkinan sebesar 5,6 kali mengalami persalinan preterm dibandingkan dengan kelompok pasien dengan rasio neutrofil terhadap limfosit serum darah ibu yang rendah (OR = 5,6, IK 95% = 1,74-18,42, p = 0,003). Simpulan: Simpulan dari penelitian ini adalah tingginya rasio neutrofil terhadap limfosit serum darah ibu merupakan faktor risiko 5,6 kali terjadinya persalinan preterm spontan.

Akurasi kadar serum Secretory Leukocyte Protease Inhibitor (SLPI) dalam menunjang diagnosis kanker ovarium: suatu uji diagnostik Putu Adi Sujana Putra; Ketut Suwiyoga; I Nyoman Gede Budiana; I Wayan Megadhana; I Nyoman Bayu Mahendra; I Made Darmayasa
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Background: Ovarian cancer is one of the most common malignant tumors found in reproductive organs in vitro. Secretory Leukocyte Protease Inhibitor (SLPI) protein is essential for the growth of ovarian cancer cells, a protein that maintains the survival of ovarian cancer cells, inhibits antiproliferative effects, and reverses the proapoptotic effect of elastase. This study aims to evaluate the role of SLPI in diagnosing ovarium cancer. Methods: The research was conducted at the Obstetrics and Gynecology Polyclinic, Sanglah Hospital, Denpasar and the Prodia Laboratory. Sampling of this study has been carried out by previous researchers in research on the accuracy of serum levels of insulin-like growth factor binding protein 2 in diagnosing ovarian cancer. The research sample (intended sample) was women aged 18 years and over with ovarian tumors who came to the Obstetrics and Gynecology Polyclinic, Sanglah Hospital, Denpasar. Data were analyzed using SPSS versi 22 for Windows. Results: The proportion of epithelial types was significantly higher in the ovarian cancer group. In ovarian cancer samples, the most samples were obtained at FIGO III Stage. Median CA125 levels, RMI scores, and SLPI levels were significantly higher in the group with ovarian cancer. The cut off value of serum SLPI used in this study was 54,000 pg/ml which was obtained from preliminary analysis on 26 training samples. Sensitivity: 78.3; specificity:66.7%; Positive predictive value: 78.3%; Negative predictive value: 66.7% Accuracy: 73.6%. Conclusion: In a diagnostic test study to assess the accuracy of SLPI serum in supporting the diagnosis of ovarian cancer, it was found that SLPI serum had good sensitivity, specificity, PPV, NPV, and accuracy values. Latar Belakang: Kanker ovarium merupakan salah satu tumor ganas yang paling sering ditemukan pada organ reproduksi secara in vitro. Protein Secretory Leukocyte Protease Inhibitor (SLPI) sangat esensial untuk pertumbuhan sel kanker ovarium, protein yang menjaga kelangsungan hidup sel kanker ovarium, inhibisi efek antiproliferatif, dan membalikkan efek proapoptosis dari elastase. Penelitian ini bertujuan untuk mengevaluasi peran SLPI dalam mendiagnosis kanker ovarium. Metode: Penelitian dilakukan di Poliklinik Kebidanan dan Penyakit Kandungan RSUP Sanglah Denpasar dan Laboratorium Prodia. Pengambilan sampel penelitian ini sudah dilakukan oleh peneliti sebelumnya pada penelitian tentang akurasi kadar serum insulin-like growth factor binding protein 2 dalam mendiagnosis kanker ovarium. Sampel penelitian (intended sample) adalah wanita berusia 18 tahun ke atas dengan tumor ovarium yang datang ke Poliklinik Kebidanan dan Penyakit Kandungan RSUP Sanglah Denpasar. Hasil: Proporsi tipe epitelial secara signifikan lebih banyak pada kelompok kanker ovarium. Pada sampel kanker ovarium, didapatkan sampel paling banyak pada Stadium FIGO III. Median kadar CA125, skor RMI, dan kadar SLPI secara signifikan lebih tinggi pada kelompok dengan kanker ovarium. Nilai cut off serum SLPI yang digunakan pada penelitian ini adalah 54.000 pg/ml yang didapatkan dari analisa pendahuluan pada 26 training sample Sensitivitas:78,3; spesifisitas:66,7%; Nilai prediksi positif: 78,3%; Nilai prediksi negatif: 66,7% Akurasi: 73,6%. Kesimpulan: Pada penelitian uji diagnostik untuk menilai akurasi serum SLPI dalam menunjang diagnosis kanker ovarium didapatkan bahwa serum SLPI memiliki nilai sensitivitas, spesifisitas, PPV, NPV, dan akurasi yang baik.

