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All Journal BALI MEDICAL JOURNAL (BMJ) E-Jurnal Medika Udayana E-Journal Obstetric & Gynecology Udayana Indonesian Journal of Obstetrics & Gynecology Science Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) ISM (Intisari Sains Medis) : Jurnal Kedokteran Neurologico Spinale Medico Chirurgico

I Wayan Megadhana

Department Of Obstetrics And Gynaecology, Udayana University, Bali, Indonesia

Author-ID : 2936248

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

Published : 26 Documents Claim Missing Document

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Kadar 25(OH)D dan rasio HDL-LDL serum yang rendah sebagai faktor risiko terjadinya preeklamsia dengan gambaran berat Leony Lim; Ketut Suwiyoga; I Wayan Artana Putra; Anak Agung Ngurah Jaya Kusuma; I Gede Mega Putra; Anom Suardika; I Wayan Megadhana
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Background: Preeclampsia is a health problem because it contributes to high rates of maternal and baby morbidity and mortality. The pathogenesis of preeclampsia is still unknown, but vitamin D deficiency and low HDL-LDL serum ratio are thought to play an important role. Therefore, a study was conducted on low 25(OH)D serum level and low HDL-LDL serum ratio as risk factors for preeclampsia with severe features.Methods: This study has a case-control design, conducted at Obstetric and Gynecology emergency room at Sanglah Hospital from January 2020 to June 2020. Subjects were 44 pregnant women, consisting 22 normal pregnant women as controls and 22 pregnant women with preeclampsia with severe features as cases, selected by purposive consecutive sampling and analyzed using SPSS 21.Results: Preeclampsia with severe features was found 5 times higher in pregnant women with low 25(OH)D serum level than in normal pregnant women (OR = 4,91, CI 95% = 1,33-18,21, p = 0,014). Preeclampsia with severe features was found 8 times higher in pregnant women with low HDL-LDL serum ratio than in normal pregnant women (OR = 7,88, CI 95% = 1,96-31,57, p = 0,002).Conclusion: Low 25(OH)D serum level and low HDL-LDL serum ratio are risk factors for Preeclampsia with severe features. Pendahuluan: Preeklamsia merupakan masalah kesehatan karena berkontribusi terhadap tingginya angka morbiditas dan mortalitas ibu dan bayi. Patogenesis preeklamsia sampai saat ini masih belum diketahui secara pasti, namun kadar vitamin D dan rasio HDL–LDL serum yang rendah diduga berperan penting dalam mekanisme terjadinya preeklamsia. Penelitian kemudian dilakukan terhadap kadar 25(OH)D dan rasio HDL-LDL serum yang rendah sebagai faktor risiko terjadinya preeklamsia dengan gambaran berat.Metode : Desain penelitian ini adalah kasus kontrol (case control) yang dilakukan di Instalasi Gawat Darurat Obstetri dan Ginekologi RSUP Sanglah, Denpasar mulai Januari 2020 sampai Juni 2020. Subyek penelitian berjumlah 44 orang ibu hamil, yang terdiri dari 22 ibu hamil normal sebagai kontrol dan 22 ibu hamil dengan preeklamsia dengan gambaran berat sebagai kasus, yang dipilih secara purposive consecutive sampling, dan dianalisis menggunakan SPSS 21.Hasil: Risiko terjadinya preeklamsia dengan gambaran berat adalah 5 kali lebih tinggi pada ibu hamil dengan kadar 25(OH)D serum yang rendah dibandingkan ibu hamil normal (OR = 4,91, IK 95% = 1,33-18,21, p = 0,014). Risiko terjadinya preeklamsia dengan gambaran berat adalah 8 kali lebih tinggi pada ibu hamil dengan rasio HDL-LDL serum yang rendah dibandingkan ibu hamil normal (OR = 7,88, IK 95% = 1,96-31,57, p = 0,002).Simpulan : Kadar 25(OH)D dan rasio HDL-LDL serum yang rendah merupakan faktor risiko preeklamsia dengan gambaran berat.

