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PENANGANAN HOLISTIK PADA KASUS PELECEHAN SEKSUAL PADA ANAK Ocviyanti, Dwiana; Khusen, Denny
Majalah Kedokteran Indonesia Vol 68 No 4 (2018): Journal of the Indonesian Medical Association Majalah Kedokteran Indonesia Volum
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

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Abstract

Pendahuluan: Kasus pelecehan seksual terhadap anak masih banyak terjadi di kalangan masyarakat. Peristiwa ini dikarenakan anak yang menjadi korban jarang melapor karena berbagai alasan, misal malu dan takut. Oleh sebab itu, sebagai orang tua harus dapat mengenali tanda-tanda anak yang mengalami pelecehan seksual. Ilustrasi Kasus: Pasien anak perempuan 15 tahun datang untuk meminta dilakukan visum. Orang tua korban mencurigai bahwa korban telah dilakukan pelecehan seksual dari masyarakat sekitar rumah, namun korban tidak mau mengaku akhirnya orang tua datang bersama polisi ke bagian forensik untuk dilakukan pemeriksaan visum. Setelah dilakukan pemeriksaan visum oleh forensik bersama kebidanan selanjutnya korban dikonsulkan ke bagian psikiatri dan anak. Diskusi: Dalam penanganan kasus pelecehan seksual terhadap anak seharusnya bersifat holistik dan terintegrasi. Semua sisi memerlukan pembenahan dan penanganan, baik dari sisi medis, sisi individu, aspek hukum, maupun dukungan sosial. Kasus ini memberikan banyak pengalaman dan mengajarkan kita untuk lebih memberikan edukasi kepada masyarakat terutama orang tua yang memiliki anak-anak agar lebih memperhatikan lingkungan dimana tempat anaknya berada dan diberikan penyuluhan mengenai pencegahan pelecehan seksual anak. Kesimpulan: Pelecehan seksual pada anak dapat terjadi di mana saja dan kapan saja serta dapat dilakukan oleh siapa saja, oleh karena itu, anak perlu dibekali dengan pengetahuan seksualitas yang benar.
MANAGEMENT OF SCHIZOPHRENIA IN PREGNANCY: A CASE REPORT Junita Indarti; Dwiana Ocviyanti; Erda Ayu Umami
Majalah Kedokteran Indonesia Vol 69 No 12 (2019): Journal of The Indonesian Medical Association Majalah Kedokteran Indonesia Volu
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.1234/jinma.v69i12.168

Abstract

Skizofrenia merupakan kelainan mental berat yang ditandai dengan gangguan proses berfikir dalam, mempengaruhi bahasa, persepsi dan rasa terhadap diri. Pengalaman psikosis biasanya berupa seolah-olah mendengar suara-suara atau delusi. Onset usia tersering terkena skizofrenia adalah 25-35 tahun (usia reproduksi). Kami melaporkan sebuah laporan kasus seorang wanita hamil berusia 27 tahun dan mengidap skizofrenia paranoid. Wanita usia reproduktif dengan skizofrenia membutuhkan penanganan komprehensif selama usia reproduksi, termasuk kontrasepsi, asuhan pra-natal, antenatal, dan post-natal, serta menjadi orang tua yang aman dan efektif.
Gynaecologic History During Adolescence to Predict Endometriosis Earlier Hartati; Dwiana Ocviyanti; Ramzi Amin; Yusuf Effendi; Zen Hafy; Radiyati Umi Partan; Rafika Novianti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 3 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i3.465

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Background. Endometriosis is a chronic gynecological disorder that generally affects women of reproductive age which is characterized by implantation of endometrial tissue, both glands and stroma outside the uterus. Research shows that the initial onset of endometriosis patients begins in adolescence. The high prevalence with atypical symptoms leads to long term delay in establishing the appropriate diagnosis. Further developments in the field of early endometriosis screening will greatly assist clinicians, especially general practitioners in areas with limited health facilities, in early detection of endometriosis. Methods. Using the electronic databases, comprehensive literature searches were conducted with the specific keywords. Full-text manuscripts published were reviewed for relevancy and importantly, reference lists were cross-checked for additional relevant studies. Results. Dysmenorrhea, chronic pelvic pain, dyspareunia, dysuria, dyschezia, and glycoprotein were found dominantly in all analyzed literature. The occurrence of endometriosis affects the functioning of women in multiple aspects of life. Endometriosis places a significant burden on teens and adult women, their families, and society as a whole. Conclusion. Combination of structured past history taking, and several biomarker level might be useful as a screening tool that easy to use and cost effective, as early diagnosis is expected to prevent further progression of endometriosis especially in adolescence.
Identifying Causes of Vaginal Discharge: The Role of Gynecologic Symptoms and Signs Farhan D Hasan; Dwiana Ocviyanti
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 1, January 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (129.529 KB) | DOI: 10.32771/inajog.v3i1.17

