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Differences of Dyspareunia in Primipara with 2nd Degree Perineal Laceration Sutured with Rapide Polyglactin 910 and Chromic Catgut Threads Wibowo, Satrio Arief; Trisetiyono, Yuli; Kristanto, Herman; Wiyati, Putri Sekar; Tjahjanto, Hary; Erwinanto, Erwinanto
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.968

BACKGROUND: Dyspareunia is persistent or recurrent pain during sexual intercourse. Perineal laceration, spontaneous or episiotomy, is one of the most common causes. Perineal lacerations that occur must be treated through suturing. Chromic catgut is a natural thread that is often used in medical practice, but this thread have a higher inflammatory response compared to Rapide Polyglactin 910. AIMS: To analyze the difference in the incidence of dyspareunia in primipara with 2nd degree perineal lacerations sutured with Rapide Polyglactin 910 and Chromic catgut threads METHOD: True experimental research with randomized controlled trial-single blinded method. The research was conducted at dr. Kariadi Semarang, RA Kartini Hospital and dr. Soeselo from August 2022 to February 2023. The research subjects were primipara with 2nd degree perineal lacerations which were divided into 2 groups, namely 45 subjects in the Chromic catgut group and 45 subjects in the Rapide Polyglactin 910 group. Evaluation of dyspareunia after 3 months was carried out using the Female Sexual Function Index (FSFI) RESULT: Subjects sutured using Chromic catgut had a 2.7 times greater risk of experiencing dyspareunia when compared to using Rapide Polyglactin 910 (OR=2.7; 95% CI=1.1-6.6). A significant confounding factor was found, namely the act of episiotomy (p=0.047; OR=9.56; 95% CI=1.86 - 48.97). After controlling for these variables, the subjects who were sewn using Chromic had a significant risk (p=0.002, OR=5.39; 95% CI=1.76-16.50) CONCLUSION: Subjects with Chromic catgut have a higher risk of experiencing dyspareunia than using Rapide Polyglactin 910 threads after 3 months of suturing.

Endothelin-1 Level In Early Onset Preeclampsia Riantyoko, Yoshi; Hadijono, Raden Soerjo; Iskandar, Teuku Mirza; Trisetiyono, Yuli; Pramono, Besari Adi; Suhartono, Suhartono; Kristanto, Herman
DINAMIKA KESEHATAN: JURNAL KEBIDANAN DAN KEPERAWATAN Vol 14, No 1 (2023): Dinamika Kesehatan: Jurnal Kebidanan dan Keperawatan
Publisher : Universitas Sari Mulia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33859/dksm.v14i1.917

Introductions: Preeclampsia is a specific syndrome in pregnancy as a result of abnormal placental invasion leading to placental hypoperfusion. Persistent hypoxia of the placenta causes the release of various inflammatory mediators into the circulation and results in local endothelial dysfunction. Increased endothelin-1 (ET-1) secretion and increased inflammatory mediators occur in preeclampsia.Aims: To analyze the relationship between endothelin-1 and early onset preeclampsia.Methods: This crosssectional study included 50 pregnant women with early onset preeclampsia (n=25) and normal pregnancies (n=25). Pregnant women aged 20-35 years with single intrauterine fetus, primigravida and multigravida who experienced early onset preeclampsia 34 weeks of gestation were included in this study. Endothelin-1 levels was measured using the Enzyme Linked Immunosorbant Assay (ELISA) method. The analysis was performed using the Mann-Whitney test. Receiving Operator Characteristic (ROC) curve analysis was used to find the cut-off value and diagnostic accuracy of endothelin-1 levels.Results: The mean of ET-1 level was significantly higher in early onset preeclampsia (0.732 ± 0.56 pg/mL) compared to normal pregnancy (0.318 ± 0.09 pg/mL) with value of p = 0.000. The ROC analysis showed the AUC value of 87.8% (p = 0.000, 95% CI 78.6%-97.1%). The cut-off value for ET-1 was 0.385 pg/mL, with 80% sensitivity and 68% specificity (PR=3.14; 95% CI 1.40-7.03).Conclusion: Increased levels of endothelin-1 (ET-1) significantly associated with early onset preeclampsia. ET-1 level ≥ 0.385 pg/mL in pregnant women with 34 weeks of gestation is potential biomarkers to predict the occurrence of early onset preeclampsia with a risk up to 3.14 times.

