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All Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)

Eka R Gunardi

University of Indonesia/ Dr. Cipto Mangunkusumo General Hospital Jakarta

Author-ID : 270694

Health Professions Medicine & Pharmacology Public Health

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Identification of microorganisms in vaginal swab and peritoneal fluid of women with endometriosis Gunardi, Eka R; Hadisaputra, Wachyu; Judio, Johny
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 4 October 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Abstract Objective: to discover correlation between microorganisms found in vaginal swab culture and in peritoneal fluid culture from laparoscopy in reproductive age women diagnosed with endometriosis. Methods: This cross sectional study was conducted in Bunda Hospital and YPK Hospital, Central Jakarta. Thirty one subjects was includedby consecutive sampling. Data were analyzed using SPSS 20.0 for Windows. Bivariate analysis was used to identify the correlation between independent and dependent variable. Results: From 31 subjects with mean age 34.42+5.056 years old, 87.1% were infertile. Vaginal swab culture was found positive in 83.9% subjects while peritoneal fluid culture was found positive only in 9.6% subjects. There was moderate correlation between chronic pelvic pain and positive vaginal swab culture (r=0.601; p=0.001), but weak correlation between Ca125 and vaginal swab culture (r=0.440; p=0.010). Peritoneal fluid culture had significant inverse correlation with left tubal patency (r=-0.346; p=0.047). There was weak correlation between vaginal swab culture and peritoneum fluid culture with correlation coefficient of 0.13. Conclusion: Most of bacteria found in vaginal swab culture and peritoneal fluid culture were the ones found in gastrointestinal tract. However, vaginal swab and peritoneal fluid culture were not sufficient to prove the hypothesis that infection has a role in pathogenesis of endometriosis. Therefore, advance and more complete examination such as LPS and PCR might be needed to be done in the future research with cohort study, to overcome the limitation of this study. Keywords: endometriosis, ascending bacterial contamination, vaginal swab, peritoneal fluid, culture   Abstrak Tujuan : Membuktikan adanya korelasi antara mikroorganisme yang ditemukan pada hasil kultur bilasan vagina dengan mikroorganisme yang ditemukan pada cairan peritoneum hasil laparoskopi perempuan usia reproduksi yang terdiagnosis endometriosis Metode :Penelitian ini menggunakan desain penelitian analitik poltong lintang yang bertujuan untuk melihat adanya hubungan korelasi serta mengetahui tingkat korelasi antara mikroorganisme kultur bilasan vagina dengan mikroorganisme pada cairan peritoneum pasien endometriosis. Hasil: Hasil kultur bilasan vagina dari 31 subjek penelitian yang diteliti, mikroorganisme terbanyak adalah Enterococcus faecalis (32.3%), Eschericia coli (29.1%), dengan 16.1 % dengan hasil kultur negatif. Sedangkan dari hasil kultur bilasan peritoneum terdapat 3 subjek (9.6%) dengan hasil positif yaitu dengan jenis bakteri Eschericia coli, Enterococcus faecalis, dan Pseudomonas. Terdapat korelasi lemah antara hasil kultur bilasan vagina dengan kultur bilasan peritoneum (r 0.13). Terdapat korelasi sedang antara kultur positif bilasan vagina dengan nyeri pelvik kronis, korelasi lemah antara kultur positif bilasan vagina dengan nilai Ca 125, dan korelasi lemah antara kultur positif cairan peritoneum dengan tuba kiri yang non paten. Kesimpulan:          Sebagian besar bakteri dari bilasan vagina dan bilasan peritoneum pada pasien endometriosis memiliki hasil bakteri dari organ pencernaan. Terdapat korelasi lemah antara hasil kultur bilasan vagina dengan kultur bilasan peritoneum pada pasien endometriosis. Kata kunci: endometriosis, kontaminasi bakteri asenden, kultur, bilasan vagina, cairan peritoneum