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Abstract Objective: To attain diagnostic accuracy of various gynecologic symptoms and signs in identifying causes of vaginal discharge. Method: Eighty-two subjects were included in this cross sectional study. Gynecologic symptoms and signs were inquired from each subject and further laboratory examinations were carried out to identify the etiology. Diagnostic accuracy for each symptom and sign was compared to the laboratory examination as the standard reference. Symptoms and signs with positive predictive value (PPV) of more than 50% were considered to have good diagnostic accuracy. Result: For bacterial vaginosis, excessive wetness in genital area; vulvar maceration; and thin, turbid, yellowish vaginal discharge had PPVs of 53%; 52%; and 52%, respectively. For candidal vaginitis, vulvar maceration; and white, curd-like vaginal discharge had PPVs of 58% and 100%, respectively. For trichomoniasis, thin, turbid, frothy, yellowish vaginal discharge; and strawberry-cervix appearance had PPVs of 60% and 100%, respectively. There were no symptoms or signs with PPV of more than 50% for chlamydial cervicitis. Diagnostic accuracy for clinical findings in gonorrheal cervicitis could not be calculated due to the small number of subjects. Conclusion: Various gynecologic symptoms and signs were found to be accurate in diagnosing bacterial vaginosis, candidal vaginitis, and trichomoniasis. No symptoms or signs were considered accurate to aid etiological diagnosis for chlamydial and gonorrheal cervicitis. Keywords: bacterial vaginosis, Candida sp, Chlamydia trachomatis, gynecologic symptoms and signs, Neisseria gonorrhoeae, Trichomonas vaginalis
Objective: There were only few studies about the characteristic of vaginal pH among contraception user in Indonesia. This study aimed to determine the effect of contraception on vaginal pH among Indonesian women. Method: This study is a cross-sectional study. The target population was Indonesian women aged 15 - 50 years. The samples consisted of 492 people. Based on the method of contraception, subjects were grouped into 4 groups, subjects with combination hormonal contraceptives, progestin only Dwiana Ocviyanti
Indonesian Journal of Obstetrics and Gynecology Volume. 34. No. 2, April 2010
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: There were only few studies about the characteristic of vaginal pH among contraception user in Indonesia. This study aimed to determine the effect of contraception on vaginal pH among Indonesian women. Method: This study is a cross-sectional study. The target population was Indonesian women aged 15 - 50 years. The samples consisted of 492 people. Based on the method of contraception, subjects were grouped into 4 groups, subjects with combination hormonal contraceptives, progestin only, condoms/IUDs, and subjects with no contraception or sterile. Vaginal acidity (pH) was examined by Dip- Stick (Merck®). Result: The average age was 30.9 ± 8.27. The methods of contraception the subjects used were combination hormonal contraception (18.0%), progestin-only (29.5%), condom/IUDs (5.1%) and no contraception/sterile (47.4%). Most subjects had vaginal pH
The Role of Hospitals in Cervical Cancer Prevention Susie Susilawati; Dwiana Ocviyanti
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 1, January 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (100.216 KB) | DOI: 10.32771/inajog.v2i1.371

