Laila Nuranna
Faculty of Medicine University of Indonesia Jakarta

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Survival rate and prognostic factors in advanced cervical cancer patients accompanied by renal impairment Rasjidi, Imam; Nuranna, Laila; Aziz, M. F.; Andrijono, Andrijono; Purbadi, Sigit; Rochani, Rochani; Supriana, Nana; Dharmeizar, Dharmeizar; Sutrisna, Bambang
Medical Journal of Indonesia Vol 14, No 3 (2005): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (364.409 KB) | DOI: 10.13181/mji.v14i3.193

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The objective of this study was to obtain information on the  survival rate  of advanced cervical cancer patients with  renal impairment (ACCRI) and its prognostic factors. In addition, it is hoped that by this method the scoring system for predicting the death of  ACCRI patients hopetully  could be obtained.  Design of the study used was retrospective cohort study. Data collected  were retrieved from  medical  records of  ACCRI patients from 1 January 1998 to  31 December 2003 at Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, with a total sample of 70 cases. The results of the study showed that mean survival of  all ACCRI patients  was 8.2 months,  mean survival at sixth month was 39%, and mean survival  at one year was 3.2%. Median survival was  5.3 months. Prognostic factors affecting the survival of ACCRI patients included  histopathological type (adenosquamous cell and cell differentiation), cortical thickness of the kidney less than 1 cm, and nephrostomy. (Med J Indones 2005; 14: 173-8)Keywords: Advance cervical cancer, renal impairment, nephrostomy, survival prognostic factor, scoring system
Clinical-pathologic factors, as predictor of lymph nodes metastasis in cervical cancer stage IB and IIA Aziz, M. F.; Andrijono, Andrijono; Nuranna, Laila; Purbadi, Sigit; Mangunkusumo, Rukmini T.; Siregar, Budiningsih; Cornain, Santoso; Saifuddin, Abdul B.; Tjarta, Achmad; Sutrisna, Bambang
Medical Journal of Indonesia Vol 13, No 2 (2004): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (232.052 KB) | DOI: 10.13181/mji.v13i2.574

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The aim of this study was to identify possible predictor factors of lymph node metastases in patients with cervical cancer stage IB and IIA. Study was conducted between May 1996 and December 2001. There were 183 patients of cervical cancer with FIGO Stage IB and IIA who were underwent radical hysterectomy and lymphadenectomy. From those 158 patients could be evaluated, consisting 43 patients with node metastases 115 patients without metastases. Research design was case control study. Case was patients with node metastases and control was those without node metastases. Multivariate analysis was made after bivariate analysis. On bivariate analysis age < 39 years, diameter of lesion > 4 cm, stage IIA > 4 cm, histopathology moderate and poor differentiation, blood and lymphatic vessel invasion were independent variables for node metastases with p value ≤ 0.05. However, on multivariate analysis younger age, parity ≥ 4, diameter of lesion, histopathology adenosquamous, and lymph vascular invasion (+) as independent factors for node metastases with p value ≤ 0.05. Conclusion: Younger age, parity ≥ 4, stage IIA > 4 cm, diameter of lesion, histopathology adenosquamous, and lymph vascular invasion (+) were risk factors for node metastases and can be used as predictors. (Med J Indones 2004; 13: 113-8)Keywords: cervical cancer, radical hysterectomy, node metastases, case control study, predictor
Survival of borderline tumors of the ovary and its prognostic factors at Dr. Cipto Mangunkusumo hospital from 1990 to 1999 Sanif, Rizal; Nuranna, Laila; Sutrisna, Bambang
Medical Journal of Indonesia Vol 11, No 4 (2002): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (208.752 KB) | DOI: 10.13181/mji.v11i4.77

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Sixty-two patients with borderline tumors of ovary were historical cohort analyzed for survival characteristics. There were 9 patients with FIGO stage IA, 9 with stage IC, 3 with stage IIIA, 2 with stage IIIB, 4 with stage IIIC, 1 with stage IV and 34 with inadequate stage tumors. Twenty one patients had surgical staging with radical surgery, 10 patient had at least a total abdominal hysterectomy and bilateral salpingo-oophorectomy, 6 patient had surgical staging with conservative surgery, 24 patient had at least a unilateral salphingo-oophorectomy or ovarian cystectomy and 1 patient had biopsy. Sixteen patients received cisplatin-based combination chemotherapy, that were 8 with inadequate stage tumors, 7 with stage III tumors and 1 with stage IV tumor. Follow-up range from 0.02 to 10.48 years, with a median of 3.5 years. Fifty nine patient were alive. Three patients died, all of disease. Recurrence were found in 4 patients. The overall 2-years survival rate was 96% and 10-years survival rate was 94%. In log rank test, residual disease and histology type were significant predictor of survival. (Med J Indones 2002; 11:222-9)Keywords: borderline tumors of ovary, survival
Survival of cervical cancer patients and its prognostic factors at Cipto Mangunkusumo Hospital, Jakarta Nuranna, Laila; Prastasari, Rahma; Sutrisna, Bambang
Medical Journal of Indonesia Vol 23, No 3 (2014): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1501.297 KB) | DOI: 10.13181/mji.v23i3.739

