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All Journal Jambi Medical Journal : Jurnal Kedokteran dan Kesehatan E-Journal Obstetric & Gynecology Udayana WMJ (Warmadewa Medical Journal) Majalah Obstetri dan Ginekologi The Indonesian Biomedical Journal Indonesian Journal of Obstetrics & Gynecology Science ISM (Intisari Sains Medis) : Jurnal Kedokteran Babali Nursing Research Jurnal Syntax Transformation Jurnal Health Sains Bioscientia Medicina : Journal of Biomedicine and Translational Research International Journal of Social Service and Research Cermin Dunia Kedokteran Indonesian Journal of Perinatology Jurnal Indonesia Sosial Sains Cermin Dunia Kedokteran Indonesian Journal of Global Health Research
I Gde Sastra Winata
Departemen Obstetri Dan Ginekologi, Fakultas Kedokteran, Universitas Udayana
Humanities Astronomy Biochemistry, Genetics & Molecular Biology Chemistry Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Earth & Planetary Sciences Economics, Econometrics & Finance Education Energy Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Library & Information Science Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Physics Public Health Social Sciences Veterinary

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p16 expression in patient with Loop Electrosurgical Excision Procedure (LEEP) Paskarani, Putu Erika; Winata, I Gede Sastra; Sitohang, Elisa Laura Oktrinita; Felyanto, Felyanto; Yuliantini, Sang Ayu Putu
Majalah Obstetri & Ginekologi Vol. 32 No. 3 (2024): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V32I32024.161-167

Abstract

HIGHLIGHTS Clinicopathologic characteristic of patient with LEEP procedures dominated by women above 35 years old, with total parity less than 3 and without history of contraceptive usage. The p16 expression analyzed by immunohistochemistry technique. The positive and negative reactivity of p16 ratio was 3:5 on LEEP specimen which microscopically appear as chronic cervicitis, low-grade and high-grade squamous intraepithelial lesion.   ABSTRACT Objective: The aim of this study was to reveal p16 expression with the clinicopathological characteristics of patients who underwent cervical biopsy using the Loop electrosurgical excision procedure (LEEP) at Udayana University Hospital, Bali, Indonesia, for the period 2020 – 2023. Materials and Methods: The research was conducted at Anatomic Pathology Laboratory of Udayana University Hospital, Denpasar, Bali, Indonesia. The samples were selected based on inclusion criteria such as the formalin fixed paraffin embedded (FFPE) sample from positive IVA patient and continue for LEEP procedure. Otherwise, the exclusion criteria were moldy FFPE sample and incomplete clinical data. Then, p16 immunostaining procedure was carried out manually. The interpretation of p16 results was analyzed using SPSS software, version 25 by International Business Machines (IBM) Corporation. Results: The positive p16 expression was revealed in 12 samples (38.7%), in contrast the negative staining appeared in 19 samples (61.3%). Unfortunately, p16 expression was not significant statistically based on age, parity, and contraceptive history, with p-values of 1.00, 0.45, and 0.65, respectively. Meanwhile, a statistically significant association was found between p16 expression and histopathologic diagnosis (p = 0.02, 95% CI 1.4 – 38.3). In addition, 22.2% of the variation of p16 expression based on multivariate analysis demonstrating a significant correlation (p = 0.01). Conclusion: p16 expression with histopathology diagnostic characteristic in patient who underwent Loop electrosurgical excision procedure (LEEP) was found statistically significant. Moreover, clinical application of p16 in daily practice should be performed with consideration especially for pre-cancer lesion in LEEP biopsy specimen procedure and clinicopathological approach is essential.
Procedures to Reduce Haemorrhage during Myomectomy for Fibroids I Gede Sastra Winata; Nicholas Renata Lazarosony
Cermin Dunia Kedokteran Vol 49 No 10 (2022): Oftalmologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i10.312

Abstract

Uterine fibroids are the most common solid tumors in the female pelvis. Myomectomy is the first choice of treatment for woman who want to keep their uterus. Haemorrhage, uterine perforation, cervical injury, and metabolic problems from excessive absorption of the distension medium, such as glycine, are risks of hysteroscopic myomectomy. There are several procedures and techniques to reduce haemorrhage during myomectomy for fibroids. Some research demonstrated excellent outcomes with uterine artery ligation. Mioma uteri adalah tumor jinak yang paling sering dijumpai pada wanita. Tindakan miomektomi adalah salah satu pilihan terapi padawanita yang tetap ingin mempertahankan rahim. Perdarahan, perforasi uterus, cedera serviks, dan masalah metabolisme akibat penyerapan berlebihan media distensi, seperti glisin, adalah risiko prosedur histeroskopi miomektomi. Beberapa prosedur dan teknik dapat mengurangi perdarahan saat miomektomi pada kasus mioma uteri. Beberapa penelitian menunjukkan hasil yang sangat baik dengan ligasi arteri uterina.
Legal Analysis of the Implementation of the Ten Steps to Successful Breastfeeding in Government Regulation Number 28 of 2024 to Support the Exclusive Breastfeeding Program in Indonesia Dolesgit, Ni Made Garnis; Parsa, I Wayan; Astuti, Ika Widi; Winata, I Gede Sastra
Babali Nursing Research Vol. 6 No. 3 (2025): July
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2025.63471

