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FAKTOR RESIKO TERJADINYA LESI PRAKANKER SERVIKS MELALUI DETEKSI DINI DENGAN METODE IVA (INSPEKSI VISUAL DENGAN ASAM ASETAT) Tia Reza; Andi Friadi
Jurnal Kesehatan Saintika Meditory Vol 5, No 2 (2022): November 2022
Publisher : STIKES Syedza Saintika Padang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30633/jsm.v5i2.1566

Abstract

Kanker leher rahim merupakan masalah kesehatan yang penting bagi wanita. Angka kejadian kanker cerviks terus terjadi peningkatan dari waktu ke waktu. Kanker ini dialami oleh lebih dari 1,4 juta wanita di seluruh dunia. Setiap tahun, lebih dari 460.000 kasus terjadi dan sekitar 231.000 orang meninggal karena penyakit ini. Di Indonesia, berdasarkan data riset kesehatan dasar (riskesdas) tahun 2013, prevalensi tumor/kanker di Indonesia adalah 1,4 per 1000 penduduk. Kanker tertinggi di Indonesia adalah kanker payudara dan kanker leher rahim. Kanker payudara dan kanker leher rahim merupakan jenis kanker tertinggi pada pasien rawat inap maupun rawat jalan di seluruh RS di Indonesia, dengan jumlah pasien sebanyak 12.014 orang (28,7%) untuk kanker payudara, dan kanker leher rahim 5.349 orang (12,8%). Sehingga diperlukan pemeriksaan kanker leher rahim dengan metode IVA yang digunakan untuk mendeteksi kanker secara dini. Tujuan penelitian ini yaitu untuk mengetahui hasil skrining IVA pada perempuan khususnya wanita usia subur yang sudah menikah di Sumatera Barat khususnya di Bukittinggi, Agam, Payakumbuh, dan Pariaman. Desain penelitian ini adalah crosssectional deskriptif analitik. Variabel penelitian ini adalah skrining metode Inspeksi Visual Asam Asetat (IVA) pada wanita yang telah menikah dan umur di atas 25 tahun. Populasi dalam penelitian ini adalah seluruh wanita usia subur yang melakukan pemeriksaan IVA di 4 wilayah tadi. Sampel yang diambil untuk 4 daerah tadi dengan cara total sampling sebanyak 414 responden. Data yang dikumpulkan menggunakan lembar observasi data sekunder dan disajikan dalam tabel distribusi. Hasil penelitian menunjukkan bahwa sebagian besar kategori IVA (+) sebanyak 48 orang dan IVA (-) sebanyak 366 orang.  Skrining menunjukkan sebagian responden dengan kategori IVA (+) dipengaruhi oleh berbagai faktor resiko dari usia, menarch < 12 tahun, usia pertama berhubungan seksual < 17 tahun, sering keputihan, merokok, terpapar asap rokok> 1 jam sehari, sering konsumsi buah dan sayur, makanan berlemak dan berpengawet, kurang aktifitas fisisk, pernah papsmear, sering berganti pasangan, riwayat keluarga kanker, kehamilan pertama > 35 tahun, pernah menyusui, menikah > 1 kali, pemakian KB, paritas, menopause, dan obesitas. Kata Kunci: Deteksi Dini; Faktor Resiko; Inspeksi Visual Asam Astetat (IVA); Skrining
Gambaran Hasil HPV Test dengan PAP Test pada Pasien dengan Lesi Prakanker Serviks di RSUP Dr M Djamil Padang Prima, Angga Trifianda; Friadi, Andi
Andalas Obstetrics And Gynecology Journal Vol. 2 No. 2 (2018)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.2.2.83-86.2018

