Awan Nurtjahyo
Department Of Obstetrics And Gynecology, Division Of Reproductive Endocrinology Fertility, Faculty Of Medicine, Universitas Sriwijaya / General Hospital Dr. Mohammad Hoesin, Palembang, South Sumatera, Indonesia

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Disorder of Sex Development, Mosaic Genetic Disorder 45x, 46xy: A Case Report Awan Nurtjahyo; Asep Nurul Huda; A. Abadi; Aditiawati; Yulisnawati H; Fadil P
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 2 (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.v6i2.449

Abstract

Background. Disorder of sex development (DSD) is a congenital disorder associated with interference in chromosomes, gonads, or sexes anatomically. Individual affected with DSD can be recognized since birth due to external genital ambiguity. Sexual chromosome DSD occurred because sexual chromosome numeric or structural disorder. Mosaic karyotype 45X/46XY is among the rare sexual chromosome DSD with incidence less than 1:15,000 live births. DSD individuals are susceptible to stigmatization. This can cause stress, negative emotion, and social isolation. Therefore, DSD individual management should be done as optimal as possible. Case Presentation: Twelve years old girl complaining a bump arose from anterior side of her genital resembles male genital since 4 years prior to admission without micturition and defecation complains. Patient has not experienced menarche. On external genital examination, we found the normal female external genital such as mons pubis, pubic hair, labia majora, labia minora, hymen, perineum, but without clitoris which in this case it is replaced by a glans of penis, arising from anterior commissure of labia majora area, with an urethral estuary. Before the management is done, patient underwent multidiscipline consultations and further examinations. Subsequently, it was approved that the joint conference formation consisting obstetric and gynecology, urologist, and pediatric endocrinologist to determine the optimal management for the patient. Conclusion: In this case, diagnosis was made with history taking, clinical examination, and supporting investigation such as ultrasound imaging and could be followed by biochemistry test, voiding cystourethrography or genitogram to determine next management. Counseling should be done in detail towards the family to know what action is best for the patient. Multidiscipline team was required to get the optimum result either in medical, ethical, or religious point of view. Surgery in this case was considered followed by long term therapy afterwards.
Cortisol Level Related to Depression in Women with Endometriosis Adnan Abadi; Aria Indrabrata; Iskandar Zulqarnain; Theodorus; Abdullah Sahab; Kemas Yusuf Effendi; Heriyadi Manan; Fatimah Usman; Awan Nurtjahyo; Cindy Kesty
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 6 (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.v6i6.537

Abstract

Background: Several main symptoms of endometriosis can lead to physical and psychological stress and also hormonal disturbances as the result of prolonged stress. Cortisol was associated with the onset of depression. This study aimed to determine the relationship between cortisol levels and depression in women with endometriosis at the Department of Obstetrics and Gynecology at Dr. Mohammad Hoesin General Hospital (RSMH) Palembang. Methods: A cross-sectional study was performed at the Reproductive Endocrinology and Infertility outpatient clinic and inpatient ward, Department of Obstetrics and Gynecology at Dr. Mohammad Hoesin General Hospital Palembang, from January to November 2020. There were 74 samples of endometriosis patients who met the inclusion criteria. The blood cortisol level was examined using the ELISA method. The determination of depression level was performed by filling out the Beck Depression Inventory questionnaire. Data were analyzed using SPSS version 22.0. Results: Seventy-four samples met the inclusion criteria. As many as 44 patients (59.5%) without depression, 20 patients (27%) with mild depression, 8 patients (10.8%) with moderate depression, and only 2 patients (2.7%) with severe depression. There were no differences in age, marital status, parity, menstrual cycle, and duration of treatment between endometriosis patients with and without depression (p > 0.05). There was a significant difference in cortisol levels between endometriosis patients with and without depression (p = 0.017). Endometriosis patients with cortisol levels ≤ 7.4 mg/dl were three times more at risk of depression than endometriosis patients with cortisol levels > 7.4 mg/dl. In addition, there was a significant relationship between cortisol level and depression status (OR = 3.023 (95% CI 1.153–7.942; p = 0.041). This study also found a significantly low negative correlation between cortisol levels and BDI scores (r = -0.249; p = 0.032). Conclusion: There was a significant relationship between serum cortisol levels and depression in women with endometriosis. Endometriosis patients with depression had significantly lower cortisol levels than endometriosis patients without depression.
Characteristics of Endometriosis Patients in Dr. Mohammad Hoesin General Hospital on 2018 to 2020 Leriva, Ratu Tenny; Iskandar Zulqarnain; Hadrians Kesuma Putra; Awan Nurtjahyo; Syifa Alkaf
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 4 (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.v6i4.478