Effect of DLBS3233, Metformin, and Their Combination on the Expressions of VEGF and Endometriosis Implants in Endometriosis Mice (A Mouse Model in Endometriosis Study) Wardana, Setya Girindra; Trisetiyono, Yuli; Hadijono, Raden Soerjo; Mulyantoro, Inu; Cahyanti, Ratnasari Dwi; Dewantiningrum, Julian
Diponegoro International Medical Journal Vol 4, No 2 (2023): December 2023
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v4i2.18393

Abstract Background: Endometriosis is a gynaecological disorder characterized by the presence of endometrial tissue outside the uterine cavity. The process of angiogenesis is regulated by VEGF which plays an important role in the development of endometriosis implants. Metformin is an insulin sensitizer that is known to have a beneficial effect in the treatment of endometriosis and DLBS3233 is a PPARγ agonist, it is hoped that it can reduce VEGF and reduce endometrial implants..Objective: To explore the effect of DLBS3233, metformin, and combination on VEGF expression and endometrial implant area of endometriosis-induced mice.Methods: This experimental study used 3-months old 28 BALB/c mice of endometriosis that were randomly and equally divided into four groups (K, P1, P2, and P3). On the 15th day, the K group was given a placebo, the P1 group was given DLBS3233 0.25 mg/day for 14 days, the P2 group was given metformin 4 mg/day for 14 days and the P3 group was given a combination. The immunohistochemistry of VEGF expression was performed from the abdominal cavity and pelvic peritoneal tissues of the mice and measured by the Remmele Scale Index, while the extracted mice's endometrial implants were analyzed with a computer tracing method. All data normality tests were calculated with the Shapiro-Wilk test. The mean difference test of all groups was analyzed using the one-way ANOVA test and the Kruskal-Wallis test.Results: There were significant differences in the expressions of VEGF (p=0.005) and endometrial implants (p=0.001). Expression of VEGF in the P3 group was significantly lower compared to others and endometrial implant area in the P2 group was significantly lower compared to others.Conclusion: DLBS3233 and Metformin may be a potentially effective drug treatments for endometriosis by decreasing VEGF expression and endometrial implants. Keywords: DLBS3233, Endometriosis, Metformin, VEGF

Factors Associated With Recurrence Of Epithelial Ovarian Cancer In RSUP Dr. Kariadi Semarang Kurube, Isabela Marsialina; Ambari, Ediwibowo; Iskandar, Teuku Mirza; Tjahjanto, Hary; Dewantiningrum, Julian; Mochtar, Arufiadi Anityo; Trisetiyono, Yuli
Diponegoro International Medical Journal Vol 3, No 2 (2022): December 2022
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v3i2.15448