Rasio platelet-limfosit serum ibu pada kehamilan preterm dan kehamilan preterm dengan Ketuban Pecah Dini (KPD): suatu studi potong-lintang Tjokorda Gde Agung Suwardewa; Anak Agung Gede Putra Wiradnyana; Made Suyasa Jaya; I Nyoman Bayu Mahendra; Ryan Saktika Mulyana; Alfonso Anggriawan
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Background: Preterm Premature Rupture of Membranes (PPROM) is one of the obstetric problems that needs special attention, apart from the high prevalence, cases of PPROM also often cause neonatal morbidity and mortality. Inflammation is thought to be the cause of the incidence of PPROM and has a relationship with the incidence of ascending genital tract infection. The physiological immune response to inflammation is characterized by an increase in the number of circulating platelets and a decrease in the number of lymphocytes. This study aims to evaluate the high ratio of platelets to lymphocytes of maternal blood serum is a risk factor for the occurrence of preterm PROM. Methods: This study is a cross-sectional study with a sample size of 70 samples, and is divided into a risk group (preterm pregnancy with PROM) and a no-risk group (preterm pregnancy without PROM). This research was conducted in the Emergency Room maternity ward and Obstetrics and Gynecology outward patient at Sanglah Hospital Denpasar for the period December 2020 to May 2021. Data were analyzed using SPSS version 26 for Windows. Results: The results of the analysis of this study obtained a statistically significant difference (p = 0.000). The group with a high maternal blood serum platelet to lymphocyte ratio had a higher risk of developing preterm PROM compared to the group with a low maternal blood serum platelet to lymphocyte ratio (PR = 2.4, 95% CI = 1.60-3.69, p = 0.000). Conclusion: The conclusion of this study is the high maternal blood serum platelet to lymphocyte ratio is a risk factor for the occurrence of preterm PROM. Latar Belakang: Ketuban pecah dini (KPD) preterm merupakan salah satu masalah obstetri yang perlu mendapat perhatian khusus, selain karena prevalensi yang besar, kasus KPD preterm juga sering menyebabkan morbiditas dan mortalitas neonatus. Inflamasi diduga sebagai penyebab dari kejadian KPD preterm dan mempunyai hubungan dengan kejadian infeksi ascending traktus genital. Respon imun fisiologis terhadap inflamasi ditandai oleh peningkatan jumlah platelet yang beredar dan penurunan jumlah limfosit. Penelitian ini bertujuan untuk mengetahui bahwa tingginya rasio platelet terhadap limfosit serum darah ibu merupakan faktor risiko terjadinya KPD preterm. Metode: Penelitian ini merupakan penelitian cross-sectional dengan jumlah sampel sebanyak 70 sampel, dan terbagi menjadi kelompok berisiko (kehamilan preterm dengan KPD) dan kelompok tanpa risiko (kehamilan preterm tanpa KPD). Penelitian ini dilakukan di kamar bersalin IGD serta Poli Obstetri dan Ginekologi RSUP Sanglah Denpasar periode Desember 2020 hingga Mei 2021. Data dianalisis dengan SPSS versi 26 untuk Windows. Hasil: Hasil analisis dari penelitian ini didapatkan perbedaan yang bermakna secara statistik (p = 0,000). Kelompok dengan nilai rasio platelet terhadap limfosit serum darah ibu yang tinggi memiliki risiko mengalami kejadian KPD preterm dibandingkan dengan kelompok dengan rasio platelet terhadap limfosit serum darah ibu yang rendah (PR = 2,4, IK 95% = 1,60-3,69, p = 0,000). Kesimpulan: Simpulan dari penelitian ini adalah rasio platelet terhadap limfosit serum darah ibu yang tinggi merupakan faktor risiko terjadinya kejadian KPD preterm.