Abstract

Objective: To determine the description of the HPV Test results with the PAP Test in patients with cervical precancerous lesions at Dr. M. Djamil Padang.Methods: This study used a descriptive method with a sample of all patients with cervical precancerous lesions who had the HPV test and PAP test results in Dr. M. Djamil Padang from January 1, 2015 - December 31, 2017. Data were taken from the patient's medical records, including diagnosis, PAP test results using the Hybrid Capture (HC) method, and HPV test. Results: During the study period, 80 patients had PAP test results leading to precancerous lesions and cervical cancer. Of the 80 patients, only 4 cases with positive HPV test results. Conclusion: In this study, there were many cervical precancerous lesions with negative HPV test results.Keywords: Cervical precancerous lesions, PAP test, the HPV test
TUMOR GANAS OVARIUM RESIDIF METASTASIS KARSINOMA MUSIN KE UMBILIKUS, PERITONEUM, DAN CAIRAN ASITES TANPA DITEMUKAN TANDA KEGANASAN PADA PEMERIKSAAN HISTOPATOLOGIS PASCA OPERATIF SEBELUMNYA Fadillah, Arif; Friadi, Andi
Andalas Obstetrics And Gynecology Journal Vol. 3 No. 2 (2019)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.3.2.130-136.2019

Abstract

Background : Malignant ovarian tumor are still the number one cause of death and the second most  of incidents for gynecological malignant tumors. The principles of management of ovarian cancer are the same as the principles of handling other malignant diseases, for the treatment of primary lesions operatively and the handling of potential sites of tumor metastases with chemotherapy. Histopathological examination is still considered a gold standard for diagnosis and definitive treatment of malignant ovarian tumors. If histopathologic results are obtained, then the patient will be planned to undergo postoperative chemotherapy. The mismatch between the preoperative and intraoperative clinical features, and the results of postoperative histopathological examination is a problem in managing cases of ovarian malignant tumors.Objective : Report a case of residive ovarian carcinoma with no appearance of malignancy marker in the previous postoperative histopathological examination.Method : Case reportCase : We report the case of a 45-year-old woman with a history of two previous laparotomy. The first operation was carried out in February 2014 on the indication of an extra ovarian cyst, resulting in the impression of a "Follicular Cysts" based on histopathological examination. The second operation was performed in March 2015, performed surgical staging tumors with an indication of malignant ovarian tumors with clinical metastases, but from histopathological examination it was found that "Cystadenoma Ovarii Muscinosum Multiloculare" and "no visible signs of malignancy", so the patient was not managed with postoperative chemotherapy. In April 2019 patients came with complaints of new mass growth, from CT-Scan and USG investigations there was a suspicious impression of a residive ovarian tumor with metastases into the omentum and massive ascites. On May 16, 2019 an optimal debulking was performed with the findings of residive mass, ascites, and mass metastases in the intra operative peritoneum. From the results of histopathological examination, it was found that "Muscinous Carcinoma with metastases to the umbilicus, peritoneum, and ascitic fluidKeywords: Malignant residive ovarian tumor, mucinous ovarian carcinoma
Peran Ultrasonografi dalam Evaluasi Pasca Operasi Friadi, Andi
Andalas Obstetrics And Gynecology Journal Vol 4, No 1 (2020)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.4.1.1-6.2020

Abstract

The role of ultrasonography (USG) in postoperative gynecology is to assess and evaluate postoperative complications. Ultrasonography are the methods which is noninvasive hence minimize the risk during examination and decrease discomfort the patients. In this literature review, we will explain three main topic role of ultrasound to evaluate postoperative condition such as hematoma, injuries due to the urinary tract and residive mass especially for gynecology oncology cases. Hematoma divided into hematoma on the stump of (the vault is hematoma) and subfascial hematoma. The use of ultrasonography also to evaluate injuries at organ of the urinary tract, especially kidney and ureters. There are two methods which are transabdominally and transvaginally to evaluate the ejection of urine that can confirm that there are no obstruction in the ureter. In addition there is a ultrasound can be used to assess hydronephrosis. In cases of cancer, ultrasound can be used to evaluate residive mass in upper abdomen such as peritoneum (peritoneal carcinomatosis) and liver metastases. Keywords: ultrasonography, hematoma, hydronephrosis, residive mass
Perbandingan Akurasi Skor ROMA dan IOTA dalam Prediksi Keganasan Tumor Ovarium Malik, Yussya Aulia; Friadi, Andi
Andalas Obstetrics And Gynecology Journal Vol 4, No 1 (2020)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.4.1.70-76.2020

