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All Journal Medikora: Jurnal Ilmiah Kesehatan Olahraga Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Kesehatan Reproduksi Jurnal Kesehatan Reproduksi Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Journal of Community Empowerment for Health Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management)

Rukmono Siswishanto

Departemen Obstetri Dan Ginekologi, Fakultas Kedokteran, Kesehatan Masyarakat Dan Keperawatan (FKKMK) UGM

Author-ID : 382357

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

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Peran Intervensi Grup Psikoterapi Suportif untuk Memperbaiki Keadaan Depresi pada Wanita Infertil di Klinik Permata Hati RSUP Dr. Sardjito Yogyakarta Mega Dhestiana; Carla Marchira; Rukmono Siswishanto; Shofwal Widad
JURNAL KESEHATAN REPRODUKSI Vol 3, No 3 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.36037

Background: Infertility is a worldwide problem, relates to a devastating condition that can destroy couples striving to have children. It can affect both men and women, and cause psychological related distress, depression, and low self- -esteem. Most interventions using directional, complete, and integrated approach have been focused on improving the quality of life of infertile men or women. Supportive psychotherapy is an example of such interventions.Objective: The study aimed to measure the effectiveness of supportive psychotherapy intervention in treating depression among infertile women.Method: A quasi experiment design using a pre and post- -test with a control group was employed in this study. Subjects were women (n=80) with infertility cases who sought for treatment at PermataHati Clinic Dr. Sardjito hospital. during the period from April to September 2014. A modified short supportive psychotherapywas to groups of patients over the course of four sessions. The sessions were managed by trained facilitatorscomprising psychiatrist and psychologist. Personal data and Beck Depression Inventory (BDI)were then used to assess the patients depression state.Result and Discussion: Findings indicated that 59.37% of the study subjects were found to have mild depression, whereas the other 40.63% had moderate depression. A significant change in BDI scores within the treatment group was found after intervention.Conclusion:Modified short supportive psychotherapy intervention can effectivelly reduce depression on infertile women.Keywords: modified short supportive psychotherapy, depression, infertile women

Evaluasi Clinical Pathway Seksio Sesarea: Keefektifan Penggunaan Antibiotika Injeksi Cefotaxime 2 Gram dalam 24 Jam untuk Mencegah Terjadinya Infeksi Luka Operasi Rathi Manjari Fauziah; Rukmono Siswishanto; Shofwal Widad
JURNAL KESEHATAN REPRODUKSI Vol 3, No 3 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.36039

Background: The usage of prophylactic antibiotics in Dr. Sardjito Hospital, Yogyakarta, is still diverse. Previously, prophylactic antibiotics that were given would be in a form of multidose and or multidrug regimen. Recently, a clinical pathway for c-section had been set up to uniform the antibiotics given. Cefotaime 2g, given intravenously, in 24 hours is the antibiotic of choice. Unfortunately, there was no data about the effetiveness of cefotaime that can be used as a basis of clinical pathway. Objective: Comparing the incidence of surgical site infection (SSI) between cefotaime 2g,/24 hours (clinical pathway or CP) with previous regimen of prophylactic antibiotics (non-clinical pathway or nonCP) and also identify the risk factors.Method: This is a retrospective cohort study with 129 subjects, divided into two groups. The CP group consists of 63 subjects, while non-CP group consists of 66 subjects. The surgical site infection was observed in the day 3 and day 10 aer C-section. Multivariat analysis was used to determine the risk factors of SSI.Result and Discussion: SSI incidence in the CP group at day 3 was higher compared to non-CP group, but it was not statistically significant (OR 4,73 95% CI 0,52 43,04), eukocytosis (>17000/mcl) was the independent risk factor for SSI (OR 7,54 95% CI 1,25 45,39).Conclusion: SSI incidence between two groups was not statistically significant but was clinically significant. The presence of leukocytosis is becoming the risk factor for SSI.Keywords: prophylactic antibiotic, c-section, cesarean section, surgical site infectio

Analisis Angka Seksio Caesarea di RSUP Dr. Sardjito Yogyakarta Tahun 2009-2013 Netty Katrina Dameria; Djaswadi Dasuki; Rukmono Siswishanto
JURNAL KESEHATAN REPRODUKSI Vol 3, No 1 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.36192