Karakteristik Pasien Kanker Serviks yang Menjalani Radikal Histerektomi dan Limfadenektomi Pelvik Bilateral di RSUP Sanglah Tahun 2018-2019 Kirana, Ni Wayan Prabasiwi; Mahendra, I Nyoman Bayu; Suwardewa, Tjokorda Gde Agung; Winata, I Gde Sastra
E-Jurnal Medika Udayana Vol 12 No 1 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i01.P16

Cervical cancer is an over or uncontrolled cell growth in the cervix, mainly caused by infection with HPV types 16 and 18. Some prognostic and predictive factors already established to determine the future therapeutic outcomes. Common treatments for early stage cervical cancer are radical hysterectomy and pelvic lymphadenectomy. This study aims to know the characteristic description of cervical cancer patients who had undergone radical hysterectomy and bilateral pelvic lymphadenectomy in Sanglah Hospital from 2018-2019. Samples were chosen from a list of inclusion and exclusion criteria. Data analysis was conducted using the software SPSS ver. 26 to obtain the characteristics of the cervical cancer case that had radical hysterectomy and bilateral pelvic lymphadenectomy based on age, parity, tumor size, clinical stage, histopathological profile which includes histopathological type, degree of differentiation, LVSI, incision margin, parametrial invasion, and pelvic lymph node metastasis. Result shows that cervical cancer patients that had radical hysterectomy and bilateral pelvic lymphadenectomy in Sanglah Hospital, Denpasar, Bali from 2018-2019 are 50.9% from the age group 46-55 years old, 69.8% with multiparity (2-4 children), 69.8% were found with tumor <4cm, and 35.8% were found with stage IIB cancer. The most common histopathological type was squamous cell carcinoma (47.2%). Vaginal incision margins and parametrial invasion were generally negative, 73.6% and 86.8%. Pelvic lymph node metastases were also mostly negative (77.4%). Most of the data on the degree of differentiation and LVSI were not listed (92.6% and 50.9%). There was no significant relationship between age, parity, tumor size, clinical stage, histopathological type, and pelvic lymph node metastases.

DESCRIPTION OF PREGNANT WOMEN WITH PREECLAMPSIA AT PROF. DR. I. G. N. G. NGOERAH HOSPITAL IN 2022 Pujawan, I Gede Agus; Wijaya Surya, I Gede Ngurah Harry; Mahendra, I Nyoman Bayu
E-Jurnal Medika Udayana Vol 13 No 6 (2024): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2024.V13.i06.P12

Preeklampsia adalah kelainan khusus kehamilan yang melibatkan difungsi endotel dan vasospasme yang biasanya terjadi setelah usia kehamilan 20 minggu hingga dapat muncul 4-6 minggu pascapersalinan yang secara klinis ditentukan oleh hipertensi dan proteinuria onset baru. Penelitian ini dilakukan untuk mengetahui gambaran ibu hamil dengan preeklampsia di RSUP Prof. Dr. I. G. N. G Ngoerah pada tahun 2022. Penelitian ini merupakan penelitian deskriptif dilakukan pada tahun 2023 dengan data sekunder berupa rekam medis pasien preeklampsia sebanyak 141 sampel yang diambil secara total sampling yang memenuhi kriteria inklusi dan ekslusi. Analisis data menggunakan univariat dengan tabel distribusi frekuensi. Hasil penelitian menunjukkan gambaran ibu hamil dengan preeklampsia di di RSUP Prof. Dr. I. G. N. G Ngoerah tahun 2022 mayoritas dengan umur ibu 26-30 tahun (33,3%), tingkat pendidikan hinggan SMA (48,9%), berprofesi sebagai ibu rumah tangga (61%), paritas 0 (31,9%), melakukan ANC (96,5%), jarak antarkehamilan < 2 tahun (27,7%), mengalami kelebihan berat badan (44%), tidak memiliki penyakit kronis (83,7%) dan tidak menggunakan kontrasepsi hormonal (69,5%). Kejadian preeklampsia mayoritas terjadi pada usia reproduksi yang sehat, maka diharapkann tenaga kesehatan dapat melakukan deteksi sedini mungkin,dapat melakukan pencegahan serta pengobatan. Kata kunci : Preeklampsia