Abstract

Ovarian cancer is the sixth most common cancer found among women. Incidence of ovarian cancer in Dr. M. Djamil Central Hospital had increased from 103 cases to 156 cases in 2011-2012. The Risk Of Ovarian Malignancy Algorithm (ROMA) consists of qualitative serum test where several variables including HE4 serum, CA125 serum, and menopausal status are turned into numerical score (Hye Yon Cho et al 2015). The latest diagnostic modalities developed by International Ovarian Tumour Analysis (IOTA) classifies tumour into four sub groups, based on ultrasound characteristics: unilocular, multilocular, adnexal mass with solid component without papilloma projection, adnexal mass with one or more papilloma projection. Based on this knowledge, author would like to investigate accuracy of ROMA and IOTA score in predicting malignancy status of early ovarian tumour.Objective: Determining ROMA and IOTA so thus can be utilised to predict wether the ovarian tumour is benign or malignant.Method: This was analytical study, with cross sectional design and took place in Obstetrical and Gynaecological Outpatient Clinic of Dr. M. Djamil Central Hospital from August 2016 to January 2019. Sample was recruited using consecutive sampling method. Sixty one participants were recruited with CI 99%. Patients who met inclusion criteria would undergo Ca125 serum test and IOTA score. HE4 level was determined after surgery  and the sample of a tumour was sent to pathology anatomy laboratory of Medical Faculty of Andalas University to investigate the malignancy status. Statistical analysis involved univariate and bivariate test. The variables included frequency distribution, ROMA, and IOTA score. Bivariate analysis included specificity, sensitivity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio.Result: Thirty one patients (50,8%) from peri menopausal group had HE4 level ≤70 pmol/L and 30 patients (49,2%) from post menopause group had HE4 level ≤140 pmol/L. Eleven patients (18%) had CA125 level <35 and 50 patients (82%) had CA125 level ≥35. ROMA index showed low risk in 17 patients (27,9%) and high risk 44 patients (72,1%). IOTA with M Rules was 51 patients (83,6%) and B rules was 10 patients (16,4%). Diagnostic value for ROMA score had sensitivity of 71,9%; RMI of 84,2%; and IOTA 82,5%. ROMA and IOTA accuracy was 68,9% and 92,2%, respectively.Conclusion: IOTA has better sensitivity in predicting ovarian tumour compared with ROMA. ROMA has higher positive predictive value compared with IOTA positive predictive value. ROMA negative predictive value is 5,9%, meanwhile for IOTA it is hard to determineKeywords: ovarian cancer, ROMA, IOTA, Ca-125, HE4
Perbandingan Nilai Risk Malignancy Index Kanker Ovarium Tipe Serosum dan Musinosum RSUP Dr. M. Djamil Padang pada Tahun 2017 Luhuria, Frita Dwi; Defrin, Defrin; Friadi, Andi
Andalas Obstetrics And Gynecology Journal Vol 4, No 1 (2020)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.4.1.87-94.2020

Abstract

The Risk Malignancy Index (RMI) is one of the simplest assessments that can assist in diagnosing and determining the prognosis of benign and malignant adnexa masses. Epithelial carcinoma is the most common type of about 90% of ovarian cancers.  As many as 35-40% of the epithelial type are serous and 6-10% are musinosum.This study aims to compare the picture of RMI value on the incidence of ovarian cancer serosum and musinosum type. This study was cross sectinal comparative study from medical records of ovarian cancer patients at obstetrics and gynecology section in DR M Djamil Hospital Padang from January 1st, 2017 until December 31st, 2017. The population was found one hundred and forty of patients with ovarian cancer and only one hundred and twenty nine of patients met the inclusion criteria and there were no exclusion criteria. Next RMI value is calculated based on RMI 1 formula, result is described in tabular form and data processing with SPSS program. Conclucion of this study is there were no differences in age distribution, ascites occurrence and age of menopause in serous and musinosum ovarian cancer. There is a difference in Ca, 125 levels in serous with musinosum ovarian cancer which also contribute to the high value of RMI. The mean value of patients‘s RMI in serous type ovarian cancer is higher than the mean value of RMI in patients with type Musinosum ovarian cancer. Keywords: index of risk malignancy, menopause, ultrasonography, anatomic pathology, serous ovarian carcinoma
Colposcopy Findings In High-Grade Cervical Precancer Lesion Friadi, Andi
Andalas Obstetrics And Gynecology Journal Vol. 4 No. 2 (2020)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.4.2.194-202.2020

