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Genital Ambiguity in a 46, XY individual : a Rare Case Zata Yuda Amaniko; Yuad, Haviz
Andalas Obstetrics And Gynecology Journal Vol. 9 No. 1 (2025)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.9.1.153-160.2025

Abstract

Introduction: Ambiguous genitalia/disorders of sexual development (DSD) is a disorder of sexual development that is atypical chromosomally, gonadally and anatomically, which is generally characterized by the presence of unclear external genitalia, which can cause biological, social and psychological problems in the patient. as well as family. Objective: To report a rare case of 46 XY disorders of sexual development. Case Report: A 20 years old patient was reported with complaints of primary amenorrhea, breasts that had not yet grown and genitals resembling male genitals. Through physical examination, fine hair appeared above the lips, acne, prominent thyroid cartilage, mammary tanner stage M1, and a structure resembling a penis on the genitalia. The patient was examined according to the algorithm for patients with DSD, namely an ultrasound examination with the result that no gonads were found, then the patient underwent a karyotyping examination with results of 46 XY. In the investigation, it revealed LH: 58.45 mIU/ml, FSH: 57.74 mIU/ml, testosterone: 228 ng/dl. Next, the patient is planned for further imaging examinations. Conclusions: DSD is genetically heterogeneous and careful assessment by a multidisciplinary team is essential to accurately diagnose DSD. Many forms of DSD go undiagnosed. It is important for physicians to have a clear decision-making pathway in evaluating patients with DSD Keywords: Disorders of Sexual Development, Ambiguous Genitalia, 46 XY
Comparison of Vaginal Microbiota Profiles in Patients With Endometriosis and Without Endometriosis Sef Zani Meria; Yuad, Haviz; Putra, Andani Eka
Andalas Obstetrics And Gynecology Journal Vol. 9 No. 1 (2025)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.9.1.74-85.2025

Abstract

Introduction: Endometriosis is a complex gynecological disease affect 10% of women in reproductive age, involving inflammation and immune regulation. Diversity of vaginal microbiota is an integral part of vaginal microecology with vaginal anatomy, endocrine system and local vaginal immunity. The disruption in microecology, dysbiosis, is known to trigger inflammatory diseases. The relationship between vaginal dysbiosis and endometriosis remains controversial Objective: To determine the comparison of vaginal microbiota profiles in patients with and without endometriosis Method: The study was case-control design on patients with and without endometriosis at Dr. M. Djamil Hospital, conducted from December 2023 to June 2024 at Dr. M. Djamil Hospital Polyclinic and the Center for Infectious Disease Diagnostic and Research Laboratory. The diagnosis of endometriosis was confirmed via ultrasonography and histology. Microbiota were measured with miSeq Illumina Next Generation Sequencing. A comparison of microbiota profiles was carried out using the Mann-Whitney test. Results: There were 40 respondents, with endometriosis (n=20) and without endometriosis (n=20). At the phylum level, the vaginal microbiota profile in the endometriosis group was dominated by Firmicutes, Proteobacteria, Actinobacteria, and Bacteroidetes, while in without endometriosis group dominated by Firmicutes, Actinobacteria, Bacteroidetes, and Proteobacteria. At the genus level, the endometriosis group was dominated by Lactobacillus sp., Desulfovibrio sp., Flavobacterium sp., and Gardnerella sp., while without endometriosis group were Lactobacillus sp., Prevotella sp., Desulfovibrio sp., and Bifidobacterium sp. There was no difference in the abundance of microbiota (p>0.05) Conclusion: There was no difference in the abundance of microbiota between endometriosis group and without endometriosis group.   Keywords: Endometriosis, dysbiosis, vaginal microbiota, Lactobacillus, Flavobacterium, Firmicutes, Proteobacteria
Correlation between Glycated Hemoglobin Levels with Polycystic Ovary Syndrome Phenotypes and Metabolic Syndrome Yuad, Haviz; Pratama, Revivo Rinda
Andalas Obstetrics And Gynecology Journal Vol. 6 No. 2 (2022)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.6.2.138-146.2022