Introductions: Epithelial ovarian cancer accounts for 90% of all ovarian malignancies. More than 70% of patients will experience a relapse even after receiving operative therapy and chemotherapy. There are several prognostic factors that influence the recurrence of ovarian cancer. In Indonesia, especially at Dr. Kariadi Hospital, Semarang, the data as mentioned above is still very limited.objective: Knowing the disease-free survival rate, optimizing surgery and factors related to the incidence of recurrence in epithelial ovarian cancer patients at Dr. Kariadi Hospital SemarangMethods: This study is a retrospective cohort study with survival analysis. Data were collected through medical records, with the study population are patients with a diagnosis of epithelial ovarian cancer who were treated at Dr. Kariadi Hospital Semarang in period January 2018-December 2019. Furthermore, patients who had been remission were observed for signs of disease recurrence for 2 years period.Results: There were 361 patients with epithelial ovarian cancer who underwent primary treatment at Dr. Kariadi Hospital, Semarang in 2018-2019. Furthermore, there were observations of recurrence in 148 patients who achieved remission. Of these 76 patients (51.4%) experienced recurrence, while 72 patients not relapse. From 148 epithelial ovarian cancer patients who underwent cytoreduction surgery at Dr. Kariadi Hospital, Semarang, 113 patients (76.4%) achieved optimal operation with a residu less than 2 cm, while 35 patients (23.6%) were not optimal with a residu more than 2 cm. FIGO stage (HR 2.44) and tumor residu (HR 2.15) were shown to be significant factors associated with the recurrence of epithelial ovarian cancer.Conclusion: Overall disease-free survival in epithelial ovarian cancer at Dr. Kariadi Semarang were 74.8% (6 months), 57.1% (1 year), 42.5% (18 months), and 37.4% (2 years). Tumor residual factors and FIGO stage were shown to be significant prognostic factors influencing the recurrence of epithelial ovarian cancer.

Perbandingan Luaran Maternal dan Perinatal Kehamilan Terkonfirmasi Covid-19 antara Gelombang Pertama dan Kedua Pandemi Irsan, Raissa Alifia; Farhanah, Nur; Trisetiyono, Yuli; Cahyanti, Ratnasari Dwi
JURNAL KESEHATAN REPRODUKSI Vol 10, No 3 (2023)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.81781

Background : New cases of COVID-19 continued to emerge due to the new variants. Pregnant women are more susceptible to severe infections.Objective : To compare the effect of COVID-19 infection on maternal and perinatal outcomes in the first and second waves.Method : An analytical observational study with a cross-sectional design was used. Samples were selected by consecutive sampling from the medical record data of RSUP Dr. Kariadi Semarang, Indonesia, with 47 cases during the first wave (1 August 2020 to 14 May 2021) and 47 cases during the second wave (16 May to 30 September 2021). Data were analysed using univariate, chi-square, fisher’s exact, and logistic regression tests with a significant value of p <0,05.Results and Discussion : Pneumonia, ICU admission, and oxygen consumptions were higher in the second than the first wave as 87.23% VS 70.21%; p = 0.044, 36.17% VS 14.89%; p = 0.018, 65.96% VS 12.77%; p < 0.0001 respectively. The severe COVID-19 infection and maternal mortality increased in the second wave (51,06% VS 14,89%; p = 0.009; 29,79% VS 8,51%; p = <0.001). There were no differences in perinatal outcomes between the first and second waves such as fetal distress, fetal growth retardation, low birth weight, nICU admission, and mortality (0.00% VS 8.51%; p = 0.117, 0.00% VS 4.26%; p = 0.495, 12.77% VS 25.53%; p = 0.116, 12.77% VS 21.28%; p = 0.272, 4.26% VS 8.51%; p = 0.677). The incidence of COVID-19 infection in neonates remained low in both waves at 17.02% VS 12.77%; p = 0.562.Conclusion : Even though a high number of severe diseases to maternal deaths were found during the second wave, neonatal COVID-19 infections remained low.

The Effect of Green Tea Extract Supplementation on Superoxide Dismutase Levels and Endometriosis Lesions: A Clinical Trial in Mice Trisetiyono, Yuli; Artanto, Yosef Adi
JURNAL KEBIDANAN Vol 14, No 2 (2024): Oktober 2024
Publisher : Politeknik Kesehatan Kementerian Kesehatan Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jkb.v14i2.11387

