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INDONESIA
Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
ISSN : 23386401     EISSN : 23387335     DOI : -
Core Subject : Health,
The Indonesian Journal of Obstetrics and Gynecology is an official publication of the Indonesian Society of Obstetrics and Gynekology. INAJOG is published quarterly.
Arjuna Subject : -
Articles 1,731 Documents
Impact of COVID-19 Pandemic on Postpartum Contraceptives Method Choice (IUD vs Tubectomy) and Characteristic Aspects: A Retrospective Descriptive Study Asih Anggraeni; Siagian, Grace; Nurinasari, Hafi; Wisdayanti, Syah Rini; Sulistyowati, Sri; Soetrisno
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 1 January 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i1.1966

Abstract

Objective: This study aims to assess the impact of the COVID-19 pandemic on postpartum contraceptive methods. Methods: This retrospective descriptive study was conducted at a single secondary center, utilizing secondary data retrieved from medical records at the Inpatient Installation of Sebelas Maret University Hospital, Surakarta, covering the period from January 2020 to January 2022. Results: Among users of intra-uterine devices (IUDs), 85% were below 35 years old, 65% were primiparous, 67% had a history of previous injectable contraceptive use, 79% received routine antenatal care, and 51% had education below a college level. These individuals were educated about the importance of contraceptive programs during the COVID-19 pandemic. Sixty-six percent of IUD insertions were conducted via vaginal delivery, and 27% had health facilities within less than 1 km. In contrast, tubectomy contraceptive users comprised 106 patients, with the majority (54%) being aged 35 years or older, all being multiparous, and 25% tested positive for COVID-19. Among tubectomy users, 43% had a history of previous injectable contraceptive use, 85% received routine antenatal care, and 54% had education below a college level. Similar to the IUD group, they were educated about the significance of contraceptive programs during the COVID-19 pandemic. Eighty-four percent of tubectomies were performed via cesarean section, and 27% of patients lived within less than 1 km from health facilities. Conclusion: The usage rates of intra-uterine devices and tubectomy for contraceptives remained stable during the COVID-19 pandemic. However, there was a decrease in postpartum in-person visits and mobility, coupled with an increase in hospitalizations.Keywords: contraceptive; family planning; intrauterine device; tubectomy
Evaluation of Therapy in Preeclampsia Patients in Several Public and Private Hospitals Juwita, Dina Ratna; Raykhan, Akhmad Amar; Nimas Arumsari; Putri, Irsalina Nurul; Ambarwati, Dewi
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 1 January 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i1.1972

Abstract

Objective: To determine the rationality and effectiveness of therapy in preeclampsia patients at the Inpatient Installation of several public and private hospital in Banyumas area from January-December 2021. Methods: This study is retrospective, employing purposive sampling for data collection. The data were extracted from the medical records of patients diagnosed with pre-eclampsia at the Inpatient Installation. The sample consisted of 212 patients with a confirmed diagnosis of pre-eclampsia. Results: From this study, it was found that antihypertensive medications given were methyldopa (52.8%), nifedipine (45.2%), and amlodipine (2%). It was found that the results of the five appropriate analyses were the suitable indication, right patient, proper medication, right dose, and correct route (100%). The antihypertensive medications used were effective in reducing the blood pressure of preeclampsia patients (100%), with an average decrease in systolic pressure by 37 mmHg, an average decrease in diastolic pressure by 22 mmHg, and an average decrease in MAP by 28 mmHg. Conclusion: Antihypertensives given to preeclampsia patients in several public and private hospitals in Banyumas were rational and effective in reducing the patient's blood pressure. Keywords: antihypertensives, effectiveness, preeclampsia, rationality.
Expression of Yap Signaling Hippo Pathway in Cervical Pre-cancerous Lesions and Cervical Cancer Rizal, M Masrur; Arifa Mustika; Wita Saraswati
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 3 Jully 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i3.1983