Background: Caesarean section is a procedure to reduce maternal and perinatal mortality and morbidity. The caesarean section rate is continuously uprising in the last 3 decades. However, the increasing rate, especially in low risk women, may compromise maternal and perinatal outcome. In 1985, WHO recommended that optimal national caesarean rates should be in the range of 5% to 10% and the rate above 15% might be less benefits. Previous study conducted in DR Sardjito hospital reported caesarean section rate in 1996 was 13.38%, while in 2001 was 18.39%. In national level, based on Indonesia Basic Health Survey 2010, caesarean section rate was 10.8%. Therefore, in this study we analyzed the rate of Caesarean section performed in DR Sardjito hospital, and studied whether the operations occurred in high-risk group or low-risk group.Objective: To compare the rate of caesarean section between high-risk group and low-risk group in DR Sardjito hospitalMethod: Retrospective cohortResult and Discussion: Participants of this study were 7821 patients undergoing labor at RSUP DR Sardjito in 2009-2013. Among them, 3152 patients underwent caesarean section and 4669 patients underwent vaginal delivery. There was an increasing in the overall caesarean section rate of 38,7% in 2009 to 43% in 2013. T-test found the presence of significant differences between the caesarean section rate of high-risk group and low-risk group in 2009-2013 (p<0.05) with a mean difference was 28.5 (20.2-36.8). Caesarean section rate of high-risk group was significantly higher than the low-risk group (p<0.05).Conclusion: There was a difference in caesarean section rate of high-risk group compared to low-risk group. Caesarean section rate in high-risk group was significantly higher than in the low-risk group.Keywords: caesarean section rate, caesarean section, low-risk group, high- risk group

Hubungan Kadar CA-125 Praoperatif terhadap Prognosis Survival Penderita Kanker Ovarium Epitelial di RSUP Dr.Sardjito Herlina Pradjatmo; Rukmono Siswishanto; Shinta Prawitasari
JURNAL KESEHATAN REPRODUKSI Vol 5, No 1 (2018)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.37949

Background: CA-125 level increases in 50% of patients with stage I, 90% of patients with stage II, 92% of patients with stage III and 94% of patients with stage IV ovarian cancer. CA-125 level were not a diagnostic tool to detect ovarian cancer, however it was useful to monitor the progressive of disease and as a prognostic marker.Objectives: The aim of this study is to prove whether CA-125 level before surgery in ovarian cancer patients at Dr. Sardjito Hospital as well as a factor that correlates to the survival prognosis of those patients.Method: This research used cohort retrospective study at Dr. Sardjito Hospital Yogyakarta.Result and Discussion: As much as 71 ovarian cancer patients which had been included in this research with inclusion and exclusion criteria. Subjects were divided into two groups. One group was for patients with low CA-125 level (≤35 U/ml) as much as 18 subjects and another group was for patients with high CA-125 level (>35 U/ml) as much as 53 subjects. The result of a bivariate analysis with an independent survival analysis (Cox’s Regression) was the stage of disease (p=0.005, HR 4.827, CI 95% 1.623 – 14.355) and residual tumour (p=0.029, HR 2.605, CI 95% 1.101 – 6.161) were a survival prognosis factor. Multivariate analysis with a survival analysis (Cox’s Regression) shows CA-125 level (p=0.031, HR 4.131, CI 95% 1.143 – 14.933) and menarche (p=0.003, HR 4.989, CI 95% 1.736 – 14.342) were significantly related with survival prognosis in EOC (Epithelial Ovarian Cancer) patients at Dr. Sardjito Hospital.Conclusion: CA-125 level affects the survival rate of epithelial ovarian cancer patients in Dr. Sardjito Hospital. Besides the level of CA-125, there are other factors that affect the survival rate of epithelial ovarian cancer patients which is the stage of cancer, residual operation and age of menarche.Keywords: CA-125 level, EOC, prognosis, survival.