Abstract

Cervical precancer lesion can generally be seen in the transformation zone. Colposcopy allows us to see an image of enlarge precancer lesion in the transformation zone. The colpocopist should consider some important things to determine the appearance of low-grade lesion or high-grade lesion. Two important things are the description of abnormal epithelium and the description of abnormal blood vessels. The description of the abnormal epithelial seen after administration of acetic acid 3-5%,  acetowhite looks faster and disappears slower. The “white” lesion is more concentrated like the color of shells, with clear border and surface contour. To find the abnormal blood vessels more clearly, we can use the green filter. High-grade lesion shows rough mosaic and rough punctation or both. In addition, finding the cervical blood vessels can help us to determine high-grade lesion. By understanding the description of the epithelial cervix and abnormal blood vessels , we will easily distinguish high-grade lesions from low grade lesion.  Keywords: cervical precancer, colposcopy findings
Extra Gastrointestinal Stromal Tumor Pada Ovarium, Kasus Jarang Liana, Nana; Nizar, RZ; Asri, Aswiyanti; Novianti, Hera; Friadi, Andi
Andalas Obstetrics And Gynecology Journal Vol. 4 No. 2 (2020)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.4.2.173-182.2020

Abstract

Objective : This article objective is to describe a woman with extra gastrointestinal stromal tumor (extra GIST) in ovary; Method : A case report and literature review; The author reports a woman 54 years old with complaints of swelling in the abdomen. Tumors suspected originate from ovary with an extension to abdominal wall. The patient had history of previous ovarian tumor surgery with pathological anatomy diagnosis was thecoma. Working diagnosis of the patient was residif ovarian malignancy and then suboptimal debulking was performed. Microscopically, ovarian tumors appear cellular and diffuse, partially arranged fascicles. Cells with rounded-spindle nuclei, mitosis ≥ 4 per 10 HPF. The conclusion was malignant thecoma which metastasizes to peritoneum and omentum. Differential diagnosis were GIST and leiomyosarcoma. Immunohistochemistry examination was performed with  Calretinin and CD117 to rule out the differential diagnosis. Calretinin were negative  and CD117 were strongly positively smeared. Based on the morphology and positive CD117 results, diagnosis was extra GIST of ovary.; Conclusion: Extra GIST in the ovary is an unusual location so that it can be misdiagnosed as a gynecological disorder. The differential diagnosis at this location is quite limited including thecoma, fibrothecoma and leiomyosarcoma.Keywords: extra gastrointestinal stromal tumor, ovary, thecoma
Malignant GIST DOG-1 Positif Pada Colon Dengan Metastasis Pada Jaringan Paraovarium Dan Cairan Asites Utami, Dini Andri; Asri, Aswiyanti; Novianti, Hera; Friadi, Andi
Andalas Obstetrics And Gynecology Journal Vol. 4 No. 2 (2020)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.4.2.183-193.2020

