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Amenore Primer et causa Hiperplasia Adrenal Kongenital Non Klasik Arifiandi, Maya Devi; Wiyasa, I Wayan Arsana
Journal of Issues in Midwifery Vol 2, No 1 (2018)
Publisher : Journal of Issues in Midwifery

ABSTRACTPrimary amenorrhea is menarche delayed at 14 of age without secondary sex or absent of menstruation at 16 of age with appearance of normal secondary sex. Congenital Adrenal Hyperplasia (CAH) is one of endocrine disturbance can cause primary amenorrhea. Three CAH phenotypes are classical salt wasting and classical simple virilizing, also non classical CAH with late onset in symptoms and diagnosis which unknown in prenatal time. Non classical CAH caused by P450C21(21-hydroxilase) deficiency, where autosomal recessive cause by mutation of gene CYP21A2. A case 16 years old female patient came with absent of menstruation and mass near vagina as penis like. Number of screening and examination, diagnosis for this patient is Non Classical Congenital Adrenal Hyperplasia. Keywords : primary amenorrhea, non classical congenital adrenal hyperplasia ABSTRAKAmenore primer adalah tertundanya menarke pada usia 14 tahun tanpa disertai seks sekunder atau tidak adanya menstruasi pada usia 16 tahun dengan adanya pertumbuhan normal seks sekunder. Hiperplasia Adrenal Kongenital (HAK) merupakan salah satu gangguan endokrin yang dapat menyebabkan terjadinya amenore primer. Terdapat tiga fenotip HAK, HAK tipe klasik yaitu classical salt wasting dan classical simple virilizing sejak lahir serta HAK non klasik dengan late-onset baik gejala maupun diagnosisnya dimana saat prenatal tidak diketahui. HAK non klasik disebabkan karena adanya defisiensi enzim P450C21 (21-hidroksilase) yang merupakan kelainan autosomal resesif yang diakibatkan oleh mutasi gen CYP21A2. Sebuah kasus seorang pasien wanita lajang usia 16 tahun dengan keluhan belum menstruasi sama sekali dan memiliki benjolan di dekat vagina menyerupai penis. Dilakukan serangkaian pemeriksaan, diagnosis pada pasien ini adalah Hiperplasia Kongenital Adrenal Kongenital (HAK) non klasik. Kata kunci: amenore primer, hiperplasia adrenal kongenital (HAK) non klasik

MENOPAUSE DAN ALZHEIMER`S DISEASE Adriana, Kusuma; Wiyasa, I Wayan Arsana
Saintika Medika: Jurnal Ilmu Kesehatan dan Kedokteran Keluarga Vol 13, No 2 (2017): DESEMBER 2017
Publisher : Universitas Muhammadiyah Malang

Struktur populasi penduduk dunia bergeser kearah penduduk berusia lanjut dengan konsekuensi munculnya penyakit-penyakit degeneratif termasuk demensia. Demensia menjadi satu masalah kesehatan masyarakat terbesar pada generasi saat ini, dan Alzheimer`s disease (AD) merupakan bentuk yang tersering dari demensia, berkisar 60-70 % dari total demensia. Perempuan mempunyai risiko lebih besar menderita AD dibanding laki-laki karena angka harapan hidup yang lebih panjang. Hal ini menyebabkan banyak perempuan hidup lebih lama setelah menopause. AD adalah gangguan neurodegeneratif dengan manifestasi klinik memori dan kognitif yang menurun drastis atau demensia disertai penurunan fungsi memori, berpikir, berbahasa dan kapasitas belajar. Etiologi AD belum diketahui dengan pasti dan penegakkan diagnosis sukar ditegakkan saat pasien masih hidup. Neurotransmiter, neuropeptida dan neurosteroid mengalami perubahan penting saat menopause yang menyebabkan gangguan pada Central Nervous System (CNS). Long Term Estrogen Deprivation (LTED) pada perempuan menopause menyebabkan neurodegenerasi, degradasi RE alfa di hipokampus yang menyebabkan hilangnya efek estradiol sebagai neuroproteksi terhadap iskemia serebral dan turunnya aktifitas choline asetyltransferase yang menyebabkan turunnya sintesis asetilkolin yang menyebabkan gangguan belajar dan memori. Penelitian mengenai pemberian estrogen sebagai terap sulih hormon masih menimbulkan kontroversi untuk terapi AD.Kata kunci : menopause, penyakit degeneratif, demensia, Alzheimer`s disease, hipoestrogen