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Objective: To evaluate the role of hospitals in DKI Jakarta on primary and secondary cervical cancer prevention. Method: This was a survey conducted to 25 hospitals, chosen with simple random sampling from 109 hospitals in DKI Jakarta. Questionnaire used for interview contained statements regarding knowledge, attitude and behavior of 117 health care professionals along with identification of facility preparedness for cervical cancer prevention within those 25 hospitals. Result: The assessment of knowledge shows that all health care professionals (100%) knew that HPV vaccination is used as a primary prevention for cervical cancer. About 98.3% respondent knew HPV vaccine injected intramuscularly. As much as 91.5% of the respondent knew HPV vaccine is given three times either at month 0, 1, 6 or at month 0, 2, 6. About 71.8% respondent knew deltoid as site for vaccine injection. Most of health care professionals (99.1%) knew VIA (visual inspection with acetic acid) can be used for early detection of cervical cancer. About 76.9% respondent knew how to interpret positive VIA results and 60.7% respondent knew how to do VIA test. As much as 93.2% health care professional knew the purpose of Pap test and about 82.1% knew how to do it. From attitude aspect, most of health care professionals (96.6%) agreed in giving HPV vaccination. About 94% of them agreed to do VIA test and about 98.3% agreed in conducting Pap test. From behavioral aspect, most of the respondent (76.9%) offered HPV vaccination to their clients/patients and 62.4% respondent did HPV vaccination. VIA test was offered and conducted by 52.1% and 30.8% of them, respectively. About 86.3% respondent offered Pap test and 71.8% did the Pap test. As many as 75% of female health care professionals who meet the qualification already had a Pap test for themselves, but only 32.5% ever been vaccinated for HPV. From facility aspect, twenty hospitals (80%) in DKI Jakarta offered HPV vaccination with Pap test can be done in all of them. VIA test and colposcopy were only available in eleven (44%) and ten (40%) hospitals respectively. Conclusion: Most hospitals in DKI Jakarta have health care professionals with good knowledge and attitude in cervical cancer prevention. However, not many have shown expected behavior in the primary prevention. Most hospitals in DKI Jakarta provide facilities for HPV vaccination and Pap test, but only few have VIA facilities and colposcopy. Keywords: cervical cancer prevention, health care professional, hospital
Microscopic Examination of Urine Samples as the Early Detection of Asymptomatic Urinary Tract Infection in Pregnant Women: A Cross-Sectional Study: Uji Mikroskopik Spesimen Urin sebagai Deteksi Dini Infeksi Saluran Kemih tidak Bergejala pada Perempuan Hamil: Sebuah Studi Potong Lintang Yeva Rosana; Dwiana Ocviyanti; Rahmah Amran
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 3 July 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (71.937 KB) | DOI: 10.32771/inajog.v7i3.899

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Abstract Objectives:To investigate the role of microscopic examination of urine sample in supporting early diagnosis of asymptomatic urinary tract infection (UTI) in pregnant women. To compare correspondence between microscopic examination and urine culture result as a gold standard diagnostic modality to support the diagnosis of UTIs and as an evidence-based to start empirical therapy. Methods: Microscopic analysis was conducted in 74 centrifuged and non-centrifuged urine samples from 317 pregnant who came to six healthcare centres in Jakarta, which showed a positive result of nitrite examination. The results of the microscopic examination of bacteriuria and leukocyturia were compared with a urine culture. Results: Sensitivity of centrifuged bacteriuria was the highest among the other microscopic parameters, which was 74% with the p-value of 0.009. Combination of bacteriuria and leukocyturia≥3/HPF dan≥5/HPF have increased the specificity with the value of 91.5% and 93.6% in non-centrifuged urine. Conclusion: This result showed that the best method of microscopic examination for early diagnosis of asymptomatic urinary tract infection in pregnant women is the detection of bacteriuria in centrifuged urine. Combination of bacteriuriaandleukocyturiatest, as well as leukocyturia≥3/HPF and≥5/HPF, can be used to rule out the diagnosis of UTI at an early stage. Keywords: asymptomatic urinary tract infection, bacteriuria, leukocyturia,microscopic examination, urine culture. Abstrak Tujuan: Mengetahui peran pemeriksaan mikroskopis sampel urin dalam mendukung diagnosis dini infeksi saluran kemih asimptomatik (ISK) pada perempuan hamil. Membandingkan kesesuaian antara pemeriksaan mikroskopis dan hasil kultur urin sebagai modalitas diagnostik standar emas untuk mendukung diagnosis ISK dan sebagai dasar bukti untuk memulai terapi empiris. Metode: Penelitian uji mikroskopik dilakukan pada 74 sampel urin disentrifugasi dan tidak sentrifugasi, dari 317 sampel urin perempuan hamil yang berobat ke-enam puskesmas di Jakarta dengan uji nitritpositif. Hasil uji mikroskopik bakteri uria dan leukosit uria dibandingkan dengan hasil kultururin. Hasil: Sensitivitas bakteriuria yang disentrifugasi menunjukan hasil yang paling baik dibandingkan dengan parameter uji mikroskopik lain, yaitu 74% dengan nilai p yang bermakna sebesar 0,009. Kombinasi bakteri uria dan leukosituria ≥3/LPB dan ≥5/LPB dapat meningkatkan spesifisitas uji dengan nilai 91,5% dan 93,6% pada urin yang tidak disentrifugasi. Kesimpulan: Hasil menunjukkan bahwa bakteri uria pada urin yang disentrifugasi, merupakan metode yang paling baik untuk membantu diagnosis dini ISK tidak bergejala pada perempuan hamil. Uji kombinasi bakteri uria dan leukosituria, serta uji leukosituria ≥3/LPB dan ≥5/LPB dapat dimanfaatkan untuk membantu secara dini menyingkirkan orang yang tidak mengalami ISK. Kata kunci: bakteriuria, infeksi saluran kemih tidak bergejala, kultur urin,leukosituria, uji mikroskopik
Improving Quality of Maternal Health Services Through Research and Improvement of Health System in Indonesia Dwiana Ocviyanti
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 4 October 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (41.089 KB) | DOI: 10.32771/inajog.v7i4.1208

