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All Journal Kertha Negara : Journal Ilmu Hukum Medicina Jurnal BETA (Biosistem dan Teknik Pertanian) E-Journal Obstetric & Gynecology Udayana The Indonesian Biomedical Journal JUTIK : Jurnal Teknologi Informasi dan Komputer Indonesian Journal of Obstetrics & Gynecology Science Jurnal Kesehatan Reproduksi Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) ISM (Intisari Sains Medis) : Jurnal Kedokteran Andalas obstetrics and gynecology journal PAEDAGOGY : Jurnal Ilmu Pendidikan dan Psikologi International Journal of Social Service and Research Indonesian Journal of Perinatology HEALTHY: Jurnal Inovasi Riset Ilmu Kesehatan Majalah Ilmiah Widyacakra Jurnal Pendidikan DEIKSIS Indonesian Research Journal on Education Seminar Ilmiah Nasional Teknologi, Sains, dan Sosial Humaniora (SINTESA) Seminar Nasional Aplikasi Iptek (SINAPTEK) JAKADARA: JURNAL EKONOMIKA, BISNIS, DAN HUMANIORA Finger : Jurnal Ilmiah Teknologi Pendidikan Paradharma: Jurnal Aplikasi IPTEK MEDIA EDUKASI: JURNAL ILMU PENDIDIKAN

I Made Darmayasa

Departemen Obstetri Dan Ginekologi, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia

Author-ID : 250183

Religion Agriculture, Biological Sciences & Forestry Arts Humanities Biochemistry, Genetics & Molecular Biology Chemistry Computer Science & IT Control & Systems Engineering Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Energy Engineering Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Library & Information Science Materials Science & Nanotechnology Mathematics Medicine & Pharmacology Nursing Physics Public Health Social Sciences Other

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Ekspresi Enzim 1 Alfa-Hidroksilase Plasenta yang Rendah sebagai Faktor Risiko Terjadinya Preeklamsia Berat Florencia Desiree; I Wayan Artana Putra; I Wayan Megadhana; Anak Agung Ngurah Anantasika; Made Darmayasa; I Gde Sastra Winata
Indonesian Journal of Obstetrics & Gynecology Science Volume 5 Nomor 2 September 2022
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v5n2.399

Abstrak Tujuan: Untuk mengetahui ekspresi enzim 1-alfa-hidroksilase (CYP27B1) pada plasenta yang rendah sebagai faktor risiko terjadinya preeklamsia (PE) berat.Metode: Penelitian ini merupakan studi kasus-kontrol yang tak berpasangan, dengan total sampel 44 kasus dan kontrol. Sampel berupa plasenta yang diproses secara imunohistokimia, untuk melihat ekspresi enzim berdasarkan histoscore kumulatif (H-score) sebagai ekspresi rendah (H-score <200) atau ekspresi tinggi (H-score >200). Regresi logistik ganda digunakan untuk memperkirakan rasio odds yang disesuaikan (OR) dengan interval kepercayaan 95% (95% CI).Hasil: Ekspresi enzim 1alfa-hidroksilase plasenta yang rendah merupakan faktor risiko terjadinya PE berat sebesar sembilan kali lebih tinggi dibandingkan dengan ekspresi enzim 1-alfa-hidroksilase yang tinggi pada plasenta (OR 9,148; IK05% 2,072-40,386, p=0,002).Kesimpulan: Ekspresi rendah 1alfa-hidroksilase plasenta meningkatkan risiko terjadinya PE berat.Low Expression of 1 Alpha-Hydroxylase Enzyme in The Placenta as Arisk Factor for Preeclampsia with Severe FeaturesAbstractObjective: This study aims to determine the low expression of the 1-alpha-hydroxylase (CYP27B1) enzyme in the placenta as a risk factor for severe preeclampsia (PE).Methods: This study is an unpaired case-control study, with a total sample of 44 cases and controls. Samples were placentas that were immunohistochemically processed, to see enzyme expression based on the cumulative histoscore (H-score) as low expression (H-score <200) or high expression (H-score >200). Multiple logistic regression was used to estimate the adjusted odds ratio (OR) and 95% confidence interval (95% CI).Results: Low placental 1-alpha-hydroxylase expression was a risk factor for severe PE which was nine times higher than placental 1-alpha-hydroxylase expression (OR 9,148; 05% CI 2.072-40,386, p=0.002).Conclusions: Low placental 1alpha-hydroxylase expression increases the risk of severe PE.Key words: 1aplha-hydroxylase, expression, placenta, risk factor, severe preeclampsia