Endometriosis is a gynaecological disorder characterised by the presence of endometrial tissue outside the uterine cavity. It affects approximately 10-15% of females of reproductive age. Oxidative stress has been identified as a significant contributing factor to the development and progression of endometriosis. In this study, we investigated the effect of green tea extract on the endometriotic implant area and serum superoxide dismutase (SOD) levels in a rat model of endometriosis. Twenty-six female Balb/c rats were randomly divided into the experimental group (EG) and the control group (CG). All subjects in the EG received green tea extract (3 mg daily) for 14 days. On the fourteenth day, endometriosis was induced in all subjects (both EG and CG). The endometriotic implant area and serum SOD levels were assessed 14 days after induction. The endometriotic implant area in the green tea extract-treated group was significantly lower than that in the control group (p=0.022, RR=0.455, 95% CI=0.065-0.96). Serum SOD levels in the EG and CG were 5.33±0.52 ng/ml and 5.20±0.91 ng/ml, respectively (p=0.507). Green tea extract effectively inhibited the progression of endometriotic implants and increased serum SOD levels in the endometriosis-induced rat model. These findings suggest that the anti-angiogenic and antioxidant properties of green tea may have therapeutic potential in managing endometriosis.

Effect Of Vitamin D Administration On Interleukin 6 (IL-6) Levels In Peritoneal Fluid In Endometrioma Patients Setyasworo, Singgeh; Mochtar, Arufiadi Anityo; Erwinanto, Erwinanto; Kristanto, Herman; Tjahjanto, Hary; Trisetiyono, Yuli
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 3 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i3.1031

BACKGROUND: An endometrioma is a cyst that occurs when endometrial tissue grows on the epithelium of the ovary. Vitamin D is a steroid hormone that can be extracted from commonly available foods and can be synthesized by humans when exposed to sunlight. Vitamin D deficiency has been reported to be associated with various pathologies, including endometrioma. Vitamin D has been reported to have anti-angiogenic effects that may inhibit the growth of endometriotic implants. AIM: Proving the effect of vitamin D administration on interleukin 6 (IL-6) levels in peritoneal fluid in patients with endometrioma. METHOD: Experimental research with two group, post-test only design with single blind that carried out at Central General Hospital (RSUP) Dr. Kariadi Semarang. The research subject was 50 patients with endometrioma on ovary. The definite diagnosis of endometrioma is made based on histopathological examination of tissue samples after the patient undergoes surgery. Patients will be divided into 2 groups, namely the vitamin D3 supplementation group and placebo. The intervention was carried out by providing vitamin D3 50,000 IU/week for a month. Evaluation of serum vitamin D levels were obtained using venous blood samples immediately when the patient was undergoing surgery. Interlukin-6 levels were obtained using peritoneal fluid samples obtained when the patient underwent surgery. Statistical analysis was carried out using the Independent T Test, Mann-Whitney U, Dependent T Test and Wilcoxon. Results are significant if p <0.05. Statistical analysis was carried out using SPSS edition 26. RESULT: Peritoneal fluid interleukin-6 (IL-6) levels between the vitamin D supplementation group and the placebo group did not show a significant difference (p=0.554). CONCLUSION: Vitamin D supplementation in endometrioma patients is not associated with peritoneal fluid interleukin-6 (IL-6) levels.

Perineal Laceration in primipara in Association with Perineal length, Fetal Head Circumference, and Fetal Weight Udjaja, Claudio; Erwinanto, Erwinanto; Kristanto, Herman; Tjahjanto, Hary; Trisetiyono, Yuli; Mochtar, Arufiadi Anityo
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 3 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i3.1117

BACKGROUND : Perineal laceration is one of the risk and complication of spontaneous labour resulting intervention in short-term and long-term quality of life. Lack of research in Indonesia on perineal length Lack of research on perineal length in Indonesia, fetal birth weight and fetal head circumference and its impact on spontaneous labour and perineal laceration gave rise to the idea of research in order to minimize the occurrence of complications from perineal laceration in spontaneous labour.OBJECTIVES : To know find out the association between perineal length, fetal head circumference, and fetal weight with degree of perineal laceration in primiparous women.METHODS : Observational cross sectional multi-center study conducted between August 2023 until October 2023 in which all subject that delivered vaginally within inclusion criteria was measured. All data will be further analized to determine the significant predictor of perineal tear.RESULTS : Based on this study The result of this study has indicated that there is no significant association of perineal length with the degree of spontaneous primiparous perineal laceration. While there is an association of fetal head circumference and fetal weight with the degree of spontaneous primiparous perineal laceration in aterm pregnancy. Based on further analysis, fetal head circumference greater than 325 mm increases the risk of severe perineal laceration 4.4 times (PR=4,4; 95% CI=1,4-13,9) and Fetal weight greater than 3097.5 grams increases the risk of 2.7 times (PR=2,7; 95% CI=1,1-6,4) the occurrence of severe perineal laceration.CONCLUSION : There is an association of fetal head circumference and fetal weight with the degree of spontaneous primiparous perineal laceration.