Abstract

Introduction: Efforts to advance the welfare of Indonesian society require the development of quality human resources. However, health issues such as stunting and obesity in children can hinder these aspirations, partly due to suboptimal breastfeeding from birth. Although there has been a significant increase in exclusive breastfeeding, there are still obstacles in its implementation, such as a lack of family support and violations of the International Code of Marketing of Breastmilk Substitutes. This study aims to analyze the implementation of the Ten Steps to Successful Breastfeeding (TSSB) advocated by WHO and UNICEF in Government Regulation Number 28 of 2024 to support the Exclusive Breastfeeding program in Indonesia.Method: This study used a descriptive-analytical method with a normative juridical approach, referring to Government Regulation Number 28 of 2024 concerning the Implementation Regulation of Law Number 17 of 2023 concerning health.Result: Almost all TSSB and all the rules of the International Code of Marketing of Breastmilk Substitutes have been included in the articles to subsequently serve as protection against inappropriate promotion of formula milk for infants and to achieve Exclusive Breastfeeding.Conclusion: It is necessary to immediately create specific follow-up regulations regarding the safe provision and administration of donor breast milk for infants in healthcare institutions and a sustainable data monitoring and management system.
Retrograde Hysterectomy Approaches in Difficult Gynaecology Surgery I Gde Sastra Winata; Ongko, Eric Gradiyanto; I Nyoman Gede Budiana; I Nyoman Bayu Mahendra; Kade Yudi Saspriyana; Pande Kadek Aditya Prayudi; Arlando Martino Anapaku; Florencia
Indonesian Journal of Perinatology Vol. 6 No. 1 (2025): (Available online: 1 June 2025)
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i1.70

Abstract

Hysterectomy remains one of the most frequently performed gynecological surgeries worldwide. While extra-fascial hysterectomy is the standard abdominal approach, complex cases involving large fibroids, severe endometriosis, adhesions, or malignancy often require alternative techniques such as the Aldridge method or retrograde hysterectomy. These challenging situations are associated with distorted pelvic anatomy, fibrosis, and adhesions, increasing the risk of complications, including injury to adjacent organs. This article reviews strategies and operative steps in managing complex abdominal hysterectomies, with emphasis on retrograde hysterectomy as a valuable approach when the cervicovaginal junction cannot be clearly identified or when extensive adhesions are present. The surgical technique is described step by step, supported by imaging and intraoperative findings, and highlights methods such as hydrodissection and careful dissection around critical structures to minimize morbidity. Preoperative imaging, intraoperative decision-making, and technical modifications are emphasized as key factors for optimizing patient outcomes. Although this study provides a detailed description of techniques under challenging hysterectomies, its limitation lies in the reliance on schematic illustrations rather than comprehensive intraoperative photographic documentation.
Procedures to Reduce Haemorrhage during Myomectomy for Fibroids Winata, I Gede Sastra; Lazarosony, Nicholas Renata
Cermin Dunia Kedokteran Vol 49 No 10 (2022): Oftalmologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i10.312

Abstract

Uterine fibroids are the most common solid tumors in the female pelvis. Myomectomy is the first choice of treatment for woman who want to keep their uterus. Haemorrhage, uterine perforation, cervical injury, and metabolic problems from excessive absorption of the distension medium, such as glycine, are risks of hysteroscopic myomectomy. There are several procedures and techniques to reduce haemorrhage during myomectomy for fibroids. Some research demonstrated excellent outcomes with uterine artery ligation. Mioma uteri adalah tumor jinak yang paling sering dijumpai pada wanita. Tindakan miomektomi adalah salah satu pilihan terapi padawanita yang tetap ingin mempertahankan rahim. Perdarahan, perforasi uterus, cedera serviks, dan masalah metabolisme akibat penyerapan berlebihan media distensi, seperti glisin, adalah risiko prosedur histeroskopi miomektomi. Beberapa prosedur dan teknik dapat mengurangi perdarahan saat miomektomi pada kasus mioma uteri. Beberapa penelitian menunjukkan hasil yang sangat baik dengan ligasi arteri uterina.
Passive Smoking as a Significant Risk Factor of Cervical Dysplasia: A Novel Findings in Single Center Study in Denpasar, Bali, Indonesia Pradnyana, I Wayan Agus Surya; Mirani Ulfa Yusrika; I Gusti Bagus Mulia Agung Pradnyaandara; I Gde Sastra Winata
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 11 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i11.1126