Sexual Abuse Disertai Kehamilan Tidak Direncanakan atau Dikehendaki pada Remaja dengan Intellectual Disability: Sebuah Laporan Kasus I Made Darmayasa; Tri Oktin Windha Daniaty; AA Sri Wahyuni
JURNAL KESEHATAN REPRODUKSI Vol 9, No 2 (2022)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.73875

AbstractBackground: Intellectual Disability in adolescents is prone to physical, mental, and sexual violence. Intellectual and adaptive disabilities make adolescents with intellectual disabilities unable to avoid environmental behavior including sexual abuse. Methods: A case report of a 12-year-old teenager with an Intellectual Disability who became pregnant as a result of sexual abuse by an unknown person. On the way, she had an abortion. Results: On examination, it was found that a 12-year-old teenager with mild mental retardation, without education, came from an incomplete family with very poor socioeconomic status. The diagnosis was confirmed by a multiaxial approach and concluded that adolescents with mild mental retardation have significant behavioral impairment and require attention or therapy (F70.1). Patients are also submissive and quiet with ego defense mechanisms that regression, and have problems with mental and intellectual development. Multidisciplinary management was carried out involving the social and medical departments.Summary: Patients with Intellectual Disabilities, especially adolescents, require special attention and a multidisciplinary, and comprehensive approach, starting from prevention, as well as in carrying out treatment.

Risk factors of preeclampsia and eclampsia in Sanglah General Hospital from March 2016 to March 2017 Ng Teng Fung Vincent; I Made Darmayasa; Anom Suardika
Intisari Sains Medis Vol. 9 No. 2 (2018): (Available online: 1 August 2018)
Publisher : DiscoverSys Inc.

Background: Preeclampsia and eclampsia have been increasing at an alarming rate. It is a challenging task for doctors and pregnant mothers. Preeclampsia defined as new onset of hypertension (â‰¥140mmHg systolic or â‰¥90mm Hg diastolic on at least two occasions 6 hours apart) and proteinuria (at least 1+ on dipstick or â‰¥300mg in a 24-hour urine collection) after 20 weeks of gestation. Eclampsia defined as neurologic involvement in the form of generalized tonic-clonic convulsions in women with preeclampsia is termed eclampsia if the seizures cannot be attributed to any other cause such as epilepsy, cerebral infection, tumor or ruptured aneurysm. Aim: This study aims to find the association of risk factors for preeclampsia and eclampsia. The risk factors for preeclampsia and eclampsia are obesity, primigravida, multiple pregnancies, diabetes, pre-existing hypertension, family history, expecting motherâ€™s age, nutritional status, and socioeconomic status. The study was carried out by using descriptive research and data were collected from medical records in Sanglah hospital which has 140 cases. Results: The results for preeclampsia are highest in expecting the age of 20-35 years old, primigravida women with gestational age > 37 weeks, overweight and overnourished women, a middle socioeconomic status and also without risk factors. The results for eclampsia are dominant in expecting age of 20-35 years old, primigravida women with gestational age > 37 weeks, women with middle socioeconomic status and majority without risk factors, and women who are overweight and overnourished. Conclusion: Preeclampsia and eclampsia cases are highest in expecting age of 20-35 years old, primigravida women with gestational age >37 weeks, overweight and overnourished women, majority women without risk factors and from middle socioeconomic status.