EFEKTIVITAS JUS BUAH SEBAGAI TERAPI KOMPLEMENTER TERHADAP TEKANAN DARAH PASIEN HIPERTENSI : A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS Mahendra, Bayu; Surudarma, I Wayan; Wihandani, Desak Made; Ruma, I Made Winarsa
E-Jurnal Medika Udayana Vol 11 No 9 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i9.P17

Hypertension treatment can be helped through complementary therapies, one of which is fruit juices. This study aimed to systematically review the evidence from various study regarding the effect of fruit juices on blood pressure in hypertensive patients and the types of fruit juices that are proven to be effective in reducing hypertension.This study is systematic review. Literature searching was conducted in four electronic databases, namely CINAHL, EMBASE, Pubmed, and Sciencedirect with the phrase fruit juices AND (hypertension OR blood pressure). Studies obtained from searching will be selected based on a screening title and abstract, eligibility criteria, and assesment risk of bias. The results of the study obtained 21 final studies with RCT research designs that passed the screening with complete eligibility criteria. However, the studies with valid results only amounted to 8 studies. These data show that as many as 5 studies prove fruit juices can reduce blood pressure in hypertensive patients and 3 other studies have stated the opposite. Thus, it can be concluded that there is strong evidence that fruit juices has a significant effect on reducing blood pressure in hypertensive patients. Fruit juices that have been shown to be effective are orange juice and queen garnet plum juice

Risk factors and characteristics of cervical cancer patients under 40 years old at Prof Dr I.G.N.G. Ngoerah Hospital Denpasar, Bali from January until December 2022 I Nyoman Gede Budiana; I Nyoman Bayu Mahendra; I Gde Sastra Winata; Kade Yudi Saspriyana; Kevin Agastya Duarsa; Pande Made Suwanpramana; Rayvany Uil; Dewi, Putu Pradnya Paramitha; Made Yudha Ganesa Wikantyas Widia; Eric Gradiyanto Ongko; I Gede Indra Kumara; Charles Richard Thene; Johan Qalaba; Made Ayu Prabawaty Indraswari; Ida Bagus Arjuna; Putu Harrista Indra Pramana; Ernest T. B. Sianturi
Indonesian Journal of Perinatology Vol. 4 No. 2 (2023): Available online : 1 December 2023
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v4i2.33

Background: Cervical cancer is the main cause of death for women worldwide. 500.000 new cases and 250.000 deaths are reported each year. In Indonesia, women as young as 25 are being diagnosed with this disease. The study will be conducted at Prof.Dr.I.G.N.G Ngoerah Hospital from January to December 2022 to analyze cervical cancer patients under 40. This study aimed to see the profile and the distribution of 40 year-old women with cervical cancer at our hospital. Methods: This descriptive study was conducted using medical records that were centered around female patients who were below 40 years of age and had been diagnosed with cervical cancer in Prof.Dr.I.G.N.G Ngoerah hospital in January - December 2022. Purposive sampling was done, and the samples were selected according to the inclusion criteria. The resulting data was presented in a table format. Results: Fifty-one cervical cancer patients aged under 40 years were included, with most of the age group being 30 – 39 years (88.2%). Twenty-eight patients (54.9%) were in the two-to-three parity group. The most dominant stage of cervical cancer is stage IIIB, with a total of 20 people (39.2%). Non-keratinizing squamous cell carcinoma (NKSCC) was the most common histopathological appearance (64.7%). Conclusions: The study found that cervical cancer commonly affects those between 30-39 years old, particularly in the form of NKSCC. Many patients are diagnosed in advanced stages of the disease. Early screening, education, and vaccination programs are crucial in preventing cervical cancer.