Pengaruh Pelatihan Ultrasonografi terhadap Tingkat Pengetahuan Residen Obstetri dan Ginekologi mengenai Keamanan Penggunaan Ultrasonografi Obstetri Suryani Puspa Dewi; Rukmono Siswishanto; Djaswadi Dasuki
JURNAL KESEHATAN REPRODUKSI Vol 6, No 1 (2019)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Tujuan: Untuk mengetahui perbandingan tingkat pengetahuan residen Obgin mengenai keamanan penggunaan USG obstetri di RSUP Dr. Sardjito antara yang sudah dan belum mengikuti pelatihan USG.Metode: Kuasi eksperimen dengan desain Post Test Only. Subyek penelitian adalah seluruh residen Obgin FK-KMK UGM yang memenuhi kriteria inklusi. Pengambilan data melalui pengisian kuesioner yang berisi pertanyaan mengenai bioeffects dan safety index pemeriksaan USG obstetri.Hasil dan Pembahasan: Subyek penelitian terdiri dari 64 subyek yang sudah mengikuti pelatihan USG dan 24 subyek yang belum mengikuti pelatihan USG. Seluruh subyek yang belum mengikuti pelatihan memiliki klasifikasi pengetahuan kurang. Dan dari 64 subyek yang sudah mengikuti pelatihan hanya 1 subyek yang memiliki pengetahuan baik (1,56%), 14 subyek dengan pengetahuan cukup (21,87%), dan sisanya dengan pengetahuan kurang (76,56%). Dari analisis tidak ditemukan perbedaan yang bermakna diantara kedua kelompok tersebut (p=0,29).Kesimpulan: Tidak terdapat perbedaan tingkat pengetahuan mengenai keamanan penggunaan USG obstetri antara residen Obgin yang sudah dan belum mengikuti pelatihan ultrasonografi. Kata kunci: Ultrasonografi; bioeffects; safety index; pengetahuan; pelatihan ultrasonografi; residen Obstetri dan Ginekologi

Faktor-faktor yang Mendukung dan Menghambat Dilakukannya Versi Luar pada Kehamilan dengan Presentasi Bokong di Yogyakarta I Made Pariartha; Rukmono Siswishanto; Nuring Pangastuti
JURNAL KESEHATAN REPRODUKSI Vol 7, No 2 (2020)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.59811

Background: Guidelines recommend that external cephalic version (ECV) should be offer to all women with fetus in breech presentation at term. Many literature show external cephalic version can lowering c-section rate caused by breech presentation.Objective: To explore the determinants (barriers and facilitators) affecting obstetricians and gynaecologists to do external cephalic version at Yogyakarta.Method: Explanatory mixed methods design with quantitative-qualitative model. Survey with validated questionnaire and in-depth interview with semi-structured question was done January 2019 until August 2019.Results and Discussion: 72 respondents (83.7%) was responded to questionnaire and in-depth interview was done to 12 respondents. Adherence to ECV guideline was varied: counselling (20.8%), advising for ECV (15.3%), and arranged for ECV to for (almost) all their clients (16.6%). Although 76.4% of respondents considered ECV to be an effective treatment for preventing caesarean childbirth, only 18.1% respondents agreed that every client with breech presentation should undergo ECV. Self-efficacy was the most important determinant influencing adherence. In-depth interview shows several determinants to performed or did not performed ECV: skill of clinicians, guideline for ECV, facility to emergency c-section, ECV characteristic, cost, other methods for breech presentation, perception about ECV in lowering c-section rate, perceived ECV risk and patient preferences.Conclusion: Most respondents agreed that ECV was effective intervention to reduce caesarean childbirth, but adherence to counselling, advising and arranging ECV for clients still very low. Several determinants influenced obstetrician and gynaecologists to perform or did not perform ECV.Keywords: External cephalic version; breech presentation; determinants.

Evaluasi KIPPas (Kartu Instrumen Prediktor Pangastuti) Jogja sebagai Instrumen Prediktor Disfungsi Dasar Panggul Pasca Persalinan Vaginal Fauzan Achmad Maliki; Nuring Pangastuti; Rukmono Siswishanto
JURNAL KESEHATAN REPRODUKSI Vol 9, No 2 (2022)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.77584