The Effect of Green Tea Extract Supplementation on Superoxide Dismutase Levels and Endometriosis Lesions: A Clinical Trial in Mice Trisetiyono, Yuli; Artanto, Yosef Adi
JURNAL KEBIDANAN Vol. 14 No. 2 (2024): Oktober 2024
Publisher : Politeknik Kesehatan Kementerian Kesehatan Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jkb.v14i2.11387

Endometriosis is a gynaecological disorder characterised by the presence of endometrial tissue outside the uterine cavity. It affects approximately 10-15% of females of reproductive age. Oxidative stress has been identified as a significant contributing factor to the development and progression of endometriosis. In this study, we investigated the effect of green tea extract on the endometriotic implant area and serum superoxide dismutase (SOD) levels in a rat model of endometriosis. Twenty-six female Balb/c rats were randomly divided into the experimental group (EG) and the control group (CG). All subjects in the EG received green tea extract (3 mg daily) for 14 days. On the fourteenth day, endometriosis was induced in all subjects (both EG and CG). The endometriotic implant area and serum SOD levels were assessed 14 days after induction. The endometriotic implant area in the green tea extract-treated group was significantly lower than that in the control group (p=0.022, RR=0.455, 95% CI=0.065-0.96). Serum SOD levels in the EG and CG were 5.33Â±0.52 ng/ml and 5.20Â±0.91 ng/ml, respectively (p=0.507). Green tea extract effectively inhibited the progression of endometriotic implants and increased serum SOD levels in the endometriosis-induced rat model. These findings suggest that the anti-angiogenic and antioxidant properties of green tea may have therapeutic potential in managing endometriosis.

Risk Factors of Ectopic Pregnancy at Dr. Kariadi Hospital Zahwa, Kamila Zettira; Trisetiyono, Yuli; Pramono, M Besari Adi; Dewantiningrum, Julian
Diponegoro International Medical Journal Vol 6, No 1 (2025): July 2025
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v6i1.25368

Background: Ectopic pregnancy lead to maternal death. There were several risk factors for ectopic pregnancy, including age, IUD, parity, history of ectopic pregnancy, history of pelvic and abdominal surgery, infertility, history of PID, history of abortion, and infertility treatment. This study aimed to prove the correlation between these factors with ectopic pregnancy at RSUP Dr. Kariadi.Objective: This study examines to prove the correlation between these factors with ectopic pregnancy at RSUP Dr. KariadiMethods: This study was an analytical observational study with case control design consisted of 134 samples, divided into ectopic pregnancy (n=67) and threatened abortion as controls (n=67), collected from patient medical records from 2019 – 2024 using purposive sampling. Data analysis was carried out using bivariate analysis with Chi Square & Fisher Exact Test and multivariate analysis with Logistic Regression Test.Results: There were correlation between history of ectopic pregnancy (p = 0,034), history of abortion (p = 0,002), and infertility (p = 0,009) with ectopic pregnancy. Other variables didn’t have significant relationship with ectopic pregnancy (p>0,05). Two risk factors were identified for ectopic pregnancy: history of abortion (p = 0,001; aOR = 3,516; 95% CI 1,632 – 7,577) and infertility (p = 0,005; aOR = 2,913; 95% CI 1,387 – 6,119).Conclusion: There were correlation between history of ectopic pregnancy, history of abortion, and infertility with ectopic pregnancy, while other variables were not related to ectopic pregnancy. History of threatened abortion and infertility were risk factors for ectopic pregnancy.

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