Cowpea (Vigna unguiculata) Extract Reduce Malondialdehyde Levels and Prevent Aortic Endothelial Cell Decline in Ovariectomized Rats Ni Putu Sri Haryati; Elisa Danik Kurniawati; Tanti Tri Lestary; Eviana Norahmawati; I Wayan Arsana Wiyasa; Dwi Yuni Nur Hidayati; Tatit Nurseta
Medical Laboratory Technology Journal Vol. 7 No. 2 (2021): December
Publisher : Poltekkes Kemenkes Banjarmasin Jurusan Analis Kesehatan

Estrogen has anti-oxidative and anti-inflammatory properties, but its levels decrease in postmenopausal women who can trigger oxidative stress. One of the most damaging effects of ROS is lipid peroxidation, and the end product is Malondialdehyde (MDA). Similarly, aging endothelium has increased oxidative stress and endothelial cell sensitivity to apoptosis. This study aimed to determine the effect of cowpea extract on serum MDA levels, aortic endothelial cell counts, and brain MDA levels in the ovariectomy model. Cowpea extract can be used as an alternative to prevent and overcome the effects that occur during menopause, such as cardiovascular problems, decreased bone mineral density, and dementia. The study used 15-month-old female Rattus norvegicus, divided into six groups (OVX, SHAM, OVX+estradiol, OVX+Vu 1.25; 2.5; and 5 mg/kg BW/day). Serum and brain MDA levels were examined by ELISA method, while the number of aortic endothelial cells were examined on histopathological preparations with Hematoxylin & Eosin (HE) staining. The mean value of serum and brain MDA levels decreased with an increase in the dose given (p-value 0.016). The mean value of aortic endothelial cells between the dose groups did not significantly differ. However, the mean value showed an increasing trend as the dose of cowpea extract was given. The results of this study indicate that the extract of cowpea has the potential as an antioxidant to reduce serum and brain MDA levels, prevent a decrease in the number of aortic endothelial cells. As prevention, cowpea extract can be used as an antioxidant and consumed since premenopause to minimize problems that occur during postmenopause.

MENOPAUSE DAN ALZHEIMER`S DISEASE Kusuma Adriana; I Wayan Arsana Wiyasa
Saintika Medika Vol. 13 No. 2 (2017): DESEMBER 2017
Publisher : Universitas Muhammadiyah Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22219/sm.v13i2.5528

Struktur populasi penduduk dunia bergeser kearah penduduk berusia lanjut dengan konsekuensi munculnya penyakit-penyakit degeneratif termasuk demensia. Demensia menjadi satu masalah kesehatan masyarakat terbesar pada generasi saat ini, dan Alzheimer`s disease (AD) merupakan bentuk yang tersering dari demensia, berkisar 60-70 % dari total demensia. Perempuan mempunyai risiko lebih besar menderita AD dibanding laki-laki karena angka harapan hidup yang lebih panjang. Hal ini menyebabkan banyak perempuan hidup lebih lama setelah menopause. AD adalah gangguan neurodegeneratif dengan manifestasi klinik memori dan kognitif yang menurun drastis atau demensia disertai penurunan fungsi memori, berpikir, berbahasa dan kapasitas belajar. Etiologi AD belum diketahui dengan pasti dan penegakkan diagnosis sukar ditegakkan saat pasien masih hidup. Neurotransmiter, neuropeptida dan neurosteroid mengalami perubahan penting saat menopause yang menyebabkan gangguan pada Central Nervous System (CNS). Long Term Estrogen Deprivation (LTED) pada perempuan menopause menyebabkan neurodegenerasi, degradasi RE alfa di hipokampus yang menyebabkan hilangnya efek estradiol sebagai neuroproteksi terhadap iskemia serebral dan turunnya aktifitas choline asetyltransferase yang menyebabkan turunnya sintesis asetilkolin yang menyebabkan gangguan belajar dan memori. Penelitian mengenai pemberian estrogen sebagai terap sulih hormon masih menimbulkan kontroversi untuk terapi AD.Kata kunci : menopause, penyakit degeneratif, demensia, Alzheimer`s disease, hipoestrogen