Abstract

Background: Colposcopy is a diagnostic procedure evaluating the cervix following an abnormal screening test. It aims to identify and treat cervical cancer precursors. Risk stratification at the end of colposcopy helps differentiate those who can return to regular screening from those needing more frequent screening or surveillance. The study examined the characteristics and risk factors of patients undergoing colposcopy for cervical dysplasia in Denpasar, Bali, Indonesia. Methods: This was a cross-sectional study of women who underwent colposcopy at BaliMed Hospital, Denpasar, Bali, Indonesia, from January 2021-December 2022. Data were derived from medical records. The gynecology oncologist performed a colposcopy examination with a biopsy sample, which was later checked by the pathologist. Bivariate and multivariate analyses were used to identify the risk factors associated with cervical dysplasia. Results: 142 patients underwent colposcopy with a mean age of 37.28+10.1 years. Seventy-eight patients (54.9%) had a low-grade cervical lesion, and 9 (6.3%) had a high-grade cervical lesion. After adjusting the employment status and education level, factors associated with cervical dysplasia were age at first intercourse <20 years (aOR [adjusted odd ratio] 2.44, 95% CI [1.04-5.69]) and history of smoking, either actively or passively (aOR 8.91, 95% CI [3.52-22.54]). From the biopsy result, patients with abnormal cervical lesions were associated with evidence of CIN (aOR 9.03, 95% CI [2.49-32.77]). Conclusion: Early age first sexual intercourse and history of smoking have been identified as significant risk factors for cervical dysplasia. Additionally, passive smoking has been shown to increase the risk. This research provides a foundational reference for future studies in this area.
Specific Histologic Type of Leiomyoma Related to Estrogen Receptor Expression Ni Wayan Armerinayanti; Desak Putu Oki Lestari; I Gde Sastra Winata
WMJ (Warmadewa Medical Journal) Vol 7 No 2 (2022): November 2022
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.7.2.4601.55-59

Abstract

Uterine Leiomyoma or fibroid is the most common gynecologic benign neoplasm which arising from monoclonal proliferation of smooth muscle cells in uterine wall. Some specific types of uterine leiomyoma, such ascellular leiomyoma, symplastic leiomyoma, mitotically active leiomyoma andmyxoid leiomyomahave different histomorphology from usual type leiomyoma. It also have wide variety of tumors size, but this study found that no correlation between type of leiomyoma and its size. Additional non-invasive therapy that predominantly developed in leiomyoma include many antagonist agents of estrogenic receptor. So, important to determine of estrogen receptor activity before that hormonal therapy prescription.Histopathology parameter that predict estrogen receptor activity in leiomyoma was not well understood. This study also try to correlate between specific histologic type of leiomyoma and estrogen receptor activity. This study was a retrospective crossectional study which analized by pearson chi-square test with p value < 0.05 and CI 95%. Result: There was significant correlation between specific histologic type of leiomyoma and estrogen receptor expression (p=0.007; p<0.05). Key Words: Leiomyoma, Estrogen Receptor
Legal Protection of Patient Personal Data in Telemedicine Practice: Aligning the Health Law and the Personal Data Protection Law Agus Arya Mahottama; I Gde Sastra Winata
Jurnal Indonesia Sosial Sains Vol. 7 No. 5 (2026): Jurnal Indonesia Sosial Sains
Publisher : CV. Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/jiss.v7i5.2332

Abstract

Digital transformation in Indonesia's health sector has accelerated the adoption of telemedicine services as an alternative to remote medical services. Although these services provide efficiency and expand healthcare access for the broader community, the practice of telemedicine raises serious juridical challenges, particularly regarding the protection of highly sensitive patient personal data. This research aims to analyze the juridical aspects of patient personal data protection in telemedicine services and examine the urgency of synchronizing the Health Law and the Personal Data Protection Law (PDP Law). Using a normative juridical legal research method with statutory and conceptual approaches, the findings indicate that a legal framework is available in Indonesia through Law No. 17 of 2023, Law No. 27 of 2022 (PDP Law), and Minister of Health Regulation No. 20 of 2019. However, there are regulatory inconsistencies, a void of technical norms, as well as weak infrastructure and human resource awareness that make patient data vulnerable to leaks. The synchronization of regulations and the adoption of international standards such as GDPR (General Data Protection Regulation) and HIPAA (Health Insurance Portability and Accountability Act) are urgently needed to create legal certainty, guarantee medical data confidentiality, and provide maximum protection for patients and healthcare workers.
Legal Consequences for Foreign Medical Personnel Providing Health Services in Indonesia without A Practice License Haekal Fahmi; Anak Agung Gede Duwira Hadi Santosa; I Gde Sastra Winata
Indonesian Journal of Global Health Research Vol. 8 No. 1 (2026): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i1.559