Background: Postpartum pelvic floor dysfunction is pelvic floor disorder, which can be in the form of pelvic organ prolapse, urinary problem, defecation problem or sexual dysfunction. The incidence of postpartum pelvic floor dysfunction occurs in 46% of postpartum women. Until now, there is no standard instrument used to estimate the incidence of postpartum pelvic floor dysfunction. In previous studies, an instrument was obtained, namely KIPPas Jogja, to estimate the incidence of pelvic floor dysfunction after delivery, but it was still not sufficient for the number of research samples needed.Objective: To evaluate the Pangastuti Jogja Predictor Instrument Card (KIPPas Jogja) as a predictor of pelvic floor dysfunction in the form of pelvic organ prolapse after vaginal delivery.Method: This study was a prospective cohort study. Subjects who gave vaginal delivery were examined according to the KIPPas Jogja instrument and then evaluated for the diagnosis of pelvic floor dysfunction in the form of pelvic organ prolapse with POPQ examination and complaints of pelvic floor dysfunction using the PFDI and FSFI instruments at 3 months postpartum.Results and Discussion: From 133 research subjects, the results of the KIPPas Jogja assessment are high risk in 42.9% of subjects and low risk in 57.1% of subjects. The incidence of pelvic floor dysfunction in the form of pelvic organ prolapse was found in 69.17% subjects. Complaints of pelvic floor dysfunction were present in 20.31% subjects and complaints of sexual dysfunction in 11.3% subjects. The sensitivity of KIPPas Jogja is 80% and specificity is 95% with a positive predictive value of 97% and a negative predictive value of 68% to detect pelvic dysfunction in the form of pelvic organ prolapse. Meanwhile, to predict complaints of pelvic floor dysfunction, measured with PFDI-20, the sensitivity was 93% and specificity was 52%, and the positive predictive value was 33% and the negative predictive value was 96%. To predict sexual dysfunction, KIPPas obtained sensitivity of 64%, specificity of 42% with a positive predictive value of 10% and a negative predictive value of 92%.Conclusion: KIPPas Jogja can be used as a predictor of postpartum pelvic floor dysfunction. Keywords: postpartum pelvic floor dysfunction, KIPPas Jogja, POPQ, PFDI-20, FSFI

Manfaat Maternal Early Obstetric Warning Score (MEOWS) dalam Memprediksi Lama Perawatan pada Pasien Preeklamsia Berat di RSUP Dr. Sardjito Sulistianto Sulistianto; Rukmono Siswishanto; Ahsanudin Attamimi
JURNAL KESEHATAN REPRODUKSI Vol 9, No 3 (2022): In Process
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.77590

Latar Belakang: skor MEOW sangat penting untuk menilai kondisi klinis pasien dengan adanya perubahan tanda vital selama pasien dirawat. Adanya perubahan ini akan berpengaruh terhadap lama perawatan pasien preeklamsia berat. Namun saat ini belum ada penelitian mengenai hubungan skor MEOW dengan lama perawatan pasien preeklamsia berat yang dirawat di rumah sakit.Tujuan: Mengetahui apakah terdapat hubungan antara skor MEOW dan lama perawatan pasien preeklamsia berat.Metode: Desain penelitian ini adalah kohort retrospektif. Subjek penelitian adalah pasien hamil dengan diagnosis preeklamsia berat sesuai dengan kriteria inklusi dan kriteria eksklusi di RSUP Dr. Sardjito sejak Juli 2020 sampai dengan Juni 2021 dengan mengambil data dari rekam medis.Hasil dan Pembahasan: Dari 86 subjek penelitian didapatkan 78 sampel yang memenuhi kriteria inklusi dan eksklusi. Berdasarkan karakteristik subjek penelitian didapatkan paritas primigravida (69,2%), obesitas (51,3%) dan riwayat hipertensi (53,8%). Hal ini sesuai referensi bahwa faktor resiko preeklamsia berat yaitu primigravida, obesitas dan riwayat hipertensi. Hasil dari ROC yaitu nilai AUC 0,878 dengan p = 0,001 dan CI 95% (0,745 – 1). Penentuan nilai cut off point skor MEOW yaitu 8,5 atau 9 dengan sensitivitas 92%, spesifisitas 71% dan Youden Index tertinggi = 0,631. Lama perawatan antara pasien dengan skor MEOW ≥9 dan pasien dengan skor MEOW <9 berbeda secara signifikan (p <0,05). Skor MEOW ≥9 memiliki lama perawatan lebih lama dibandingkan skor MEOW <9. Tidak ada perbedaan bermakna antara variabel luar dan skor MEOW (p >0,05). Tidak ada perbedaan bermakna antara variabel luar dan lama perawatan (p >0,05).Kesimpulan: Pasien preeklamsia berat yang mengalami persalinan di RSUP dr. Sarjito dengan skor MEOW tinggi memiliki lama perawatan yang lebih lama dibandingkan dengan skor MEOW rendah.Kata Kunci: MEOWS, preeklamsia berat, lama perawatan.