Faktor determinan kematian ibu di RSUP Sanglah Denpasar tahun 2016 Rela Hamdanillah; Anom Suardika; Made Darmayasa; Ida Bagus Gde Fajar Manuaba
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Maternal mortality is the death of women during pregnancy or within 42 days of delivery, whether associated with pregnancy or complications exacerbated by pregnancy and not related to incidental causes. Maternal mortality is a critical indicator in assessing the level of wellbeing and public health status. The risk of maternal death is divided into three such as remote determinants, intermediate determinants, and acute clinical determinants.Aim: This study aims to determine the determinant factors as a role player in maternal mortality at Sanglah Hospital Denpasar in 2016.Method: This research is cross-sectional descriptive research conducted at RSUP Sanglah Denpasar. The sample of the study was all mothers died at Sanglah Hospital during the year 2016. The data obtained in the form of patient medical record data. Data were analyzed by descriptive methods.Result and Conclusion: The maternal mortality caused by the remoted determinant factors which were the highest in the maternal group with 9-12 years of education (77.3%) and the working mother group (54.5%). On the intermediate determinant, the highest is at age 20-35 years (81.8%), with parity 2-3 (63.6%), 2-10 year of gestational distance (54.5%), the most top obstetric factors are preeclampsia/eclampsia (27.2%), but the nonobstetric cause is the leading cause of maternal mortality. Kematian ibu adalah kematian wanita selama masa kehamilan atau dalam kurun waktu 42 hari setelah melahirkan, baik yang berhubungan dengan kehamilan maupun komplikasi yang diperburuk oleh masa kehamilan, serta tidak berhubungan dengan penyebab incidental. Angka kematian ibu merupakan indikator penting dalam menilai tingkat kesejahteraan dan status kesehatan masyarakat. Faktor yang berkontribusi terhadap kematian ibu secara garis besar dapat kelompokkan menjadi penyebab obstetrik dan penyebab non obstetrik. Menurut McCarthy dan Maine, risiko kematian ibu dibagi menjadi 3 yaitu, determinan jauh, determinan antara dan determinan dekat.Tujuan: Untuk mengetahui faktor-faktor determinan yang berperan dalam kematian ibu di RSUP Sanglah Denpasar tahun 2016.Metode: Penelitian ini merupakan penelitian deskriptif cross-sectional yang dilakukan di RSUP Sanglah Denpasar. Sampel penelitian adalah semua ibu meninggal di RSUP Sanglah selama tahun 2016. Data yang diperoleh berupa data rekam medis pasien, kemudian dianalisis secara deskriptif.Hasil dan Kesimpulan: Kematian ibu yang disebabkan karena faktor determinan yang tertinggi yaitu pada kelompok ibu dengan pendidikan 9-12 tahun (36,4%) dan kelompok ibu yang bekerja (54,5%). Pada faktor determinan antara yang tertinggi yaitu pada usia 20-35 tahun (81,8%), dengan paritas 2-3 (63,6%), jarak kehamilan 2-10 tahun (54,5%), faktor penyebab obstetrik yang tertinggi adalah preeklampsia/eklampsia (27,2%), namun secara garis besar penyebab non obstetrik merupakan penyebab utama kematian ibu.

Karakteristik ibu hamil dengan hiperemesis gravidarum di RSUP Sanglah Denpasar tahun 2017 Luh Putu Mahatya Valdini Putri; A. A. Gede Putra Wiradnyana; I Made Darmayasa
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Background: Hyperemesis gravidarum is severe and over vomiting suffered as of early in pregnancy until 20 weeks of gestation. It may be harmful to the mother's health that can lead to weight loss of more than 5% and cause metabolic disorders. If it does not get proper treatment, it affects complications, even maternal and fetal deaths.Aim: The study aims to generalize the characteristic of pregnant patients who suffered hyperemesis gravidarum in Sanglah General Hospital.Method: This study is a cross sectional retrospective descriptive study with data retrieval on patient records for one year in 2017. This research was conducted at Space Cempaka Obstetrics and Medical Record Division Sanglah Hospital Denpasar.Result and Conclusion: pregnant women with hyperemesis gravidarum based on motherâ€™s age is highest experienced by pregnant women in the age group 20-35 years as many as 6 people (75%). Based on maternal age, pregnant women with hyperemesis gravidarum is highest experienced by pregnant women in the first trimester as many as 5 people (62.5%). As regard with the parity, Â it was highest experienced by pregnant women in the parity group nullipara as many as 4 people (50%). Moreover, maternal education is highest academic of pregnant women who have junior high and high school education, each of them as many as 3 people (37.5%). Based on the job status is highest experienced by pregnant women who work as many as 5 people (62.5%).