Turmeric (Curcuma longa) Decoctum Had no Effect on Vascular Endothelial Growth Factor (VEGF) and Vascular Endothelial Cadherin (VE-cadherin) Expression in the Chick Embryo Sri Winarsih; I Wayan Arsana Wiyasa; Sri Andarini; Sumarno Reto Prawiro
Research Journal of Life Science Vol 5, No 2 (2018)
Publisher : Lembaga Penelitian dan Pengabdian kepada Masyarakat, Universitas Brawijaya

Turmeric (Curcuma longa) as a medicinal plant has widely consumed by pregnant women. The absence of dose standardization and the regulation of turmeric consumption in pregnancy raise concerns, especially if taken in early pregnancy. Angiogenesis is the process of new blood vessel formation from previously existing blood vessels, and plays an important role in embryogenesis and placentation during pregnancy. Angiogenesis is regulated by angiogenic molecules, such as VEGF and VE-cadherin. Turmeric has antiangiogenic effects in which the crude extract is pharmacologically more potent compared to the pure curcumin form. This study aimed to determine whether a turmeric decoctum affects the expression of VEGF and VE-cadherin in chick embryos. Turmeric was extracted by the decoction and freeze dried methods to obtain turmeric decoctum powder. This was tested on embryonated chicken eggs, which were divided into four groups; control group (2% DMSO) and treatment groups receiving various doses of the turmeric decoctum (200 ppm, 300 ppm and 400 ppm). The eggs used were less than 7 days after oviposition and incubated for 16 hours prior to injection of the treatment solution in ovo to the center of the yolk, followed by reincubation for up to 48 hours. Intraembryonic VEGF and VE-cadherin expression were assessed by whole-mount immunohistochemistry and quantified using image analysis techniques. This study showed administration of turmeric decoctum up to 400 ppm had no effect on the expression of VEGF and VE-cadherin in chick embryos.

Ekstrak ethanol pegagan (Centella asiatica) meningkatkan osifikasi tulang dan panjang badan larva zebrafish (Danio rerio) model stunting usia 9 hari pasca fertilisasi Evi Zahara; Een Nuraenah; Tri Yuliyani; Darwitri Darwitri; Husnul Khotimah; Umi Kalsum; I Wayan Arsana Wiyasa; Nurlaili Ramli; Agus Hendra Al Rahmad; Mohammad Muljohadi Ali
AcTion: Aceh Nutrition Journal Vol 3, No 2 (2018): AcTion Vol 3 No 2 Tahun 2018
Publisher : Department of Nutrition at the Health Polytechnic of Aceh, Ministry of Health

Centella Asiatica (Linn) Urban is known as Gotu Kola. Centella Asiatica (CA) is rich in micro and macronutrients. The aim of this study was to investigate the effect of ethanol extract of CA on bone ossification and body length in zebrafish larva stunting model at 9 dpf. This study used zebrafish at 2 hpf (hour post-fertilization) - 9 dpf (day post-fertilization). The population of 300 larvae divided into 5 groups consisting of control group, rotenone group (exposed by 12.5 ppb of rotenone) and 3 rotenone+CA groups that exposed to CA extract for 4, 5 and 6 days, respectively. The CA extract was obtained by maceration method with ethanol solvent. The results showed that rotenone 12,5 ppb able to inhibit the growth of larvae >2SD of body length and decrease bone ossification at rotenone group, were significantly different from the control group. Administration of CA extract was increased expression of cartilage at rotenone+CA5 as well rotenone+CA6 group and increase expression of bone at the rotenone+CA5 group and also increase body length rotenone+CA groups significantly different from rotenone group. It can be concluded that the period of CA extract exposure can correct the length of the body reaching 99.6% at 9 dpf and increased bone ossification in a time-dependent manner.Centella asiatica (Linn) Urban dikenal dengan nama pegagan. Centella Asiatica (CA) kaya akan mikro maupun makro nutrisi yang diperlukan bagi tubuh terutama masa pertumbuhan. Penelitian ini bertujuan mengetahui efek ekstrak etanol CA terhadap osifikasi tulang dan panjang badan larva zebrafish model stunting yang diinduksi rotenone pada 9 hari post fertilisasi. Penelitian ini menggunakan zebrafish mulai 2 hpf (hour post fertilisation) - 9 dpf (day post fertilisation), populasi larva sejumlah 300 yang dibagi 5 kelompok yang terdiri dari kelompok kontrol, kelompok rotenon (dipapar rotenone 12,5 ppb) dan 3 kelompok rotenone+CA yang diberikan pegagan selama 4, 5 dan 6 hari secara berurutan. Ekstrak CA diperoleh melalui metode maserasi dengan pelarut etanol. Hasil penelitian menunjukkan bahwa rotenone dapat menghambat pertumbuhan panjang larva >2SD dan menurunkan osifikasi tulang pada kelompok rotenon secara signifikan dibanding kontrol. Pemberian ekstrak CA dapat meningkatkan ekspresi tulang rawan kelompok rotenone+CA5 maupun rotenone+CA6 dan meningkatkan ekspresi tulang keras kelompok rotenone+CA5 serta meningkatkan panjang badan kelompok rotenone_CA secara signifikan dibanding kelompok rotenone. Dapat disimpulkan bahwa lamanya pemberian ekstrak CA dapat meningkatkan osifikasi tulang dan meningkatkan panjang badan mencapai 99.6% pada 9 dpf.