Abstract

Background. Endometriosis is defined as the presence of endometrial-like tissue outside the uterus. The prevalence of endometriosis is not known with certainty because it is necessary to perform a laparoscopy to confirm the diagnosis of endometriosis and is usually found during examination for other indications. This study aims to explore the characteristics of endometriosis patients at Dr. Mohammad Hoesin General Hospital Palembang. Methods. This research is descriptive observational research. The research data were obtained from the medical records of endometriosis patients treated at Dr. Mohammad Hoesin General Hospital Palembang from 2018 to 2020. Results. Of the 105 sample data studied, the most distribution of endometriosis patients was in the reproductive age group (15-49 years) (99%), menarche 12-14 years (67.6%), the location of endometriosis in the ovaries (58.1%), status indoor workers (99%), marital status (85.7%), fertile (43.8%), and infertile patients (41.9%), the chief complaint of dysmenorrhea (66.7%), stage IV disease (63, 8%), nullipara (60%), surgical management (79%). Conclusion. Most of the characteristics of endometriosis patients were in the reproductive age group (15 – 49 years), menarche 12-14 years, endometriosis location in the ovary, indoor worker status, marital status, infertility, the main complaint of dysmenorrhea, stage IV disease, nullipara, surgical treatment.
Characteristics of Endometriosis Patients in Dr. Mohammad Hoesin General Hospital on 2018 to 2020 Leriva, Ratu Tenny; Iskandar Zulqarnain; Hadrians Kesuma Putra; Awan Nurtjahyo; Syifa Alkaf
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 4 (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.v6i4.478

Abstract

Background. Endometriosis is defined as the presence of endometrial-like tissue outside the uterus. The prevalence of endometriosis is not known with certainty because it is necessary to perform a laparoscopy to confirm the diagnosis of endometriosis and is usually found during examination for other indications. This study aims to explore the characteristics of endometriosis patients at Dr. Mohammad Hoesin General Hospital Palembang. Methods. This research is descriptive observational research. The research data were obtained from the medical records of endometriosis patients treated at Dr. Mohammad Hoesin General Hospital Palembang from 2018 to 2020. Results. Of the 105 sample data studied, the most distribution of endometriosis patients was in the reproductive age group (15-49 years) (99%), menarche 12-14 years (67.6%), the location of endometriosis in the ovaries (58.1%), status indoor workers (99%), marital status (85.7%), fertile (43.8%), and infertile patients (41.9%), the chief complaint of dysmenorrhea (66.7%), stage IV disease (63, 8%), nullipara (60%), surgical management (79%). Conclusion. Most of the characteristics of endometriosis patients were in the reproductive age group (15 – 49 years), menarche 12-14 years, endometriosis location in the ovary, indoor worker status, marital status, infertility, the main complaint of dysmenorrhea, stage IV disease, nullipara, surgical treatment.
Serum Vitamin D Levels, Visual Analog Scale Dysmenorrhea Score, and Endometriosis ASRM Classification: a Relationship Study Rizany, Selly; Abadi, Adnan; Agustiansyah, Patiyus; Nurtjahyo, Awan; Irfanuddin; Usman, Fatimah; Hartati; Mirani, Putri; Krisna, Ratih; Amran, Rizani; Prasetiyo, Muhammad Ath Thaariq
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 1 January 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i1.1947

Abstract

Objective: To assess the correlation between vitamin D levels, dysmenorrhea intensity measured by the visual analogue scale (VAS), and the stage of endometriosis determined by the American Society of Reproductive Medicine (ASRM) grading score. Methods: A cross-sectional study was conducted involving 37 women diagnosed with suspected endometriosis who met the inclusion and exclusion criteria. The aim was to determine the correlation between vitamin D levels, dysmenorrhea VAS scores, and the ASRM endometriosis stage at RSUP Dr. Mohammad Hoesin Palembang from November 2021 to April 2022. Bivariate analysis was employed to assess correlation, utilizing Pearson's correlation test and the Spearman Rank correlation test as an alternative method. Results: There was a significant positive correlation between vitamin D levels and the VAS score for dysmenorrhea (r = 0.678; p = 0.000) and a very strong positive correlation between vitamin D levels and the degree of endometriosis (r = 0.774; p = 0.000) based on Spearman Rho's correlation test. Conclusion: There is a significant relationship between vitamin D levels with the VAS score of dysmenorrhea and the degree of endometriosis ASRM. Keywords: american society of reproductive medicine, endometriosis, visual analogue scale, vitamin D