Characteristic of Cervical Cancer in Reproductive Woman (Under 40 years old) at Prof. I.G.N.G. Ngoerah Denpasar Bali from January - December 2023 Suwiyoga, Ketut Suwiyoga; Budiana, i Nyoman Gede Budiana; Mahendra, I Nyoman Bayu; Winata, I Gde Sastra Winata; Saspriyana, Kade Yudi Saspriyana; Prayudi, Pande Kadek Aditya Prayudi; Ongko, Eric Gradiyanto Ongko; Hitasari, I Gusti Ayu Made Putri; Septiani, Winty Septiani; Mardana, I Wayan Rivandi Pradiyadnya Mardana; Ronaldo, Fransiscus Ronaldo; Yoga, I Putu Bagus Mulyana Yoga
Indonesian Journal of Perinatology Vol. 5 No. 2 (2024): (Available online: 1 December 2024)
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v5i2.53

Background: Cervical cancer caused 275,000 deaths globally, with the mortality rate up to 52%. In the past 30 years, the percentage of young women affected by cervical cancer has increased, ranging from 10% to 40%. This study aims to describe the case of cervical cancer in reproductive women in Prof Dr. I.G.N.G Ngoerah General Hospital. Method: This is a cross-sectional retrospective descriptive study involving all cases of cervical cancer diagnosed from January to December 2023 in Prof Dr. I.G.N.G Ngoerah General Hospital. Prof Dr. I.G.N.G Ngoerah General Hospital. We included all cases of cervical cancer proven by histopathology or ultrasound reports. Data were tabulated in the table and analyzed using SPSS version 24.0. Result: We involved 61 patients in this study, with the mean age of participants was 33.91± 4.98. Most patients had two children (45.16%). Patients predominantly came with stage IIB (33.87%). Tumor size was varied, with ≤4 cm being more dominant (67.74%). Chemoradiotherapy was preferred for the management of cervical cancer (37.10%) Conclusion: The characteristics of patients with cervical cancer were varied compared to the literature. Multifactorial risk factors of this disease could explain these. The management should be tailored to the clinical condition of the patient's guidance under the available consensus.

Prognostic significance of tumor angiogenesis markers in advanced cervical cancer undergoing chemotherapy Mahendra, I Nyoman Bayu; Winata, I Gde Sastra; Setiawan, William Alexander; Putra, Ida Bagus Agung Widnyana; Darmayasa, Putu Bagus
Sains Medika: Jurnal Kedokteran dan Kesehatan Vol 15, No 2 (2024): December 2024
Publisher : Faculty of Medicine, Universitas Islam Sultan Agung (UNISSULA), Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30659/sainsmed.v15i2.28943

Cervical cancer is the second leading cause of cancer-related deaths among women worldwide. Despite advancements in screening programs and vaccination efforts, a significant proportion of patients present with advanced-stage disease, characterized by severe manifestations and a poor prognosis. Clinical evidence highlights substantial variability in the sensitivity of chemotherapy regimens among cervical cancer patients, often resulting in suboptimal therapeutic outcomes and increased risk of complications. This underscores the need for reliable molecular markers to predict prognosis and optimize therapy. Angiogenesis plays a pivotal role in the development and progression of solid tumors, including cervical cancer. Key tumor angiogenesis markers, such as vascular endothelial growth factor (VEGF) and its receptor (VEGFR), are critical in driving tumor progression in advanced cervical cancer. Studies have demonstrated significant correlations between VEGF levels and important prognostic parameters, including tumor size, metastasis, and chemotherapy response. Consequently, tumor angiogenesis markers like VEGF and VEGFR hold potential as valuable predictive tools to guide the management of advanced cervical cancer, particularly in patients undergoing chemotherapy.

Retrograde Hysterectomy Approaches in Difficult Gynaecology Surgery I Gde Sastra Winata; Ongko, Eric Gradiyanto; I Nyoman Gede Budiana; I Nyoman Bayu Mahendra; Kade Yudi Saspriyana; Pande Kadek Aditya Prayudi; Arlando Martino Anapaku; Florencia
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.v6i1.70

Hysterectomy remains one of the most frequently performed gynecological surgeries worldwide. While extra-fascial hysterectomy is the standard abdominal approach, complex cases involving large fibroids, severe endometriosis, adhesions, or malignancy often require alternative techniques such as the Aldridge method or retrograde hysterectomy. These challenging situations are associated with distorted pelvic anatomy, fibrosis, and adhesions, increasing the risk of complications, including injury to adjacent organs. This article reviews strategies and operative steps in managing complex abdominal hysterectomies, with emphasis on retrograde hysterectomy as a valuable approach when the cervicovaginal junction cannot be clearly identified or when extensive adhesions are present. The surgical technique is described step by step, supported by imaging and intraoperative findings, and highlights methods such as hydrodissection and careful dissection around critical structures to minimize morbidity. Preoperative imaging, intraoperative decision-making, and technical modifications are emphasized as key factors for optimizing patient outcomes. Although this study provides a detailed description of techniques under challenging hysterectomies, its limitation lies in the reliance on schematic illustrations rather than comprehensive intraoperative photographic documentation.