The Genistein Daidzein in Kudzu Root (Pueraria lobata) Extract Decreased Malondialdehyde Plasma Levels in Hypoestrogenic Rats Nany Nita Noviana; Nina Rini Suprobo; I Wayan Arsana Wiyasa
Asian Journal of Health Research Vol. 1 No. 1 (2022): Volume 1 No 1 (April) 2022
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Introduction: Menopause can reduce women's quality of life and cause health issues. The decline in estrogen during menopause is thought to trigger oxidative stress. When the creation of antioxidants does not match the synthesis of reactive oxygen species (ROS) as an antidote, oxidative stress ensues, characterized by malondialdehyde. The aim of the research is to evaluate the effect of the dose of isoflavone genistein daidzein powder in Kudzu root (Pueraria lobata) extract on the decrease in plasma malondialdehyde (MDA) plasma levels in hypoestrogenic rats. Methods: 30 rats Wistar rats were separated into five groups, namely: the control group, the ovariectomy (OVX) group, waited two weeks to produce hypoestrogenic rats. Of the four groups, the positive group was not given a Pueraria lobata powder containing the isoflavones genistein and daidzein (IGD), and the other group was given 15 mg, 30 mg, 60 mg per kg body weight per day, respectively. Twenty-one days later, the mice were killed, and plasma was taken to be checked for MDA levels using spectrophotometry. Results: Genistein Daidzein in kudzu root extract was effective in reducing the oxidative stress. All IGD doses significantly reduced plasma MDA levels. At a dose of 60mg/kg BW, the plasma MDA levels were comparable to those in the control group, it could prevent a significant increase in plasma MDA levels in hypoestrogenic rats. Conclusion: Isoflavone Genistein and Daidzein of kudzu root (Pueraria lobata) extract reduced MDA plasma levels in hypoestrogenic rats.

Local Non Soy Isoflavone Attenuates Bone Loss In The Menopausal Women I Wayang Agung Indrawan; I Wayan Arsana Wiyasa; Achmad Hidayat; Qonita Prasta Agustia
Asian Journal of Health Research Vol. 1 No. 2 (2022): Volume 1 No 2 (August) 2022
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Background: Identification and isolation of local non-soy isoflavone based on cow pea (Vigna unguiculata) by The Indonesian Menopause Society (PERMI) in Malang District, Indonesia No published studies have directly examined the effect of that non-soy isoflavone on bone mineral density in menopausal women. Objective: To determine the effect of 24 weeks' consumption of non-soy isoflavone (67,5 mg) to reduce osteoporotic bone loss in menopausal women. Design and Methods: Menopausal subjects were randomly assigned, double-blind to treatment: non-soy isoflavone (n-30), or placebo (n-30). At baseline and posttreatment, bone mineral density (BMD) was measured by using quantitative ultrasonography. Collected data were analyzed by Analysis of Covariance (ANCOVA). Results: There were no differences in BMD changes between the treatment and placebo group for 24 weeks intervention. The mean of BMD changes in treatment group were 0,952 (p-value 0,006, SE-0,221) from baseline, and the placebo group had mean at -0,768 (p-value -0,006, SE-0,212). Despite this, coffee as the concomitant variable had a significant effect on BMD changes (p value=0,43) at 3rd-month evaluation, but not in 6 months. Participant compliance is good. Conclusion: Non-soy Isoflavone attenuates bone loss in menopausal women. Keywords: non-soy, phytoestrogen, osteoporosis, postmenopausal women

