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All Journal BALI MEDICAL JOURNAL (BMJ) E-Jurnal Medika Udayana E-Journal Obstetric & Gynecology Udayana Indonesian Journal of Obstetrics & Gynecology Science ISM (Intisari Sains Medis) : Jurnal Kedokteran GANESHA MEDICINA
I Gede Mega Putra
Departemen/KSM Obstetri Dan Ginekologi, Fakultas Kedokteran Universitas Udayana-RSUP Sanglah Denpasar, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Public Health

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Journal : E-Journal Obstetric

 1 
AKURASI PERSENTASE CD4 DAN ABSOLUT CD4 TIDAK BERBEDA DALAM MEMPREDIKSI VIRAL LOAD PADA IBU HAMIL TERINFEKSI HUMAN IMMUNODEFICIENCY VIRUS TRIMESTER II DAN III DI BALI Mega Putra, Gede
E-Journal Obstetric & Gynecology Udayana Vol 4, No 1 (2015)
Publisher : E-Journal Obstetric & Gynecology Udayana

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Kehamilan dengan infeksi human immunodeficiency virus (HIV) semakin meningkat beberapa dekade terakhir. Faktor risiko utama penularan dari ibu ke bayi adalah tingginya viral load HIV di dalam darah ibu. Namun, viral load hanya dapat diperiksa dengan PCR yang biayanya sangat mahal. Rendahnya sistem imunitas berkaitan dengan semakin tingginya viral load HIV. Pemeriksaan CD4 dapat digunakan untuk menilai status imunitas dengan harga yang ekonomis. Persentase CD4 dinilai lebih baik dalam menilai status imunitas pasien dibanding absolut CD4. Tujuan penelitian ini adalah untuk mengetahui perbedaan akurasi antara persentase CD4 dibandingkan absolut CD4 untuk memprediksi viral load pada ibu hamil terinfeksi HIV.   Penelitian uji diagnostik ini melibatkan 22 ibu hamil terinfeksi HIV yang datang ke Poliklinik PMTCT RSUP Sanglah, bulan September 2011 sampai dengan Agustus 2012 yang diambil secara consecutive sampling. Darah diambil untuk pemeriksaan viral load, CD4, dan DL. Pemeriksaan viral load dilakukan dengan PCR di laboratorium biologi molekuler FK Universitas Udayana. Pemeriksaan CD4 dan DL dilakukan di laboratorium RSUP Sanglah. Dilakukan analisis dengan tabel silang 2x2 menggunakan SPSS 17 for windows® version untuk menilai sensitivitas, spesifisitas, dan tingkat akurasi antara persentase CD4 dan absolut CD4 untuk menilai viral load HIV.   Hasil analisis menunjukan persentase CD4 memiliki sensitivitas sebesar 75,0%, spesifisitas sebesar 88,9%, dan akurasi sebesar 86,4% dalam menilai viral load pada ibu hamil terinfeksi HIV. Absolut CD4 yang memiliki sensitivitas 50,0%, spesifisitas 77,8%, dan akurasi sebesar 72,7%. Hasil uji Chi-Square menunjukaan tidak ada perbedaan bermakna antara akurasi persentase CD4 dan absolut CD4 (P = 0,457).   Simpulan dari penelitian ini adalah Persentase CD4 dan absolut CD4 memiliki akurasi yang tinggi untuk memprediksi viral load pada ibu hamil terinfeksi HIV. Tidak terdapat perbedaan akurasi yang bermakna antara persentase CD4 dan absolut CD4.   Kata kunci: Ibu hamil HIV, viral load, CD4
TERDAPAT PERBEDAAN EKSPRESI HER-2/NEU PADA KANKER OVARIUM DERAJAT DIFERENSIASI BAIK DAN BURUK Mega Putra, Gede
E-Journal Obstetric & Gynecology Udayana Vol 2, No 3 (2014)
Publisher : E-Journal Obstetric & Gynecology Udayana

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Kanker ovarium masih menjadi masalah kesehatan di dunia terkait dengan insiden dan mortalitasnya. HER-2/neu  merupakan salah satu faktor yang diduga berperan dalam mekanisme karsinogenesis kanker ovarium epithelial. Penelitian ini merupakan studi cross-sectionaldi Bagian Kebidanan dan Penyakit Kandungan, Patologi Anatomi dan Rekam Medis Rumah Sakit Umum Pusat (RSUP) Sanglah, Denpasar yang dilakukan mulaiJuli 2011 sampai Juli 2013 dengan sampelpenelitian sebanyak 44 buah blok parafin. Sampel blok parafin ini dikelompokkan berdasarkan atas derajat diferensiasi kanker ovarium, yaitu: kanker ovarium derajat diferensiasi baik, sedang, dan buruk. Kemudian masing-masing kelompok stadium dilakukan pemeriksaan ekspresi HER-2/neu dengan teknik imunohistokimia. Selanjutnya dilakukan penilaian perbedaan ekspresi HER-2/neu pada  kanker ovarium derajat diferensiasi baik,sedang, dan buruk Uji Chi-square. Penelitian ini memperoleh adanya perbedaan ekspresi HER-2/neu pada kanker ovarium derajat diferensiasi baik dan buruk (p =0,034). Sedangkan pada analisis statistik ekspresi HER-2/neu pada kanker ovarium derajat diferensiasi baik dan sedang (p =0,330) demikian pula ekspresi HER-2/neu pada kanker ovarium derajat diferensiasi sedang dan buruk (p =0,358) masing-masing tidak terdapat perbedaan. Disimpulkan bahwa terdapat perbedaan ekspresi HER-2/neu pada kanker ovarium derajat diferensiasi baik dan buruk.
CD4 PERCENTAGE AND CD 4 ABSOLUT ACCURATION WAS NOT DIFERRENT IN THE PREDICTION OF VIRAL LOAD IN TRIMESTER II AND III HIV INFECTED PREGNANT WOMEN IN BALI Mega Putra, I gede
E-Journal Obstetric & Gynecology Udayana Vol 2, No 4 (2014)
Publisher : E-Journal Obstetric & Gynecology Udayana