The low level of plasma vitamin C as a risk factor of preterm premature rupture of membrane Muhammad Freddy Candra Sitepu; Ketut Suwiyoga; Anak Agung Ngurah Jaya Kusuma; I Gusti Putu Mayun Mayura; Made Darmayasa; I Wayan Artana Putra
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Introduction: Preterm premature rupture of membrane (PPROM) still becomes a problem related with perinatal morbidity and mortality which is caused by multifactorial risk factor; especially strength of foetal membrane. Collagen is the main component of foetal membraneâ€™s extracellular matrix whereas plasma vitamin C roles as a collagen biosynthesis enzyme-dependent co-factor, down-regulator activity of MMP-1, MMP-2, and MMP-9 and also as antioxidant in remodelling and preventing structural damage extracellular matrix. The purpose of this study is to prove the low plasma level of vitamin C as a risk factor for PPROM on preterm pregnancy.Method: This study was an analytical observational unpaired case-control performed from March 23rd until August 23rd 2018 at Polyclinic and Emergency Unit of Obstetrics and Gynaecology Sanglah Central General Hospital, Buleleng General Hospital, Mangusada General Hospital, Sanjiwani General Hospital, Wangaya General Hospital, and Prodia Clinical Laboratory Denpasar. The samples were preterm pregnancy women with premature rupture of membrane (PROM) as a case group and without premature rupture of membrane as a control group. The samples were taken from peripheral venous blood and level of plasma vitamin C is measured by HPLC method. The data were analysed by SPSS for Windows 20.0 version program then presented as table and narrative.Result: Forty subjects were divided into 2 groups, 20 preterm pregnancy with PROM as a case group and 20 preterm pregnancy without PROM as a control group. Characteristic subject based on maternal age, gestational age, parity of both groups was 27.4 and 26.1 years old, 31 and 31 weeks, and also 1 and 1 time (p>0.05), not significantly different. The mean level of plasma vitamin C on case and control group were 3.90 Â± 1.61 dan 9.24 Â± 2.31 mg/L (p=0.001). On the case group the low level of plasma vitamin C was 51 times (OR= 51; CI 95% = 7.57â€“343.73; p=0,001) higher than the control group.Conclusion: The low level of plasma vitamin C is a risk factor of PPROM.

Profil penggunaan kontrasepsi di klinik Nurjaya, Kabupaten Badung, Bali Ida Bagus Arjuna; I Made Darmayasa
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Background: Contraceptive services are a series of activities, including the provision of education, counseling, medical eligibility screening, provision of contraception, installation or revocation, and handling side effects or complications in an effort to prevent pregnancy. According to BKKBN, active birth control participants among Couples of Childbearing Age (CCA) in 2020 amounted to 67.6%. Bali is ranked 7th, with a participation rate of 66.9%. The pattern of choosing the type of contraceptive in 2020 showed that most acceptors chose to use injectable methods, followed by pills. There aren't many similar studies targeting private clinics. It is very interesting to conduct a study on the pattern of contraceptive use in Nurjaya Clinic, one of the private clinics in Bali that also organizes contraceptive programs. Methods: This study is a descriptive epidemiology survey. The sample in this study is secondary data in the form of a register of contraceptive acceptors in Nurjaya Clinic from November 2020 to October 2021. The instruments used in this study are patients' register data and data analysis techniques using univariate analysis that is calculated in percentages and presented in a table and narrated. Results: The use of injectable contraceptives is still the main choice of CCA in Nurjaya Clinic, with users at 78.5% of all contraceptive acceptors, followed by other methods, namely IUD at 13.9%, birth control pills at 6%, and implants at 1.6%. Injectable contraceptives were also the top choice in every age group, 92.6% in the 21year old age group, 74.2% in the 21 to 35-year-old age group, and 82.8% in the 35-year-old age group. Conclusion: The most widely used contraception use in Nurjaya Clinic is injectable contraceptives for all of the age groups of <21 years, 21-35 years, or >35 years. Latar Belakang: Pelayanan kontrasepsi adalah serangkaian kegiatan meliputi pemberian KIE, konseling, penapisan kelayakan medis, pemberian kontrasepsi, pemasangan atau pencabutan, dan penanganan efek samping atau komplikasi dalam upaya mencegah kehamilan. Menurut BKKBN, peserta KB aktif di antara Pasangan Usia Subur (PUS) tahun 2020 sebesar 67,6%. Bali menempati peringkat 7 dengan tingkat keikutsertaan KB sebesar 66,9%. Pola pemilihan jenis alat kontrasepsi pada tahun 2020 menunjukkan bahwa sebagian besar akseptor memilih menggunakan metode suntik, diikuti oleh pil. Masih sedikitnya penelitian serupa yang menargetkan klinik swasta, sangat menarik untuk dilakukan suatu penelitian mengenai gambaran penggunaan kontrasepsi di Klinik Nurjaya sebagai salah satu klinik swasta di Bali yang turut menyelenggarakan program KB. Metode: Penelitian merupakan survei epidemiologi deskriptif. Sampel dalam penelitian ini merupakan data sekunder berupa register akseptor KB di Klinik Nurjaya bulan November 2020 hingga Oktober 2021. Instrumen yang digunakan dalam penelitian ini adalah data register pasien serta teknik analisis data menggunakan analisis univariat yang dihitung persentasenya serta disajikan dalam bentuk tabel dan dinarasikan Hasil: Penggunaan kontrasepsi suntik masih menjadi pilihan utama PUS di Klinik Nurjaya, dengan pengguna sebesar 78,5% dari seluruh akseptor kontrasepsi, diikuti metode lainnya yaitu IUD 13,9%, pil KB 6%, dan implan 1,6%. Kontrasepsi suntik juga menjadi pilihan utama pada seluruh kelompok usia yaitu 92,6% pada kelompok usia 21 tahun, 74,2% pada kelompok usia 21-35 tahun, dan 82,8% pada kelompok usia 35 tahun. Kesimpulan: Penggunaan kontrasepsi paling banyak digunakan di FKTP swasta Klinik Nurjaya adalah KB suntik, baik pada kelompok usia <21 tahun, 21-35 tahun, maupun >35 tahun.