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Biopsychosocial Aspect of Pregnant Women Suspected Brainstem Death: Aspek Biopsikososial pada Perempuan Hamil dengan Kecurigaan Mati Batang Otak Dwiana Ocviyanti; Ribkhi A. Putri
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 2 April 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i2.1269

Abstract

Abstract Objectives: Diagnosis of brainstem death and the vital organ function support in the pregnant woman to prolong gestation to attain fetal viability is still controversial. The decision is influenced by ethical and legal issue in the country. Another consideration is the hospital cost and health insurance coverage. This article purpose is to report a case and discuss the biopsychosocial aspect of this issue, so the doctors know how to decide a similar case.Methods: We reported a suspected brainstem death in pregnant women and discussed the holistic approach.Case: This case is a-38-year-old women, third pregnancy, 22 weeks of gestation, referred from the secondary hospital in a comatose condition. She was diagnosed with brainstem dysfunction due to intracranial mass and cerebral oedema. She wasn't diagnosed with brainstem death due to the electrolyte imbalance that can cause this condition. We did the multidisciplinary management approach. We decided the termination of pregnancy would only be performed if the fetus reaches 28 weeks of gestational age (with survival rate on perinatology is 31%). From the husband point of view, since the attending doctors have not declared the mother to be dead, then the husband still want to keep the mother in full life support. The patient and the fetus died on the 8th day of hospitalization. The patient was fully paid for by Indonesian Health Insurance.Conclusion: Maternal brainstem dysfunction and brainstem death during pregnancy are rare. In Indonesia, ethical and legal consideration to keep both mother and fetus are appropriate with the general social, cultural, and religious values. However, we recommend managing every single case individually with an intensive multidisciplinary approach due to the possibility of the different personal value of the patient.Keywords: brainstem dysfunction, brain death, pregnancy, fetal, ethic, legal. Abstrak Tujuan: Diagnosis kematian batang otak dan dukungan fungsi organ vital pada perempuan hamil untuk melanjutkan kehamilannya sampai janin dapat hidup jika dilahirkan masih kontrovesi. Keputusan ini dipengaruhi oleh etik dan hukum di suatu negara. Pertimbangan lainnya adalah biaya perawatan rumah sakit dan cakupan asuransi kesehatan. Artikel ini bertujuan melaporkan sebuah kasus dan mendiskusikan aspek biopsikososialnya, sehingga para dokter dapat mengambil keputusan pada kasus lain yang serupa.Metode: Kami melaporkan kasus perempuan hamil dengan kecurgaan kematian batang otak dan mendiskusikan pendekatan holistiknya.Hasil: Kasus perempuan usia 38 tahun, kehamilan ketiga, 22 minggu, dirujuk dari rumah sakit sekunder dalam kondisi koma. Pasien didiagnosis dengan disfungsi batang otak akibat massa intracranial dan edema serebri. Pasien tidak didiagnosis dengan meti batang otak karena kondisi ini masih dapat dikarenakan gangguan keseimbangan elektrolit. Kami melakukan pendekatan multidisiplin. Diputuskan terminasi kehamilan akan dilakukan hanya jika janin mencapai usia kehamilan 28 minggu (dengan harapan hidup dari perinatology 31%). Dikarenakan dokter belum mengatakan pasien sudah meninggal, suami pasien menginginkan pasien dalam topangan alat. Pasien dan janinnya meninggal pada hari ke-8 perawatan. Pembiayaan pasien dengan menggunakan BPJS.Kesimpulan: Disfungsi batang otak dan kematian batang otak selama kehamilan adalah kasus yang jarang. Di Indonesia, etik dan hukum yang berlaku untuk menjaga kehidupan ibu dan janin sesuai dengan nilai sosial, budaya, dan agama. Namun demikian, kami merekomendasikan mlakukan tata laksana setiap kasus secara individu dengan pendekatan multidisiplin dikarenakan perbedaan nilai pribadi pasien dan keluarga.Kata kunci: disfungsi batang otak, etik, hukum, janin, mati batang otak, kehamilan.
Analysis of Antenatal Care Quality in Cases of Referred Pregnant Women in Emergency Rooms Based on MCH Book Records: Analisis Kualitas Asuhan Antenatal Berbasis Telaah Buku KIA pada Kasus Rujukan Ibu Hamil di Unit Gawat Darurat Dwiana Ocviyanti; Joan M. Sari
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 3 July 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i3.1339