Abstract

Background: Polycystic Ovary Syndrome (PCOS) is one of the endocrine disorders that causes oligo-anovulation, clinical and biochemical signs hyperandrogenism and ovarian- specific morphological signs on ultrasound examination are common in women of reproductive age. Conditions of insulin resistance and hyperandrogenism accompanied by hypertension and obesity can lead to dyslipidemia that can meet the diagnostic criteria for the metabolic syndrome. The American Diabetes Association approved the examination of glycated hemoglobin (HbA1c) levels as a routine screening for impaired glucose tolerance and hyperglycemic conditions. Examination of HbA1c levels using the method Point of Care Test. Several studies have shown a direct correlation between elevated HbA1c levels and complications of PCOS, providing evidence that HbA1c plays a potential role in PCOS. This study aims to determine the correlation between HbA1c levels with PCOS phenotype and metabolic syndrome. Methods: The study used an analytical study with a cross sectional analytic study design, the number of samples was 52 respondents. The sample was using selected consecutive sampling and then analyzed for HbA1c levels using POCT, PCOS phenotype, and metabolic syndrome for univariate and bivariate. Results: The study with 52 respondents with PCOS patients, the results showed that the number of respondents with increased HbA1c levels was 17 (32.7%) respondents, most of the respondents with phenotype A were 30 (57.7%) respondents. The number of PCOS respondents with metabolic syndrome was 21 (40.4%) respondents. The results of statistical tests showed that correlation between the PCOS phenotype and HbA1c levels. The proportion of the incidence of metabolic syndrome was higher in respondents with phenotype A than phenotypes B, C, and D. The proportion of metabolic syndrome was higher in the category of elevated HbA1c levels compared to normal HbA1c levels, based on statistical tests there was a correlation between HbA1c levels and metabolic syndrome. Conclusion: There was an increase in HbA1c levels in PCOS patients in this study, which was 32.7% and most of the respondents were with phenotype A. Less than half of the respondents had metabolic syndrome. Statistically, there is a correlation between HbA1c levels and PCOS phenotype in PCOS patients and a correlation between HbA1c levels and metabolic syndrome in PCOS patients.
Pregnancy with severe preeclampsia, acute kidney injury and nephrotic syndrome Serudji, Joserizal; Yuad, Haviz; Ambelina, Syntia
Andalas Obstetrics And Gynecology Journal Vol. 7 No. 1 (2023)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.7.1.330-337.2023

Abstract

Background: Preeclampsia is one of the main causes of maternal death every year. Preeclampsia can have badconsequences for both the mother and the fetus. Complications in the mother in the form of HELLP syndrome(Hemolysis, Elevated Liver Enzyme, Low Platelet), pulmonary edema, kidney disorders, bleeding, placentalabruption and even maternal death. Complications in infants can be premature birth, fetal distress, low birthweight or intra uterine fetal death (IUFD).Case Report: A 34 year old female patient was brought to the emergency room of Dr. M. Djamil Padang, sent tothe Batusangkar Private Hospital with complaints of shortness of breath which has been increasing when lyingdown. Physical examination found blood pressure 190/136. The patient was diagnosed with G2P1A0H1 gravidpreterm 25-26 weeks, PEB on maintenance dose MgSO4 regimen from outside, suspected nephrotic syndrome,CAP with hypoxemia, pleural effusion, AKI with metabolic acidosis, UTI, hyponatremia, hypoalbuminemia.Discussion: Preeclampsia, eclampsia and HELLP syndrome are serious and life-threatening conditions faced bypregnant women. Early diagnosis and prompt treatment via a multidisciplinary team in the ICU setting canprevent complications and reduce morbidity and mortality. The most common indications for intubation andmechanical ventilation are respiratory failure and hemodynamic instability. The cause of death in this patientwas multiple organ failure which was exacerbated by suspected nephrotic syndrome and suspected SLE.
A Case Report: Unusual Case of Heterotopic Pregnancy with Chronic Ectopic Pregnancy Pagi, Putri Embun; Yuad, Haviz
Andalas Obstetrics And Gynecology Journal Vol. 7 No. 2 (2023)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.7.2.453-459.2023