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.

PEMBENTUKAN PORTOFOLIO OPTIMALMENGGUNAKAN SINGLE INDEX MODELPADA SAHAM LQ 45 DI BURSA EFEK INDONESIA (BEI)TAHUN 2014-2016 I Made Darmayasa
Majalah Ilmiah Widyacakra Vol 1 No 01 (2018): Majalah Ilmiah Widyacakra
Publisher : STIE BIITM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (811.008 KB)

The research aims to know the optimal portfolio formation using single index model in LQ 45 stocks in the period 2014-2016, to know the proportion of funds used to invest in the optimal portfolio with a single index model and to know return and risk of optimal portfolio with a single index model. This research uses a descriptive research and quantitative approach. The method used in this research is single index model. Samples were taken of 32 companies from LQ 45 index. Samples taken in this study using purposive sampling technique. The result showed that from the 32 samples company elected 26 company that forms composition optimal portfolio with the proportion of shares AKRA 3,9%, WSKT 9%, PTPP 6%, TLKM 12%, GGRM 6,3%, UNVR 7%, BBCA 10%, PWON 4%, ADRO 3,4%, LSIP 1%, UNTR 2,6%, PTBA 2%, ADHI 1,9%, WIKA 2,3%, BBRI 4,5%, SMRA 2,4%, LPKR 1,7%, BMRI 5%, INDF 2,5%, ASII 4%, BBNI 3%, ASRI 1%, BSDE 2,4%, KLBF 2%, MNCN 0,4% and AALI 0,1%. Based on portfolio has formed the result of reckoning return portfolio is 3,9% and risk portfolio 0,0005%.Suggestion from the result of research, investor can invest in 26 of optimal portfolio shares because the resulting return is positive and optimal portfolio risk is much smaller than if investing in one shares only.

Penerapan Robert Buckman's Six-step Protocol pada Kehamilan dengan Kanker Ovarium I Made Darmayasa; Amelia Dwi Nurulita Sugiharta; Sarah Endang S Siahaan
JURNAL KESEHATAN REPRODUKSI Vol 9, No 3 (2022)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.73772

Latar Belakang: Penyampaian berita buruk merupakan salah satu materi penting dalam ketrampilan komunikasi medis. Diperlukan pendekatan khusus dalam penyampaian informasi medis yang dapat menimbulkan respon buruk. Diagnosis kanker ovarium sendiri disertai kehamilan yang tidak direncanakan merupakan berita buruk yang sangat stress full, apalagi akan dilakukan terminasi kehamilan. Diperlukan protokol yang bisa dijadikan panduan untuk menyampaikannya kepada pasien.Tujuan: Untuk mempelajari dan menerapkan Robert Buckman's Six-step Protocol dalam menyampaikan satu laporan kasus berita medis yang buruk (medical breaking bad news) yang dialami seorang perempuan yang menderita kanker ovarium dan hamil, serta akan dilakukan terminasi kehamilan.Metode: Sebuah laporan kasus tentang penderita Kanker Ovarium, hamil tanpa perencanaan dan akan dilakukan terminasi.Hasil dan Pembahasan: Pada saat dilakukan pendekatan klinik dengan diagnosis multiaxial, pada axis I didapatkan penderita dengan Gangguan Penyesuaian dengan Reaksi Campuran Cemas (F32.2), pada axis II dtemukan adanya ciri kepribadian cemas, MPE acting out, dan displacement. Pada axis III pasien hamil ketiga usia kehamilan 16 Minggu + Kista Ovarium curiga Ganas. Pada axis IV, pasien harus menghadapi masalah dengan penyakitnya disertai adanya kehamilan. Serta pada avis V Global Assessment of Functioning didapatkan 61-50 sedangakan Global Assessment of Functioning 1 tahun terakhir 90-81. Diterapkan Robert Buckman's Six-step Protocol sebagai panduan dalam menyampaikan informasi buruk tersebut.Kesimpulan: Pasien-pasien kanker ovarium dengan kehamilan yang tidak direncanakan dan akan dilakukan terminasi kehamilan merupakan kelainan medis yang berat dapat diikuti dengan kecemasan dan depresi. Perlu pendekatan khusus mulai dari penyampaian informasi/diagnosis, rencana tindakan dan menghadapi risiko maupun komplikasi yang mungkin dapat terjadi. Terhadap kecemasan dan depresi yang tetap muncul, dilakukan terapi farmakologis dan dikombinasikan dengan non-farmakologi seperti Mindfulness-based cognitive behavioral therapy, dan cognitive behavior therapy. Kata kunci: Robert Buckman's Six-step Protocol; kehamilan tidak direncanakan; kanker ovarium