Kadar heat shock protein 70 cairan amnion yang tinggi sebagai faktor risiko terjadinya ketuban pecah dini pada kehamilan aterm Ines Kurniaty Hartono; Ketut Suwiyoga; I Ketut Surya Negara; I Gede Mega Putra; Made Bagus Dwi Aryana; I Gde Sastra Winata; I Wayan Megadhana
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Background: Premature rupture of membranes (PROM) is a condition that complicates labor with an unclear pathogenesis. HSP70 is thought to be involved in this pathogenesis process and the presence of HSP in the extracellular compartment reflects tissue damage and induces an immunologic response. Therefore, this study aimed to study the relationship between HSP70 levels in amniotic fluid and the incidence of PROM.Methods: This study used a case-control design in the ER delivery room and the laboratory of Sanglah Hospital, Denpasar. Samples were taken from mothers who gave full term delivery in the emergency room at Sanglah Hospital Denpasar with mothers who gave birth at term with KPD as cases and mothers who gave full term delivery without KPD as controls. Data was taken from medical records and measured levels of HSP70 at the Sanglah Hospital Denpasar Laboratory. Data analysis was performed using the Mann-Whitney test and ROC test.Results: A total of 28 cases and 28 controls were recruited. There were no significant differences in baseline characteristics between cases and controls. The MannWhitney test found significant differences in the mean levels of HSP70, 11.58 (±8.16) ng/mL in controls and 17.15 (±6.51) ng/mL in cases, respectively. ROC analysis found an AUC of 0.737 with an optimal cutoff value of 12.5 ng/mL. An amniotic fluid HSP70 level of more than 12.5 ng/mL was associated with PROM with an OR of 17.33 (95% CI 3.43 - 87.70).Conclusion: High amniotic fluid HSP 70 level is a risk factor for PROM in term pregnancy. Latar belakang: Ketuban pecah dini (KPD) merupakan suatu kondisi yang mempersulit persalinan dengan patogenesis yang belum jelas. HSP70 dianggap terlibat dalam proses patogenesis ini dan keberadaan HSP di kompartemen ekstraseluler mencerminkan kerusakan jaringan dan menginduksi respon imunologi. Oleh karena itu, penelitian ini bertujuan untuk mempelajari hubungan kadar HSP70 dalam cairan ketuban dengan kejadian KPD.Metode: Penelitian ini menggunakan desain kasus kontrol di ruang bersalin IGD dan Laboratorium RSUP Sanglah Denpasar. Sampel diambil dari ibu yang bersalin cukup bulan di ruang bersalin IGD RSUP Sanglah Denpasar dengan ibu yang melahirkan cukup bulan dengan KPD sebagai kasus dan ibu yang bersalin cukup bulan tanpa KPD sebagai kontrol. Data diambil dari rekam medis dan dilakukan pengukuran kadar HSP70 di Laboratorium RSUP Sanglah Denpasar. Analisis data dilakukan dengan menggunakan uji Mann-Whitney dan uji ROC.Hasil: Sebanyak 28 kasus dan 28 kontrol direkrut. Tidak ada perbedaan yang signifikan dalam karakteristik dasar antara kasus dan kontrol. Uji MannWhitney menemukan perbedaan yang signifikan dalam tingkat rata-rata HSP70, masing-masing 11,58 (± 8,16) ng/mL pada kontrol dan 17,15 (± 6,51) ng/mL dalam kasus. Analisis ROC menemukan AUC 0,737 dengan nilai cutoff optimal 12,5 ng/mL. Tingkat HSP70 cairan ketuban lebih dari 12,5 ng/mL dikaitkan dengan PROM dengan OR 17,33 (95% CI 3,43 - 87,70).Simpulan: kadar HSP 70 cairan amnion yang tinggi merupakan faktor risiko terjadinya KPD pada kehamilan aterm.

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.

Friedman Curve Positively Correlates with Cesarean Section and Oxytocin Augmentation in Active Phase Delivery as Compared to Partograph: Kurva Friedman Berkorelasi Positif dengan Seksio Sesarea dan Augmentasi Oksitosin pada Fase Aktif Persalinan dibandingkan Partograf Anak Agung Ngurah Anantasika; I Wayan Artana Putra; Ida Bagus Putra Adnyana; I Wayan Megadhana; Ryan Saktika Mulyana; Agustinus Darmawan Hariyanto
Indonesian Journal of Obstetrics and Gynecology Volume 11 No. 3 July 2023
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v11i3.1867