Abstract

The utilization of foreign health workers in Indonesia has become an increasingly common phenomenon in line with the development of globalization and cross-border mobility. The purpose of this study is to identify and analyze the legal consequences of foreign medical personnel providing health services in Indonesia without a practice license. This study uses a normative research design, and the method of collecting legal sources in this study is document study. Documentary study can be described as a method of collecting several documents related to the issue being studied, both from primary and secondary legal materials. Collection of Normative Legal Materials The main methods used to collect normative legal materials are Library Research and Documentary Research. The legal materials sought are classified into three types: Primary Legal Materials (in the form of legislation), secondary legal materials (law books/literature, legal research journals), and tertiary legal materials (law dictionaries, law encyclopedias). After all the data has been collected, it is then reviewed and interpreted in relation to legal principles and theories The results of this study are that foreign medical personnel must fulfill several requirements before practicing in Indonesia, such as licensing, certification and registration, competency tests, areas of foreign medical personnel and accompanying personnel, time restrictions, and compensation. Based on the Health Law as stipulated in Article 442, sanctions are imposed on any foreign medical personnel who intentionally practice in Indonesia without a SIP, which can result in the medical or health personnel being punished with a maximum imprisonment of 5 (five) years or a maximum fine of Rp. 500,000,000.00 Efforts to take action against foreign medical personnel by the Ministry of Health and Professional Organizations include guidance and mediation by professional organizations, internal guidance by health agencies, verbal and written warnings by health agencies, guidance, supervision, and control by health agency personnel, revocation of licenses, and revocation of practice.
Co-Authors A.A.N. Anantasika Agus Arya Mahottama Anak Agung Gede Duwira Hadi Santosa Anak Agung Gede Putra Wiradnyana Anak Agung Ngurah Anantasika Anthony Stephen Halim Arlando Martino Anapaku Charles Richard Thene Clara Amanda Daniel Hadinata Susanto Desak Putu Oki Lestari Dewi, Putu Pradnya Paramitha Dolesgit, Ni Made Garnis DPG Jananuraga Maharddhika Endang Sri Widiyanti Eric Gradiyanto Ongko Ernest T. B. Sianturi Ernest TB Sianturi Felyanto, Felyanto Fenyta Christyani FLORENCIA Florencia Desiree Haekal Fahmi I Gede Indra Kumara I Gede Mahendra Adiguna Dira I Gede Mega Putra I Gusti Ayu Putri Kartika, I Gusti Ayu I Gusti Bagus Mulia Agung Pradnyaandara I Ketut Surya Negara I Ketut Suwiyoga I Made Darmayasa I Nyoman Bayu Mahendra I Nyoman Gede Budiana I Nyoman Gede Budiana I Nyoman Hariyasa Sanjaya I Wayan Agus Surya Pradnyana I Wayan Artana Putra I Wayan Megadhana I Wayan Parsa Ida Bagus Arjuna Ida Bagus Gde Fajar Manuaba IGN. Wiranta Permadi Ika Widi Astuti, Ika Widi Ines Kurniaty Hartono Johan Qalaba Kade Yudi Saspriyana Kade Yudi Saspriyana Ketut Suwiyoga Kevin Agastya Duarsa Lazarosony, Nicholas Renata Made Ayu Prabawaty Indraswari Made Bagus Dwi Aryana Made Yudha Ganesa Wikantyas Widia Maria Septiana Parmonang Aroean Mirani Ulfa Yusrika Musa Taufiq Musa Taufiq Ngakan Ketut Darmawan Ni Luh Wita Astari Widhusadi Ni Wayan Armerinayanti Nicholas Renata Lazarosony Nicholas Renata Lazarosony Nyoman Bayu Mahendra Ongko, Eric Gradiyanto Pande Kadek Aditya Prayudi Pande Kadek Aditya Prayudi Pande Made Suwanpramana Paskarani, Putu Erika Piere Emanuel Yoltuwu Piers Andreas Noak Pradnyana, I Wayan Agus Surya Putu Bagus Darmayasa Putu Doster Mahayasa Putu Harrista Indra Pramana Rayvany Uil Ryan Saktika Mulyana Sitohang, Elisa Laura Oktrinita Sucitawati, Putu Devita Tjokorda Gde Agung Suwardewa Wibawa, I Gusti Ngurah Agung Satria William Alexander Setiawan Yuliantini, Sang Ayu Putu