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Background: Cervical cancer is the second most common cancer among Indonesian women. Information concerning survival probability is very important for the patient and institution. Our last data about cervical cancer survival was studied for more than 10 years ago. This study aimed to know the latest cervical cancer survival and its prognostic factors.Methods: This is a retrospective cohort study which enrolled cervical cancer patients treated at Cipto Mangunkusumo Hospital in 2005-2006. Subjects were followed-up for minimum of 5 years. Kaplan-Meier and Cox regression analysis was used to determine the survival probability and to assess prognostic factors.Results: A total of 447 patients who met the study criteria were selected. Stage III was the largest proportion on the study (41.6%). Most of the histopathology type was squamous cell carcinoma (71.6%). This study revealed that median survival was 63 months with the overall 5-years survival probability to be 52%. Tumor size did not influence overall survival rate. Stage III and IV had lower survival probability (HR 3.27 and 6.44). Poor differentiation and uncompleted therapy also had lower survival probability (HR 2.26 and 2.22). Histopathology of others (neuroendocrine) had lower survival probability (HR 2.85). However, it was not statistically significant on multivariate analysis.Conclusion: Median survival time for cervical cancer patients at Cipto Mangunkusumo Hospital was 63 months. There were improvement in the survival rate comparing from the study in 1997. In this study, the independent prognostic factors for survival were tumor staging, tumor differentiation, and completion of therapy.
Primary Prevention – Vaccination – New Era To Eradicate Cervical Cancer, Is It True Or Gimmick? nuranna, laila
Indonesian Journal of Cancer Vol 4, No 5 (2010): Workshops 2010
Publisher : "Dharmais" Cancer Center Hospital

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Faculty member at Division of Gynecologic OncologyDepartment of Obstetrics and GynekologyFaculty of Medicine University of Indonesia Dr Cipto Mangunkusumo National General Hospital -JakartaGraduated from Faculty of Medicine University of Indonesia 1979.Finished from residency training in Obstetrics and Gynecologyat Faculty of Medicine UI/dr Cipto National General Hospital, 1986Received Doctoral degree at the same institutions, 2005Fellowship program from Gynecologic Oncology atGroningen university The Netherland/Academisch Ziekenhuiz Groningen, 1988Member of some Profesional Organization,Coordinator of Female Cancer Program Region JakartaFull text : http://www.scribd.com/doc/43595177/Primary-Prevention-Vaccination-New-Era-To-Eradicate-Cervical-Cancer-Is-It-True-Or-Gimmick
Giant Condyloma Acuminatum in a Woman with AIDS Nuranna, Laila
Indonesian Journal of Obstetrics and Gynecology Volume. 36, No. 4, October 2012
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Objective: To describe a case of Giant Condyloma Acuminatum with aspect of HIV and some concerns about the CD4. Result: We describe 2 cases, the first case is a giant Condyloma in HIV patient and the second case is a giant Condyloma in pregnant woman. The patient in the first case was a 40-year-old woman with AIDS (CD4 is 290) who was undergoing anti-retroviral therapy. She was found to have a giant condyloma acuminatum of the vulva. Electrocautery excision was performed, and afterwards the quality of life has improved significantly. The second case patient is a 30-year-old G4P3A0 woman with a giant condyloma acuminatum. She was 30 weeks pregnant with a single fetus. On the external genitalia there was a giant condyloma mass on the vulva extending towards the peri-anal area, obstructing the introitus. The electrocautery excision was performed. She was discharged from the hospital on the second day in good condition. She had a spontaneous delivery after reaching full term. Conclusion: Although the giant Condyloma Acuminatum is combined with HIV, but it’s not as difficult as imagined because the tumor’s base is not wide, but shaped like inverted mushroom and it is not necessary to do local flap reconstruction. [Indones J Obstet Gynecol 2012; 36-4: 206-10] Keywords: electrocautery excision, giant condyloma acuminatum, surgery in AIDS
Papsmear Examination for Diagnosing PreCancer Lesion in Invisible SquamoColumnar Junction Nuranna, Laila; Daud, Sulaeman; Purwoto, Gatot; Winarto, Hariyono; Nuryanto, Kartiwa H
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No.3, July 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Objective: To know the concealed pre-cancer lesion in women with invisible squamo-columnar junction (SCJ) by Papsmear examination. Method: This study was a descriptive cross-sectional design starting from August 2014 to March 2015 at several Public Health Cares in Jakarta. A total of 1,682 subjects were screened by Acetoacetate Visual Inspection (AVI) examination. After the data was collected, the process was continued by verification, editing, and coding. The descriptive analysis showed the percentage of SCJ in age distribution, the percentage of AVI examination based on SCJ, and the percentage of Papsmear examination in invisible SCJ according to negative AVI result. Result: There were 1,484 (88.2%) women with the visible SCJ and 198 (11.8%) women with invisible SCJ. The percentage of invisible SCJ in the menopausal women group was 122 (61,6%); meanwhile, in the non-menopausal women group, it was 76 (38.4%). Almost half of the percentage from visible SCJ was found in menopausal women group 45.8% (103/225 women). The positive AVI result was 4 (7.1%) in the menopausal women group and 52 (92.9%) in non-menopausal women group. The result of Papsmear examination with invisible SCJ were 197 (100%) normal. Conclusion: Almost half of visible SCJ was found in menopausal women group. Most of positive AVI result was found in the nonmenopausal women group. All women with the invisible SCJ have a normal Papsmear result. Keywords: acetoacetate visual inspection, papsmear, pre-cancer lesion, squamo-columnar junction
Post-operative Recovery Assessment of Urinary Tract Dysfunction Following Radical Hysterectomy for Cervical Cancer Patients Nuranna, Laila; Kusuma, Sang A F Adi
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 4 October 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (91.495 KB) | DOI: 10.32771/inajog.v6i4.852