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Abstract

Pregnancy with HIV infection keeps increasing in the last decades. The main risk factor of transmission is from the mother to the baby due to high viral load in mother circulation system. However, viral load examination with PCR method is very expensive to be conducted. The low immunity system correlates with the increasing HIV viral load. CD4 examination is done to evaluate immune system with a cost-effective method. CD4 percentage provides better information on the overall immune function compared to absolute CD4. The aim of this study was to get accurate alternative examination to predict viral load in HIV infected pregnant women. A diagnostic study involved 22 HIV infected pregnant women who came to PMTCT Outpatient Clinic Sanglah Hospital, from September 2011 until August 2012 with consecutive sampling. Blood samples were collected to do viral load, CD4, and CBC examination. Viral load examination was done with PCR examination in the molecular biology laboratory in Faculty of Medicine Udayana University. CD4 and CBC examination was done in Sanglah Hospital Laboratory. Analysis was done with 2x2 cross tab using SPSS 17 for windows® version to get sensitivity, specificity, and accuracy range between percentage of CD4 and CD4 absolute to asses HIV viral load. Analysis result showed that CD4 percentage had got sensitivity 75,0%, specificity 88,9%, and accuracy 86,4% in assessing viral load in HIV infected pregnant women. CD4 absolute had got sensitivity 50,0%, specificity 77,8%, and accuracy 72,7%. Chi-Square analysis showed there was no difference accuracy between CD4 percentage and CD4 absolute (P = 0,457). Conclusion from this study was that CD4 percentage and CD4 absolute had high accuracy to predict viral load in HIV infected pregnant women. No difference accuracy between CD4 percentage and CD4 absolute. Keywords: Pregnancy with HIV, viral load, CD4
THE DIFFERENCES OF PROTEIN 53 EXPRESSION IN OVARIAN EPITHELIAL TUMOR BENIGN, BORDERLINE AND MALIGNANT TYPE Mega Putra, I Gede
E-Journal Obstetric & Gynecology Udayana Vol 2, No 5 (2014)
Publisher : E-Journal Obstetric & Gynecology Udayana

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Abstract

Ovarian tumor is a gynecologic oncology problemthroughoutthe worldand is thefifthcause of deathfrom cancerin women. Ovarian tumor classification into benignepithelial ovariantumors, borderlineandmalignanthas causeddifficulties inits management, especially for borderlinetypein young womenwhostillwant to preservetheir reproductivefunction. Variousstudies have been conductedtofindamarkerthatcan beusedforearly detection, prognosisandguidanceinits management,which are expected todecreasemorbidity andmortalityandimprove survival. Therefore, someresearchers performedgeneticapproach torevealthe occurrence ofthetumoretiopathogenesis. One of the genesthat play a rolein the occurrence ofatumorisP53whichis a genethat expressesa protein53(p53).The purpose ofthis study wastodeterminethe expression ofp53andthe differenceintypesof epithelial ovariantumorsbenign, borderlineandmalignant. This was a cross-sectional study in Obstetrics and Gynecology, Pathology Anatomy and Medical Records Departments of Sanglah Central Public Hospital Denpasar, which was conducted from July 2011 until December 2013 with sample of 49 paraffin blocks pieces. Paraffin block samples were grouped based on the type of epithelial ovarian tumors which are benign, borderline and malignant. Eachgroupof tumortypes was then examined for its p53 expressionbyimmunohistochemical technique. Furthermore, the differencesbetweenbenignepithelial ovariantumors, borderlineandmalignant were determined usingChi-Square test. The averages ofage, Body Mass Index(BMI), parity, andhistory ofhormonal contraceptionin all threetypesof epithelial ovariantumors groups werehomogeneous. P53 expression in ovarian epithelial tumor was 6,25% in benign type, 15,38% in borderline type, and 40% in malignant type. Based on Chi square test, there was a significant difference in p53 expression between the benign epithelial ovarian tumor and malignant type (p=0,024), no significant difference in p53 expression between the benign type and borderline type (p=0,448), and no significant difference in p53 expression between the borderline type and the malignant type (p=0,202).   Key word : p53 expression, benign epithelial ovarian tumor, borderline and malignant type.
Co-Authors Aditya Prabawa Anak Agung Ngurah Anantasika Anak Agung Ngurah Jaya Kusuma Andy Susanto Anom Suardika Demetria Jesica Lim Endang Sri Widiyanti I Gde Sastra Winata I Gede Mahendra Adiguna Dira I Gede Ngurah Harry Wijaya Surya I Ketut Surya Negara I Ketut Suwiyoga I Nyoman Gede Budiana I Wayan Artana Putra I Wayan Megadhana Ida Bagus Gde Fajar Manuaba Ines Kurniaty Hartono Jeffy Winarta Wahjudi Kadek Fajar Marta Ketut Yoga Mira Pratiwi Leony Lim Made Bagus Dwi Aryana Ni Putu Omasih Kiantimi Nyoman Bayu Mahendra Putra Agung Eka Aricandana Putu Raka Widhiarta Stella Kawilarang, Stella