Contraceptive User’s Profile Gunardi, Eka R
Indonesian Journal of Obstetrics and Gynecology Volume. 1, No. 4, October 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To obtain informations regarding the profile of contraceptive users in Raden Saleh Clinic, Jakarta. Method: A cross-sectional study was conducted in June 2012, at Raden Saleh Clinic, Jakarta. The study population was the patient who came to Raden Saleh Clinic from 2008 until 2011. Results: The mean age of the contraception users was 34.06 and the mean of their husband’s age was 38.91 years old. Most of the patients were graduated from senior high school (43.2%) and university (37.9%). More than half of the patients (55.2%) were not working and more than a half of their husband (53.2%) were private employee. Almost all (92.6%) of the patient were married. Most of the patient (38.8%) came with no prior contraception. After consultation, all patients had chosen their preferred contraceptive methods, namely IUD (61.4%), injectable contraception (20.9%), pill (13.7%), sterilization (3.4%), and implant (0.6%). Conclusion: Family planning reduces maternal mortality and the best method is different for each patient because of the difference in their own condition and the consideration of the cost and benefit. [Indones J Obstet Gynecol 2013; 1-4:179-82] Keywords: contraception, contraceptive users profile

Pregnancy Outcome in Infertility Patient with Endometriosis Cyst after Laparoscopic Cystectomy Gunardi, Eka R; Tritama, Duta A; Satria, Luky; Situmorang, Herbert
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 1. January 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To investigate about the rate of pregnancy in womenwho had undergone laparoscopic cystectomy.Methods: This was a retrospective study. Data were taken from themedical records of patients with infertility in Fatmawati Hospital,Jakarta, Indonesia. Data then analyze to know is there anyassociation between age, infertility duration, bilaterality of the cyst,tubal patensy, r-AFS stage with pregnancy rate.Results: A total of 64 subjects were recruited in this study. Therewere 23 subjects (35.9%) that got pregnant within one year afterundergoing laparoscopic procedure. Those who were 35 years oldor less had a greater chance to get pregnant (p = 0.01, OR = 6.75),duration of infertility  3 years had a greater chance to getpregnant with OR = 3.2 and p value = 0.032, r-AFS stage II and IIIhad a greater chance to get pregnant to with (p = 0.04, OR = 3.25and 4.25).Conclusion: The pregnancy rate after laparoscopic procedure is35.9% in this study. There are correlation between age, durationof infertility, and r-AFS staging with pregnancy rate.[Indones J Obstet Gynecol 2018; 6-1: 34-38]Keywords: endometriosis, infertility, laparoscopy, pregnancy

Promising Male Hormonal Contraceptive are Well Established Soon a Reality Gunardi, Eka R; Soetarso, Arnold; Addina, Putri
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 4, October 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To understand the modalities used for male hormonal contraception. Methods: Literature review Conclusion: Male contraceptive methods are still limited but hormonal contraceptive methods are being developed. The basic mechanism of male hormonal contraception is to inhibit spermatogenesis by suppression of the hypothalamic-pituitary-testicular axis function. Administration of testosterone or androgen derivative that is given in combination with progestin or GnRH antagonist shows that male hormonal contraceptive is reversible, effective, and acceptable as a male contraceptive method. However, no method of male hormonal contraceptive is ready for clinical use and marketed due to limited studies. [Indones J Obstet Gynecol 2015; 3-4: 239-243] Keywords: GnRH antagonist, male hormonal contraceptive, progestin, testosterone

A Red Card for Plagiarism Gunardi, Eka R
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

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User Profile and Factors Correlating to Duration of Intrauterine Device Use Gunardi, Eka R; Fadli, Fadli
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To determine the demographic and clinical profile of intrauterine device (IUD) users and factors correlating to duration of IUD use. Method: We conducted a prospective observational study of 867 patients who underwent IUD insertion in Raden Saleh Outpatient Clinic during the period of January - December 2011. All patients were followed for 1 year to ascertain any complaint of discharge after insertion. Spearman correlation test was conducted to inves- tigate the strength of correlation and significance between age, parity, and discharge, with duration of IUD use. Result: During year 2011, 867 patients (median of age=34 [range=14-49]; median parity=2 [range=0-7]) underwent IUD insertion in Raden Saleh Clinic. The majority of subjects were aged between 31-35 years old and were willing to use IUD for 4 years. Bivariate analysis revealed a significant correlation between age, parity, and vaginal discharge with duration of IUD use. The strongest correlation was identified between age and duration of use (r=0.25, p0.002 for parity and duration of use; r=0.05 p=0.045 for discharge and duration of use). Conclusion: Most IUD users were aged 31-35 years, who were willing to use IUD for 4 years. Factors that correlated with duration of IUD use were age, parity, and vaginal discharge. Keywords: contraceptive, duration of use, family planning, intrauterine device