Co-Authors Abi Rafdi Azizi Aji Priambodo Alfonso Anggriawan Anak Agung Gede Putra Wiradnyana Arlando Martino Anapaku Aryana, Made Bagus Dwi Bay, Godefridus Paulo Budiana, i Nyoman Gede Budiana Budiana, Nyoman Gede Charles Richard Thene Daniel Hadinata Susanto Danny Aguswahyudi Darmayasa, Putu Bagus Deni Saputra Desak Made Wihandani Dewi, Putu Pradnya Paramitha Dwija, Ida Bagus Nyoman Putra Endang Sri Widiyanti Eric Gradiyanto Ongko Ernantje Hendrik Ernest T. B. Sianturi FLORENCIA Hanny Aditanzil Hanny Aditanzil Hitasari, I Gusti Ayu Made Putri I Gde Sastra Winata I Gede Indra Kumara I Gede Mega Putra I Gede Ngurah Harry Wijaya Surya I Gusti Putu Mayun Mayura I Ketut Surya Negara I Ketut Suwiyoga I Made Darmayasa I Nyoman Gede Budiana I Wayan Megadhana IB Putra Adnyana Ida Bagus Arjuna Ida Bagus Gde Fajar Manuaba Jaqueline Sudiman Johan Qalaba JOHANA SENSY LENI MANNA KADE YUDI SASPRIYANA Kade Yudi Saspriyana Kevin Agastya Duarsa Kirana, Ni Wayan Prabasiwi Kolobani, Matias Kurniasih Zaitun Kusuma, A.A.N Jaya Lingga Arti Saputra, Lingga Arti Luh Putu Iin Indrayani Maker Made Ayu Prabawaty Indraswari Made Bagus Dwi Aryana Made Suyasa Jaya Made Yudha Ganesa Wikantyas Widia MANNA, JOHANA SENSY LENI Mardana, I Wayan Rivandi Pradiyadnya Mardana Marta, Kadek Fajar Ngakan Ketut Darmawan Ni Kadek Ari Chintya Vedantari Ni Kadek Deby Cindra Dewi Ni Komang Vina Indriyani Ni Putu Pramana Saras Utami Ongko, Eric Gradiyanto Ongko, Eric Gradiyanto Ongko Pande Kadek Aditya Prayudi Pande Made Suwanpramana Prayudi, Pande Kadek Aditya Prayudi, Pande Kadek Aditya Prayudi Pujawan, I Gede Agus Putra, Ida Bagus Agung Widnyana Putu Adi Sujana Putra Putu Doster Mahayasa Putu Harrista Indra Pramana Putu Raka Widhiarta Putu Srinata Dampati Rayvany Uil Riyanto, Ari Budi Riza Firman Satria Ronaldo, Fransiscus Ronaldo Ruma, I Made Winarsa Ryan Saktika Mulyana Saspriyana, Kade Yudi Saspriyana Septiani, Winty Septiani Sulaeman, Maman Suprapto Suprapto Surudarma, I Wayan Surya, I Gede Ngurah Harry Wijaya Surya, Wirma Suwarni Suwarni Suwiyoga, Ketut Suwiyoga Suyatno, Sugeng Syaiful Anwar, Agus Setiadi, Suwali, Tasia Irma Endriani Tjokorda Gde Agung Suwardewa Tjokorda Istri Putri Adhyasari Wulandari Wijaya Surya, I Gede Ngurah Harry William Alexander Setiawan Winata, I Gde Sastra Winata Yoga, I Putu Bagus Mulyana Yoga

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Abstract

Abstract

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