Abstract

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasm of gastrointestinal tract that originate from Interstitial Cell of Cajal (ICC). The correct diagnosis of GISTs is important for therapeutic reasons of imatinib. Recently, DOG-1 has been introduced as an important diagnostic marker with high sensitivity and specificity. We report a caseof 40 years old woman with pain and swollen stomach in left lower quadrant since four month before come to the hospital. Ultrasound examination showed hipoechoic lession in the posterior of uterus and ascites. Paraovarian mass attached to the transverse colon and ascites was found on surgery. Histopathology diagnosis was a mesenchymal stromal tumour suggestive malignant GIST. Citological examination of asites fluid show a malignancy metastases. Immunohistochemistry showed negative for c-kit and positive for DOG-1, the conclusion is a GIST. Immunohistochemistry examinations are important to make defenitive diagnosis for GIST.  C-kit-negative GIST sare still rare, but defenitive diagnosis must be made because related to target therapy. DOG 1 has been proven in 89% of c-kit-negative GIST and claimed more sensitive and spesific.Keywords: GIST, c-kit, DOG-1, ICC, paraovary
Diagnostic Test On Modified Score Of Cesarean Section History In Placenta Accreta Index In Predicting Placenta Accreta Diagnosis In Rsup Dr M Djamil Widayat, Widayat; Friadi, Andi; Bacthiar, Hafni
Andalas Obstetrics And Gynecology Journal Vol. 5 No. 2 (2021)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.5.2.215-230.2021

Abstract

Introduction : Placenta accreta is defined as abnormal implantation of placenta villi which invades myometrium without the presence of decidua bacalis resulting in placenta that is difficult to remove. Based on the depth of invasion, placenta accreta is divided into three grades, placenta accreta, placenta increta, and placenta percreta. Placenta accreta developes if chorionic villi attaches to endometrium beyond desidua basalis. Placenta increta develops when chorionic villi invades the whole myometrium. Placenta percreta developes when chorionic villi attaches beyond myometrium reaching serous and abdominal organ. Based on clinical manifestation, placenta accreta is the common term being used. Incident of abnormal placenta invasion varies from 1 : 93.000 up to 1 : 540 pregnancy. PA incidence had increased four times from 1994 to 2002 in line with increased of caesarean section procedure. Other study showed history of caesarean section increased risk of placenta accreta up to 8,7 times. Placenta accreta index (PAI) was developed based on scoring process or various parameters assessment to help diagnose placenta accreta. The parameters including: history of caesarean section ≥ 2 times, lacunae grade, sagittal smallest myometrial thickness, anterior placenta previa and birding vessel. High PAI indicates high risk of abnormal placenta invasion based on histology.Objective : This study aims to investigate modified history of cesarean section score in placenta accreta index in predicting placenta accreta diagnosis in RSUP DR M  Djamil Padang.Material and methods : This was analytical study with cross sectional design. Study population was 84 placenta accreta patients in RSUP Dr. M. Djamil Padang from 2016 to 2019. Study sample was recruited using simple random sampling technique after meeting inclusion and exclusion criteria. Statistic analysis was done using Cohen’s Kappa test. Diagnostic test including sensiticivy, specivicity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy.Result : Strenght of agreement diagnosis placenta accreta based on PAI showed Kappa score of -0,002 (Kappa score < 0,2) which indicated  poor strength of agreement. Strenght of agreement diagnosis placenta accreta based on modified PAI showed Kappa score of 0,353 (Kappa score range from 0,21 to 0,40) which indicated fair strength of agreement. PAI diagnostic test yield sensitivity of 97,1%, specificity of 2,8%, positive predictive value of 48,5%, negative predictive value of 50%, and accuracy of 48,6%. Modified PAI diagnostic test yield sensitivity of 97,1%, specificity of 38,9%, positive predictive value of 60%, negative predictive value of 93,3%, and accuracy of 67,1%.Conclusion : PAI has high sensitivity, low specificity, moderate positive predictive value, moderate negative predictive value, and moderate accuration. Modified PAI has high sensitivity, moderate specificity, moderate positive predictive value, high negative predictive value, and high accuracy. PAI diagnosis has poor strength of agreement compared with pathology anatomy. Modified PAI diagnosis has fair strength of agreement compared with pathology anatomy. Modified PAI has identical sensitivity with standard PAI, meanwhile for specificity, positive predictive value, negative predictive value, and accuracy, modified PAI yields higher result compared to PAI.Keywords: Modified score of history caesarean section, placenta accreta index, Modified placenta accreta index, diagnostic test of placenta accreta diagnosis