Family Planning Problem in Indonesia Gunardi, Eka R
Indonesian Journal of Obstetrics and Gynecology Volume 4, No. 4, October 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

N/A

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

Acceptor Comment of PostPlacental Copper T380A Intrauterine Device Gunardi, Eka R; Malik, Adila RA; Oktavianti, Febby; Meria,, Riry; Ardianto, Fachreza; Marian, Christina
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 1, January 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To describe the characteristics of subjective complaints reported by post-placental inserted intrauterine device (IUD) acceptor, especially those who used Copper T380A (CU T380A) type of IUD. Methods: Seventy-two-married women whose age ranged from 19 to 44 years old and received post-placental IUD in Dr. Cipto Mangunkusumo Hospital, Jakarta, were included in this study. Subjective complaints regarding the use of CU T380A IUD were evaluated twice including during the puerperium and six months afterwards by a direct interview. Results: Most respondents were 20-35 years old, 50% of whom were primiparous (n=36). There were 42% respondents reporting pain during insertion, 32% respondents reporting abdominal pain during the use, 22% respondents reporting menstrual disorder, 18% respondents reporting vaginal discharge, and 3% respondents complaining of having IUD repulsion. Conclusion: There are variety of subjective complaints reported after post-placental IUD use. However, most of the respondents does not complain anything. [Indones J Obstet Gynecol 2017; 5-1: 19-22] Keywords: complication, contraception, intrauterine device (IUD) post-placental, postpartum

The Efficacy of Monoplant® and Indoplant® as Contraceptive Methods: A Comparative Study Gunardi, Eka R; Ballo, Frista
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 2, April 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To determine the effectiveness, safety, and time of insertion between Monoplant® with Indoplant® to prevent pregnancy. Methods: Data were collected from November 2015 until May 2016 in Raden Saleh Clinic. A total of 153 patients met the inclusion and exclusion criteria for the study and were divided into 77 patients who received Monoplant® and 76 patients received Indoplant®. The study period was 6 months. Results: The data obtained showed no significant difference in the effectiveness of both contraceptive methods. In addition, side effects such as menstrual disorders and weight gain did not differ significantly in those study groups. However, the time of insertion between Monoplant® and Indoplant® was siginificantly different (162.91 + 197.04 + 49.81 seconds versus 44.96 seconds, p<0.001). For complications such as skin irritation, inflammation, there are no differences between Monoplant® (0.0%) and Indoplant® users (0.0%). Conclusion: There are no significant differences in efficacy and side effects using Monoplant® and Indoplant® during the 6-month follow-up. However, the insertion time of Monoplant® is shorter compared to Indoplant®’s. Monoplant® can be considered for use as contraception with the effectiveness and side effects are almost the same, but with shorter time of insertion compared to Indoplant ®. [Indones J Obstet Gynecol 2017; 5-2: 94-98] Keywords: contraception, implant, indoplant®, monoplant®

Co-Authors Addina, Putri Aldri Frinaldi Ardianto, Fachreza Ballo, Frista Biran Affandi Fadli Fadli Farid, Retno B Hadiyono, Suryo Herbert Situmorang Herbert Situmorang Hoesni, R Hasan M Ichsan, TM Judio, Johny Lestari, Renny Malik, Adila RA Manan, Heriyadi Manan, Heriyadi Marian, Christina Meria,, Riry Mukti, Alexander Oktavianti, Febby Pramana, Noor Ridwan, Rusdi S Rizani Amran Satria, Luky Situmorang, Herbert Soetarso, Arnold Taher, Mardiah Tandjung, Thamrin Tritama, Duta A Wachyu Hadisaputra Widohariadi Widohariadi

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