MANAJEMEN PERSEDIAAN OBAT DENGAN PENDEKATAN PERIODIC REVIEW SYSTEM Rukmono Siswishanto; Erna Kristin; Irwan Endrayanto Aluicius
Journal of Health Service Management Vol 24 No 04 (2021)
Publisher : Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Background: Continuity of drug availability in hospitals with no excessive supplies is still a problem. The range of inaccuracies in the plan for drug needs can be wasteful in procurement costs and affect the continuity of health services. Hospitals need to improve historical processing data on drug absorption to optimize drug demand planning. Objective: The research aimed to simulates optimizing the planning and control of drug inventory using the periodic review system. Methods: Case study research to plan drug needs, using daily drug uptake data longitudinally (2014-2017). The obtained formulas are used to perform simulations by comparing drug supplies based on existing methods with optimization methods on accurate uptake data in 2018. Interviews In-depth research is carried out on informants selected based on the relationship with system. Data analysis was performed using the t-test statistical test and qualitative data were analyzed using open coding. Results: An assessment of 10 types of drugs, each of 5 drugs has carried out in the fast moving and slow-moving groups. Eight out of the ten drugs reviewed, there were significant differences in drug supply between the existing method and the periodic review system method. The price of drug supplies during 2018 is Rp.13,315,337,556, while the existing method is Rp. 16,481,465,208. There were 25 cases of drug shortages worth Rp. 655,282,174 in the periodic review system method that is lower than the existing method, which is 31 instances of drug shortages worth Rp.756,743,295. Conclusion: The periodic review system method has advantages compared to existing methods in terms of fewer inventories and cost needs, and the occurrence of fewer drugs shortages and the budget to finance the drug shortages rates. Thus periodic review system method has the potential to improve the planning of drug needs in hospitals.

Blood Supply Management During COVID-19 Pandemic and Ramadhan Fasting at a Tertiary Hospital Teguh Triyono; Usi Sukorini; Rukmono Siswishanto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 2 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i2.1993

The worldwide pandemic of Coronavirus Disease 2019 (COVID-19) has a major implication for blood donation. The beginning of the pandemic occurred at the same time as Ramadhan fasting. This study aimed to evaluate blood donation, blood use trends, and several factors associated with the need for transfusion during the COVID-19 pandemic and Ramadhan fasting in Dr. Sardjito General Hospital (SGH). Information on blood donation and the use of blood components in the SGH-Blood Centre (SGH-BC) from 1 February to 30 September 2019 and 2020 were collected and analyzed. The average number of blood donations from February to September 2020 declined by 11.22% compared to the previous year. The average use of blood components from February to May 2020 also declined compared to the previous year. the decline found in this study was Packed Red Cells (PRC) by 15.43%; Thrombocyte Concentrate (TC) by 23.03%; Whole Blood (WB) by 73.64%; Fresh Frozen Plasma (FFP) by 10.56%; and Thrombocyte Apheresis (TA) by 32.87%. Two characteristics of donors remain unchanged between 2019 and 2020. Most of them were males and age younger than 25 years old. However, there was a shifting characteristic of donors in blood group, weight, and hemoglobin level. Declined number of blood donations might be caused by the pandemic situation and Ramadhan fasting. Blood usage also decreased in the early of this pandemic. The SGH-BC had modified some strategies to increase blood donation and decrease blood component use in this situation.

Co-Authors . Aida . Windarwati Achmad, Bayu Fandi Ahsanudin Attamimi Anna Ismiana Anna Ismiana Ardian Rahmansyah Carla Marchira Chandra, Lukman Ade Dameria, Netty Katrina Dewi, Suryani Puspa Dhestiana, Mega Dian Riski Ariesta Dibtyanusa, Ajib Djaswadi Dasuki Djaswadi Dasuki Djaswadi Dasuki Doddy Sutanto Erna Kristin Ery Surya Sevriana Fauzan Achmad Maliki Hera Nirwati Herlina Pradjatmo Himawan Sartono I Made Pariartha Ika Puspitasari Irwan Endrayanto Aluicius Irwan Taufiqurrahman Irwan Taufiqurrahman Izwin Ramadona Kumara, Intan Fatah Lili Ratnawati Lydia Olivia Marchira, Carla Mega Dhestiana Mohammad Hakimi Mohammad Hakimi Mutiara Nugraheni Netty Katrina Dameria Nuring Pangastuti Nuring Pangastuti Nuring Pangastuti Nuring Pangastuti, Nuring Ova Emilia Pradjatmo, Herlina Primalia Sulistiowati Rahmalina Rahmansyah, Ardian Ramadona, Izwin Rathi Manjari Fauziah Rathi Manjari Fauziah Ratnawati, Lili Satriagraha, Oky Ardian Shinta Prawitasari Shofwal Widad Sulistianto Sulistianto Suryani Puspa Dewi Sutono Sutono Teguh Triyono Usi Sukorini Valentin Widri Enggal Wirimena Hurimah Yasmina Ema Yasmina Ema

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