Co-Authors AA Sri Wahyuni Amelia Dwi Nurulita Sugiharta Anak Agung Gede Putra Wiradnyana Anak Agung Ngurah Anantasika Anak Agung Ngurah Jaya Kusuma Anom Suardika Antika, Sindi Ariani, Ni Ketut Putri Ariani, Ni Komang Arista, Luh Febi ARYANI , LUH NYOMAN ALIT Astuti, Ni Made Erpia Ordani Aulia Iefan Datya Bay, Godefridus Paulo Chrismayoga, I Made Donny Dr. Christimulia Duarsa, Vidya Saraswati Putri Eka Yadnya, Ni Putu Evert Solomon Pangkahila Florencia Desiree I Gde Sastra Winata I Gede Agus Mertayasa I Gede Mega Putra I Gede Ngurah Harry Wijaya Surya I Gusti Ayu Puspawati I Gusti Putu Mayun Mayura I Kadek Dedi Susila Yasa I Ketut Suwiyoga I Made Bagus Widiastra I Made W Jembawan I Nyoman Gede Budiana I Nyoman Sucipta I PUTU PRANATHA SENTOSA I Wayan Artana Putra I Wayan Jian Ambara Raja I Wayan Megadhana I Wayan Susrama I Wayan Tika I Wayan Toni Astika Putra I Wayan Yuda Tama Wiguna Ida Bagus Arjuna Ida Bagus Gde Fajar Manuaba IWK Teja Sukmana Janawati, Desak Putu Anom KADE YUDI SASPRIYANA Krismawintari, N.P.D. Kunto Ajibroto, Kunto Kusuma, A.A.N Jaya Kusuma, Anak Agung Ngurah Jaya Luh Putu Mahatya Valdini Putri Made Bagus Dwi Aryana Marta, Kadek Fajar Muhammad Freddy Candra Sitepu Mustaqmah, Sri Asyrafil Natanael, Raymond Josafat Major Ng Teng Fung Vincent Ni Ketut Sri Diniari, Ni Ketut Sri Ni Komang Ayunda Paramita Ni L.P. Suarmi Sri Patni Ni Luh Putu Suarmi Sri Patni Ni Luh Sri Purnama Pradnyani Ni Made Erni Damayanti Ni Made Erpia Ordani Astuti Ni Made Nena Sucilestari Ni Nyoman Eva Listyani Ni Nyoman Sulastri Ni Putu Candra Vania Pebrianti Ni Putu Devi PradnyaWulantari Nicholas Renata Lazarosony Nicholas Renata Lazarosony Nyoman Bayu Mahendra Ordani Astuti, Ni Made Erpia Pradnyana, Putu Beny PUTRA, SURYA PRADNYANA Putu Adi Sujana Putra Putu Doster Mahayasa Putu Suarmi Sri Patni R. Tri Priyono Budi Santoso Rela Hamdanillah Ryan Saktika Mulyana Santoso, R. Tri Priyono Budi Sarah Endang S Siahaan Sari, Ni Kadek Dwita Sidhi Bayu Turker Susrama, I Wayan Tri Oktin Windha Daniaty TULUS, ANGELINA Wardani, Ida Aju Kusuma Wasita, Putu Aristya Adi Wasita Wati, Ni Putu Eka Yadnya William Alexander Setiawan Winarso, Ervinna Agatha

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