Objective: To investigate the correlation between cesareansection and oxytocin augmentation in childbirth monitoredwith the Friedman curve compared to the World HealthOrganization (WHO) partographs.Methods: An analytic cross-sectional study was conductedfrom March to May 2021, involving mothers giving birthwhose delivery process was monitored using either theFriedman curve or the WHO partograph (n=28 for eachgroup) at Wangaya Hospital in Denpasar City. The durationof the active phase until delivery, occurrence of cesareansection, and administration of oxytocin augmentationwere assessed using the Friedman curve and the WHOpartograph. The normality of the data was tested using theKolmogorov-Smirnov test, and the Spearman correlationtest was employed to measure the direction and strengthof the correlation.Results: There was no signifi cant difference between thegroups in terms of monitoring the active phase until deliveryusing the Friedman curve compared to the WHO partograph(p=1.000 > 0.05). Maternal monitoring with the Friedmancurve showed a positive correlation with the occurrenceof cesarean section compared to the WHO partograph(r=0.296, p=0.027). Additionally, monitoring childbirth withthe Friedman curve exhibited a positive correlation with theadministration of oxytocin augmentation compared to theWHO partograph (r=0.298, p=0.026).Conclusion: The fi ndings suggest a stronger positivecorrelation between the incidence of cesarean section andthe administration of oxytocin augmentation in childbirthmonitored with the Friedman curve compared to the WHOpartograph.Keywords: cesarean section, Friedman curve, oxytocinaugmentation, WHO partograph.AbstrakTujuan: Untuk menentukan korelasi antara operasi sesardan augmentasi oksitosin pada persalinan yang dipantaudengan kurva Friedman dibandingkan dengan partografOrganisasi Kesehatan Dunia (WHO).Metode: Desain penelitian analitik potong lintangdilakukan pada Maret-Mei 2021, dengan melibatkan ibubersalin yang proses persalinannya dipantau menggunakankurva Friedman atau Partograf WHO (n=28 untuk setiapkelompok) di ruang bersalin di Rumah Sakit Wangaya,Kota Denpasar. Waktu fase aktif hingga kelahiran bayi,persalinan seksio sesarea, dan augmentasi oksitosin dinilaidengan menggunakan kurva Friedman dan Partograf WHO.Uji normalitas dilakukan dengan uji Kolmogorov-Smirnov,dilanjutkan dengan uji korelasi Spearman untuk mengukurarah dan kekuatan korelasi.Hasil: Pemantauan ibu bersalin dengan kurva Friedmandibandingkan dengan Partograf WHO dalam hal faseaktif-persalinan bayi menunjukkan tidak ada perbedaanyang signifi kan di antara kedua kelompok (p = 0,000 >0,05). Pemantauan ibu dengan kurva Friedman berkorelasipositif dengan kejadian bedah sesar dibandingkandengan Partograf WHO (r = 0,296, p = 0,027). Selain itu,pemantauan persalinan dengan kurva Friedman berkorelasipositif dengan pemberian oksitosin dibandingkan denganpartograf WHO (r = 0,298, p = 0,026).Kesimpulan: Terdapat korelasi positif yang lebih tinggiantara kejadian bedah sesar dan pemberian augmentasioksitosin pada proses persalinan yang dipantau dengankurva Friedman dibandingkan dengan partograf WHO.Kata kunci: augmentasi oksitosin, kurva friedman, partografWHO, seksio sesarea

HUBUNGAN TINGKAT PENGETAHUAN TENTANG KANKER SERVIKS DENGAN PERILAKU DETEKSI DINI PADA PEGAWAI YANG BEKERJA DI FAKULTAS KEDOKTERAN UNIVERSITAS UDAYANA Widyasari, Putu Kartika; Budiana, I Nyoman Gede; Megadhana, I Wayan; Putra, I Wayan Artana
E-Jurnal Medika Udayana Vol 11 No 3 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i03.P07

Cervical cancer is a cancer caused by the oncogenic type of Human Papilloma Virus (HPV). This cancer ranks as the second common cancer in Indonesia. Among the 32,469 thousand new cases, there are 18,279 thousand of patients mortality. Cervical cancer can be prevented by early detection. The high prevalence of cervical cancer in Indonesia is due to the lack of public knowledge and awareness. In addition, the level of knowledge also affects the participation of women to conduct cervical cancer early detection. The faculty of medicine is very close to health issues and active to educate public regarding health. Therefore, the entire academic community is expected to be aware of and care about their respective personal health. This study is aimed to determining the correlation between cervical cancer knowledge level with early detection behavior towards employees at Faculty of Medicine, Udayana University. This study was an observational using a cross-sectional method and total sampling method for the data collection. Based on the results of the study, there was a significant relationship between the respondent’s knowledge level with cervical cancer early detection behavior (p-value <0.05). The group of respondents with insufficient knowledge, most of them said that they had never conducted early detection of cervical cancer as many as 8 people (80.0%). Meanwhile, most of the respondents with sufficient knowledge stated that they had conducted early detection of cervical cancer as many as 21 people (61.8%). Keywords : knowledge, cervical cancer, early detection, employees.

Co-Authors Agustinus Darmawan Hariyanto Anak Agung Gede Putra Wiradnyana Anak Agung Ngurah Anantasika Anak Agung Ngurah Anantasika Anak Agung Ngurah Jaya Kusuma Andy Susanto Anom Suardika Arthawan Arthawan Ary Widayana Clara Marcaelia Valerian Daniel Hadinata Susanto Danny Aguswahyudi Florencia Desiree Gede Angga Permana AW I Gde Sastra Winata I Gede Egy Saputra Jaya I Gede Mahendra Adiguna Dira I Gede Mega Putra I Gede Ngurah Harry Wijaya Surya I Gusti Agung Ayu Sri Wulandari Pramana I Gusti Putu Mayun Mayura I Ketut Surya Negara I Ketut Suwiyoga I Made Darmayasa I Nyoman Gede Budiana I NYOMAN MANTIK ASTAWA I Wayan Artana Putra Ida Bagus Gde Fajar Manuaba Ida Bagus Putra Adnyana Ida Bagus Rendra Kurniawan Artha Ines Kurniaty Hartono Kadek Fajar Marta Ketut Putera Kemara Leony Lim Made Bagus Dwi Aryana Nyoman Bayu Mahendra Putera Kemara Putra Agung Eka Aricandana Putra, I Wayan Artana Putu Adi Sujana Putra Putu Doster Mahayasa Riza Firman Satria Ryan Saktika Mulyana Sugianto Sugianto Tjokorda Gde Agung Suwardewa Widyasari, Putu Kartika Yosevangelika Hutabarat

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