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Abstract Objectives: To assess the length of recovery phase in urinary tract dysfunction following radical hysterectomy for cervical cancer patients in Ciptomangunkusumo Hospital. Methods: This survey study was conducted in Cipto Mangunkusumo Hospital from September 2016 to May 2017. Subjects were cervical cancer patients from stage IA2 to IIA2 underwent radical hysterectomy. Suprapubic catheter (SPC) was inserted to observe the urine production after procedure. Patients were then directed for bladder training protocol involving clamping and opening SPC. Sensation of bladder fullness followed by spontaneous micturition were recorded. Measurement of post voiding residual (PVR) urine volume after spontaneous micturition until less than 100 mL was considered as resolution of urinary tract dysfunction. The average days of every achieved phase were then calculated. Results: Twenty-nine subjects underwent radical hysterectomy during observation period. But only 21 subjects continued the bladder training protocol and recorded for the recovery phases. The average time needed to obtain sensation of bladder fullness and spontaneous micturition were 7.57 ± 4.78 days (median 5 days, minimum 3 days,  maximum 22 days)and  8 ± 5.21 days (median 6 days, minimum 3 days, maximum 23 days). The objective PVR urine became less than 100mL was obtained after 21.42 ± 18 days (median 18 days, minimum 7 days, maximum 74 days). Conslusion: Following radical hysterectomy, recording the recovery phase of urinary tract dysfuction is essential to ensure complete resolution. Complete resolution of the urinary dysfunction is achieved after 21.42±18 days in average (median 18 days, minimum 7 days, maximum 74 days). Keywords: cervical cancer, radical hysterectomy, urinary tract dysfunction, post voiding residual volume.   Abstrak Tujuan: Menilai masa pemulihan disfungsi saluran kemih setelah histerektomi radikal pada pasien kanker serviks di RSUPN Ciptomangunkusumo. Metode: Studi survei dilakukan di RSUPN Cipto Mangunkusumo dari September 2016 hingga Mei 2017. Subjek penelitian terdiri dari pasien kanker serviks stadium IA2 hingga IIA2 yang menjalani histerektomi radikal. Kateter suprapubik (SPC) digunakan sebagai alat untuk memantau produksi urin pasca operasi. Pasien diinstruksikan untuk mengikuti protokol bladder training yaitu melalui prosedur menutup dan membuka kateter. Rasa sensasi ingin berkemih dan berkemih spontan. Pengukuran residu volume urin pasca berkemih dibawah 100mL dianggap merupakan indikator pemulihan disfungsi saluran kemih. Rata-rata hari dari setiap fase kemudian dihitung. Hasil: Dua puluh sembilan subjek didapatkan selama penelitian. Namun, hanya 21 subjek yang dapat mengikuti protocol bladder traning dan dicatat perkembangan pemulihannya. Rata-rata hari yang diperlukan untuk merasakan sensasi berkemih dan berkemih spontan adalah 7,57 ± 4.78 hari (median 5 hari, minimum 3 hari, dan maksimum 22 hari) dan 8 ± 5.21 hari. (median 6 hari, minimum 3 hari dan maksimum 23 hari) Rata-rata hari untuk mencapai residu urin di bawah 100 mL adalah 21.42 ± 18 (median 18 hari, minimum 7 hari, dan maksimum 74 hari). Kesimpulan: Setelah prosedur histerektomi radikal, pencatatan masa pemulihan penting untuk dipantau untuk memastikan pemulihan lengkap. Rata-rata hari yang diperlukan untuk pemulihan adalah 21.42 ± 18 hari (median 18 hari, minimum 7 hari, dan maksimum 74 hari). Kata kunci: kanker serviks, histerektomi radikal, disfungsi saluran kemih, volume residu paska berkemih.
Changes in Cortisol Levels before and after Supportive Psychotherapy in Patients with Comorbid Cervical Cancer Distress with Depression Type Nuranna, Laila; Nuryanto, Kartiwa H; Andriansyah, Andriansyah; Elvira, Sylvia D; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 3 July 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (281.702 KB) | DOI: 10.32771/inajog.v6i3.784