Abstract

Background : Heterotopic pregnancy describes the occurrence of two pregnancies in different implantation sites simultaneously, mostly manifested as intrauterine and ectopic pregnancies (ampullary in 80%). The  incidence has been documented due to the increase incidence of pelvic inflammatory diseases. Case: A 28-years-old primipara woman with suspected chronic ectopic pregnancy, differential diagnosed with ovarian cyst. Previously, the patient had complete abortion because abdominal and pelvic pain still present, she decided to seek treatment at RSUP dr. Mdjamil, from ultrasound was found suspected chronic ectopic pregnancy differentially diagnosed with ovarian cyst. Laparoscopy had done then,  the intraoperative findings found that there was a chronic ectopic pregnancy in the left ampullary tubal and then left salpingectomy was performed.Conclusion: This case is one of the unusual clinical presentations of heterotopic pregnancy. This case highlights the importance of including heterotopic pregnancy in the differential diagnosis especially in patients with persistent abdominal and pelvic pain after complete abortion. 
Management of Hyperprolactinemia Caused by Pituitary Microadenoma Muttaqin, Ibnu; Yuad, Haviz
Andalas Obstetrics And Gynecology Journal Vol. 8 No. 1 (2024)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.8.1.642-647.2024

Abstract

Hyperprolactinemia is an increase in fasting levels of the hormone prolactin above 20 ng/ml in men and above 25 ng/ml in women. Hyperprolactinemia occurs more often in women of reproductive age, with a percentage of 9 – 17%. The etiology of hyperprolactinemia can occur due to abnormal pituitary secretions, systemic disease, use of drugs, damage to the hypothalamus-pituitary axis. A 33-year old female patient came to the FER Polyclinic at M. Djamil Hospital with complaints of not menstruating for the past 2 months. Irregular menstruation since 15 years ago, menstruation 2-3 times in 6 months, irregular cycle for 7-8 days. The patient also complained of a fluid like breast milk coming out of the breast for 5 years, initially the fluid came out in a trickle and then gradually reduced and now the fluid comes out occasionally if the breast is squeezed. From the supporting examinations carried out, it was found that the prolactin hormone level in this patient was 134.53, and the results of the MRI examination showed a mass measuring 1.05x1.12x0.5 mm, which was diagnosed as secondary amenorrhea, hyperprolactinemia, and suspected pituitary microadenoma. The patient will be monitored for general condition and vital signs, as well as consultations with colleagues involved, such as consultations to the Internal Medicine section, Endocrinology, Metabolic and Diabetes Subdivision.
The Relationship of Vitamin D Topolycystic Ovary Syndrome (PCOS) Teenagers at Koto Tangah Padang District High School in 2022 Utomo, Hardi Cahyo; Yuad, Haviz; Burhan, Ida Rahmah
Andalas Obstetrics And Gynecology Journal Vol. 8 No. 1 (2024)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.8.1.615-631.2024

Abstract

PCOS is characterized by increased ovarian and adrenal androgen secretion, hyperandrogenic symptoms such as hirsutism, acne and/or alopecia, menstrual irregularities, and polycystic ovaries. The prevalence of PCOS in 2016 was 6−21% of reproductive age worldwide. PCOS is the most common female endocrine disorder with a prevalence of around 4-6% in women of reproductive age in Indonesia. Vitamin D deficiency can increase PCOS symptoms. The research design was cross-sectional. The study was conducted at SMA N 7, SMA N 8 and SMA N 13 Padang in Koto Tangah District in May-August 2022. The research sample was high school students who experienced menstrual cycle disorders and were willing to agree to informed consent for the study with a sample size of 59 respondents. Vitamin D levels were examined using the 25-Hydroxyvitamin D ELISA Kit. Data were analyzed by chi-square test. The results showed that 86.4% of respondents experienced vitamin D deficiency. Statistically there was a relationship between PCOS in adolescents accompanied by hyperandrogens and vitamin D levels, there was a relationship between PCOS in adolescents accompanied by obesity and vitamin D levels, there was no relationship between PCOS in adolescents accompanied by acanthosis nigrican and vitamin D levels, and there was no relationship between PCOS in adolescents accompanied by hyperandrogens, obesity and acanthosis nigrican with vitamin D levels in SMA Koto Tangah District Padang in 2022. The conclusion of this study is that there is a relationship between PCOS in adolescents accompanied by hyperandrogens and vitamin D levels and there is a relationship between PCOS in adolescents accompanied by obesity and vitamin D levels.