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Objective: To determine the quality of antenatal care received by pregnant women, and perceptions of pregnant women and antenatal care providers regarding antenatal care.Method: A quantitative and qualitative study of cases of referred pregnant women in the Emergency Room (ER) of Dr. Cipto Mangunkusumo Hospital (RSCM) from 2017–2018 was conducted. Quantitative data was obtained by assessing the overall completeness of filling in the Maternal Child Health (MCH) book used to report the antenatal care received by the subjects. The completeness of antenatal care in the health facility was obtained using a checklist. Qualitative data was obtained by interviewing pregnant women and antenatal care providers in health facilities.Result: There were 1.442 cases of referred pregnant women in RSCM’s ER for the year 2017–2018, of whom 820 possessed and could show their MCH Book. Pregnancy in adolescence below 20 years (9.1%) and pregnancy after age 35 (19.5%) were reported. Most pregnant women were well educated (74.3%), referred from hospital or clinic (57.6%), received antenatal care in a public health center (38.7%), were in labor (32%), and were in the third trimester of pregnancy (92%). All subjects presented an incomplete MCH book. Almost half had inadequate antenatal frequency (46%). The completeness of antenatal care components in health care was 90–100%. Qualitatively, the perceptions of mothers and antenatal care providers regarding quality of antenatal care, was inadequate.Conclusion: The quality of antenatal care in the case of referred pregnant women at the RSCM’s ER based on MCH Book records did not meet the required standard.Keywords: antenatal care quality, MCH book Abstrak Tujuan: Menentukan kualitas asuhan antenatal pada kasus rujukan ibu hamil di IGD RSCM yang memiliki buku KIA, dan persepsi ibu hamil yang memiliki buku KIA dan tenaga kesehatan pemberi layanan kesehatan tentang asuhan antenatal. Metode: Dilakukan studi kuantitatif dan kualitatif pada kasus rujukan ibu hamil di IGD RSCM yang memiliki buku KIA tahun 2017-2018. Pengambilan data kuantitatif dilakukan dengan telaah kelengkapan pengisian buku KIA secara umum, Kelengkapan komponen asuhan antenatal di fasilitas layanan kesehatan (fasyankes) asal asuhan antenatal didapatkan dari survei menggunakan daftar tilik. Pengambilan data kualitatif dilakukan dengan wawancara mengenai persepsi ibu hamil dan tenaga kesehatan pemberi pelayanan asuhan antenatal di fasyankes asal asuhan antenatal Hasil: Terdapat 1.442 kasus rujukan ibu hamil di IGD RSCM selama tahun 2017- 2018, 820 di antaranya memiliki dan dapat menunjukkan buku KIA. Terdapat subjek dengan usia kehamilan remaja dibawah 20 tahun (9,1%) dan usia diatas 35 tahun (19,5%). Sebagian besar ibu hamil yang dirujuk cukup berpendidikan (74,3%), dirujuk oleh RS atau klinik (57,6%) dan mendapat asuhan antenatal di puskesmas (38.7%), dalam status persalinan inpartu (32%), dengan usia kehamilan trimester III (92%). Semua subjek (100%) dinyatakan tidak lengkap dalam pengisian halaman di buku KIA. Hampir setengah subjek mempunyai jumlah kunjungan antenatal yang tidak ideal (46%). Kelengkapan komponen asuhan antenatal di fasyankes asal asuhan antenatal berkisar 90-100%. Secara kualitatif, didapatkan persepsi ibu hamil dan tenaga kesehatan pemberi asuhan antenatal, terhadap kualitas asuhan antenatal masih kurang tepat.Kesimpulan: Kualitas asuhan antenatal pada kasus rujukan ibu hamil di IGD RSCM berdasar rekam Buku KIA belum memenuhi standar. Kata kunci: buku KIA , kualitas asuhan antenatal.