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Objective: To prove the success of supportive psychotherapy thatwas provided as a distress therapy on advanced cervical cancer.Knowing the prevalence of distress type of depression in patientwith epithelial cervical cancer, proving the benefits of psychotherapysupportive for distress can decreasing cortisol level in cervicalcancer patient, can assess distress thermometer score, HAM-D17score and scoring incident predictors of distress with depressiontype.Methods: There were 32 subjects from 71 advanced cervical cancerpatients had mild-moderate depression. Then randomizationblocking was performed to determine a subject who entered thetreatment group (n = 16) who got supportive psychotherapy orcontrol group who got common psychotherapy (n = 16). All ofparticipants assessed the distress level with cortisol value, distressthermometer score, and HAM-D17 score before and after they gotsupportive psychotherapy.Results: After the intervention of psychotherapy in the treatmentgroup decreased HAM-D17 score, the average decline 7.53 (SB 3.34).The mean decreasing in the control group was 3.98 (SB 2.85). Thereis a significant difference in mean reduction in HAM-D17 scores ontreatment and control groups with p = 0.003 (p <0.005). There wasdecreasing blood cortisol level in the treatment group amounted to39.43, while the control group there was a drop of 1.59. The reductionof cortisol level in the treatment group and the control has a pvalue0.302. After got supportive psychotherapy, found a decreasingthe average value of the thermometer distress in the treatmentgroup 3.02 and the control group 2.51, with a p value more than0.492.Conclusion: There were 45% of cervical cancer patients in the clinicexperiencing distress disorder with depressive type. The bloodcortisol level could be decreased by giving supportive psychotherapywith a mean decrease of 39.43 nmol/l. There was a significantreduction in the level of depression (HAM-D17 score) of 7.53 pointsand distress thermometer impairment by 3 points after givensupportive psychotherapy. Obtained scoring predictors for theoccurrence of distress type of depression in patients with advancedcervical cancer with a sensitivity of 46.15% and a specificity of89.47%.[Indones J Obstet Gynecol 2018; 6-3: 179-187]Keywords: cervical cancer, cortisol, distress, distress thermometer,HAM-D17 score
The Association between Menstrual Disorder and Work Disturbance among Employees Nuranna, Laila; Abdullah, Iftikar; Kayika, I. Putu G.; Pratama, Gita
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 1. January 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2269.202 KB) | DOI: 10.32771/inajog.v6i1.751

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Objective: To investigate the association between menstrualdisorders including each menstrual cycle disorder, durationand volume of menstrual bleeding disorder, menstrual intervaldisorder, and another disorder that related to menstruationagainst disruption of work among employees.Methods: This study used a cross sectional design. Samplerandomization with winpepi® software for Windows 7®. Dataanalysis using SPSS 24® software for Windows 7®.Results: A total of 150 subjects were recruited in this study. Theprevalence of menstrual disorder was 87%, menstrual cycledisorder 3%. Menstrual volume disorder 31%, 15% menstrualabnormalities, 83% menstrual pain disorder and premenstrualsyndrome 71%. Prevalence of work disturbance was 49% formild disturbance, 47% for moderate disturbance and severework disturbance by 4%. There was a relationship betweenmenstrual volume disorder, hypermenorrhoea, and menstrual /dysmenorrhoea pain to occupational disruption among theemployee at RSCM (p <0.001). The submission of the proposedleaves due to menstrual disorder in the proposed permit for1 day by 73%.Conclusion: The prevalence of severe work disturbance due tomenstruation is not high but can lead to disruption in runningjobs and activities. However, it is important to be a concern so thatthe employees get good management and care.Keywords: employee, menstrual leave, menstrual disorder, prevalence,work disturbance