Case Report: Hyperprolactinemia In Suprasellar Meningioma Nirwan Nugraha; I Wayan Arsana Wiyasa; Donny Wisnu Wardhana; Wino Vrieda Vierlia; Edy Mustofa
Asian Journal of Health Research Vol. 1 No. 2 (2022): Volume 1 No 2 (August) 2022
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Introduction: Hyperprolactinemia is a condition in which abnormally elevated prolactin levels (normal prolactin levels are 10-28 g/L) is a common endocrine disorder. Establishing the diagnosis and etiology of hyperprolactinemia should include a thorough medical history and the use of drugs, physical examination, laboratory tests, analysis of the pituitary, and sella turcica features. Pituitary tumor imaging analysis using MRI remains the method of choice. The main goals of managing hyperprolactinemia are restoring and maintaining fertility function and preventing osteoporosis. The choice of treatment depends on the underlying etiology. Case Presentation: A 33-year-old woman complained that her right side of vision could not function properly, and her left side of vision began to blur, which started four years ago with irregular menstrual disorders, and milk came out of her breasts. On breast examination, Tanner 5 was found with galactorrhea and pubic hair Tanner stage 3. On Laboratory examination found FSH (5.50 mIU/mL), LH (1.7 mIU/mL) and prolactin (1125 IU/mL). The MRI examination showed an extra-axial solid mass, broad-based on the planum sphenoidal to the dorsum sellae, suggesting a meningioma; with compression of the optic chiasm, middle cerebral artery, and bilateral anterior cerebral arteries, size 3.1 x 2.8 x 2.3 cm. Conclusion: Hyperprolactinemia with meningiomas is a unique case. First-line therapy for prolactinomas is dopamine agonist administration and, in this case, is followed by surgery, which showed significant results.

Effect of Phaleria macrocarpa Extract on NF-KB, MMP-2, and MMP-9 Expression in Endometriosis Mice Model Annissa Febriani; Sutrisno Sutrisno; Yahya Irwanto; Irfani Baihaqi; I Wayan Arsana Wiyasa; Bambang Rahardjo
Asian Journal of Health Research Vol. 1 No. 3 (2022): Volume 1 No 3 (December) 2022
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v1i3.35

Introduction: Endometriosis is the most common disease that affects the reproductive health and function of women of reproductive age. Treatment for endometriosis includes surgery and medication. Phaleria macrocarpa is a plant native to Indonesia that contains bioactive fractions known to have antiproliferative and apoptotic effects. Therefore, this study aimed to evaluate the effect of Phaleria macrocarpa extract on matrix metalloproteinases (MMP-2 and MMP-9) and NF-KB expression in the endometriosis mice model (Mus musculus). Methods: This study used a Randomized Post-Test Only with Control Group Design. Involves six groups, namely a negative control group (healthy mice without flavonoids from Phaleria macrocarpa fruit extract), a positive control group (an endometriosis model without being given flavonoids from Phaleria macrocarpa fruit extract), and a treatment group, namely a group given four different doses of flavonoids from Phaleria macrocarpa fruit extract: 3.75 milligrams per day, 7.5 milligrams per day, 11.25 milligrams per day and 15 milligrams per day. expressions of NF-KB, MMP-2, and MMP-9 were seen using Immunohistochemistry staining and observed under a microscope with 40x magnification. The data collection used an immunoratio technique with ImageJ analysis software. Furthermore, data analysis using the one-way ANOVA method. Results: In this study, the treatment group with four different doses of Phaleria macrocarpa extract could reduce the expression of MMP-2, MMP-9, and NF-KB. Groups with higher doses of Phaleria macrocarpa extract showed lessen of MMP-2, MMP-9, and NF-KB expression. Conclusion: In the endometriosis mice model, Phaleria macrocarpa fruit can reduce NF-KB, MMP-2, and MMP-9 expression.

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