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All Journal Jurnal Kedokteran Universitas Palangka Raya Jurnal Kedokteran Meditek
Franciska, Shelly
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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Serial Kasus : Presentasi Klinis dan Tata Laksana Nodul Endometriosis Subkutan Franciska, Shelly; Harzif, Achmad Kemal; Lethulur, Shindie Dona Kezia
Jurnal Kedokteran Meditek Vol 31 No 2 (2025): MARCH
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v31i2.3479

Abstract

Introduction: Subcutaneous endometriosis is a rare condition with endometrial tissue localized outside the pelvis and often mimics general endometriosis. The novelty of this study is an in-depth understanding of the specific risk factors associated with subcutaneous endometriosis after cesarean section and how optimal therapeutic approaches can provide better outcomes in patients with a history of endometriosis. This study aims to explore the clinical presentation, outcomes, and managerial approaches to this condition, as well as provide evidencebased recommendations for its management. Case Illustration: This study involved seven patients at Cipto Mangunkusumo Hospital (January 2022–December 2024). Data collected included demographics, age, BMI, initial symptoms, time of symptom onset, history of cesarean section, history of endometriosis, complications, nodule size, therapeutic approaches, and clinical outcomes. Discussion: Of the seven patients, three underwent one cesarean section, two underwent two operations, and two underwent more than two cesarean sections. A history of diffuse adenomyosis was found in three patients. Subcutaneous nodules located mainly in the cesarean scar, had highly variable sizes and caused significant pain (VAS 5–6). Dienogest therapy was given to three patients and significantly reduced pain. Conclusion:Subcutaneous endometriosis is often associated with a history of abdominal surgery, especially cesarean section. Extrapelvic location can be mistaken for keloid or fibroma, which hinders timely diagnosis. The novelty of this study lies in emphasizing the importance of multidisciplinary collaboration in the management of subcutaneous endometriosis, especially involving plastic surgeons to improve aesthetic results and prevent recurrence. Treatment involving hormonal therapy or surgery, based on the size and location of the nodule, is essential for optimal results.
Ketidakseimbangan Th17 dan Treg Pada Pasien PCOS Dengan Resistensi Insulin: Tinjauan Literatur Terhadap Potensi Suntikan Terapi Franciska, Shelly; Hestiantro, Andon; Kartika, Tasya
Jurnal Kedokteran Universitas Palangka Raya Vol 13 No 1 (2025): Jurnal Kedokteran Universitas Palangka Raya
Publisher : Fakultas Kedokteran, Universitas Palangka Raya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37304/jkupr.v13i1.17456

Abstract

Polycystic ovary syndrome or polycystic ovary syndrome (PCOS) is a metabolic-endocrine disorder characterized by oligoovulation/anovulation, hyperandrogenism, and polycystic ovaries on ultrasound. Globally, PCOS affects 6-21% of women of reproductive age and about 95% of them experience insulin resistance. In Indonesia, the prevalence of PCOS reaches 5-10% where 72.04% are associated with infertility and insulin resistance. Immunoendocrinology notes that the immune response plays a role in the development of PCOS. Several mechanisms cause chronic inflammation caused by insulin resistance, hyperandrogenemia, and dyslipidemia. Research shows a correlation between pro-inflammatory cytokines, especially T-helper 17 (Th17) cells and T-regulatory cells (Treg), in PCOS and insulin resistance. Th17 cells increase inflammation, while Tregs play the opposite role, with their differentiation modulated by interleukin-6 (IL-6) and Transforming Growth Factor-β (TGF-β). Th17/Treg balance can be regulated by targeting IL-6. This study compared Th17 and Treg levels in PCOS patients with and without insulin resistance using IL-17 and IL-10 markers. Th17 was higher and Treg was lower in PCOS with insulin resistance, resulting in a higher Th17/Treg ratio compared to patients without insulin resistance. The results of this study provide an opportunity to target the Th17/Treg axis in new therapies to break the cycle of PCOS and insulin resistance and reduce complications
Co-Authors Achmad Kemal Harzif Hestiantro, Andon Kartika, Tasya Lethulur, Shindie Dona Kezia