Abstract

Abstract Objective: To determine the expression of YAP in cervical pre-cancerous and cervical cancer lesions.Methods: Researchers systematically searched five databases using the checklist for Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guideline and Newcastle-Ottawa Scale (NOS).. Inclusion criteria were the original study of YAP expression in cervical pre-cancerous lesions and cervical cancer, observational and experimental study, and using immunohistochemical techniques. The study protocol was registered in the PROSPERO database of systematic review (IDCRD42023407469). Results: The data search in this study followed the PRISMA Guideline, which includes phases of identification, screening, and inclusion of studies. Initially, 245 articles were identified across five databases: Pubmed (105), ScienceDirect (8), Scopus (29), Web of Science (26), and ProQuest (77). After removing duplicates, 157 studies remained. During the initial screening, 142 studies were excluded, leaving 15 studies for further evaluation. These were assessed based on the use of immunohistochemistry staining for YAP expression and staining result. Subsequently, ten studies were excluded for either not using immunohistochsmistry or lacking staining result, resulting in five studdies selected for qualitative analysis. These five studies were evaluated using the New Ottawa Scale, as detailed in Table 1, and their YAP Expression characteristics are summarized in Table 2. Conclusion: This systematic review showed that YAP expression at all levels ranging from normal tissue, cervical intraepithelial neoplasia, squamous cell carcinoma, and adenocarcinoma had increased expression in the cytoplasm or cell nucleus following the development of cervical cancer and tumorigenesis influenced by intra-tumor heterogeneity for YAP expression. YAP is expressed in the cytoplasm and nucleus, with different functions. YAP expression in these two sites Excessive YAP expression will trigger epithelial changes into mesenchyme which also plays a role in cancer development. This YAP expression also correlates with HPV, in which YAP levels will be maintained and increased.Keywords: cervical cancer, cervical pre-cancerous lesions, YAP expression.
Anemia in Pregnancy and Its Maternal Perinatal Outcome Indra Putra, Iriawan; Joice Margaretha Mathilda Sondakh; Juneke Joice Kaeng
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 3 Jully 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i3.1989

Abstract

Objective: To investigate the relationship between anemia in pregnancy and maternal perinatal outcomes. Methods: This was a retrospective cohort study. This research was held at Prof. Dr. R. D. Kandou General Hospital Manado. Data was taken from January 2021 to December 2022. Results: There were 1953 deliveries which 1304 subjects (66.7%) with anemia 649 subjects with anemia (33.3%), 489 subjects with mild anemia, and 160 subjects with moderate-severe anemia. The median maternal age was 28 years for mild anemia. The majority of mothers have a high school education. A total of 326 study subjects were multigravidas with mild anemia. The results of severe preeclampsia with mild anemia were 30 subjects. Prolonged labor tends to be higher in the mild anemia group. The highest distribution was observed in the mild anemia group, with 12 cases of maternal mortality, 88 cases of premature birth, 78 cases of low birth weight (LBW), 75 cases of disorders leading to decreased scores, and 24 cases of fetal mortality. In research subjects, IUGR tends to be more common in groups with moderate-severe anemia with 14 subjects (8.8%). Hemoglobin levels showed a median of 11.6 g/dL with a distribution midway between 10.5 and 12.6 g/dL. The mean MCV value is 76.1 fL (SD 8 fL). The mean MCH value was 24.8 + 3.6 pg. The MCHC value is 32.5%. Conclusions: There are no significant relation in pregnant women with anemia with preeclampsia, prolonged labor, maternal mortality rate and IUGR, but there are significant relation between anemia in pregnancy with increase rate of caesarean section, premature delivery, low birth weight, low APGAR score and fetal death. Keywords: anemia in pregnancy, maternal outcome, neonatal outcome
Management of Vulvovaginal Candidiasis in Pregnancy Levina, Jessica; Ocviyanti, Dwiana; Adawiyah, Robiatul
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 2 April 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i2.1990

Abstract

Pregnancy is a risk factor for vulvovaginal candidiasis (VVC). The most common cause of VVC in pregnancy is Candida albicans. During pregnancy, physiological changes occur, such as increased levels of estrogen, lower vaginal pH, increased production of vaginal mucosal glycogen and immunological changes so that Candida colonization in the vagina increases. Increased colonization can be symptomatic or asymptomatic. When symptoms and signs of vulvar pruritus, pain, swelling, redness, burning, dyspareunia, dysuria, vulvar edema, fissures, excoriation and vaginal discharge are found, it is necessary to perform microscopic examination and/or fungal culture to establish the diagnosis of VVC. Topical intravaginal antifungal therapy such as clotrimazole and nystatin, are the recommended treatment for VVC in pregnancy that has been shown its safety. Treatment with oral antifungal is not recommended because of the risk of causing congenital abnormalities in the fetus. Prophylactic administration in the last trimester of pregnancy in asymptomatic VVC cases provides good pregnancy and neonatal outcomes but is still being debated. In severe, prolonged or recurrent cases of VVC, other co-infections may be sought which may also need to be managed. Administration of probiotics for VVC therapy still requires further research.
Human Immunodeficiency Virus in Pregnancy a Retrospective Study on Maternal and Perinatal Outcomes Muralikrishnan Nambiar; Nikhil shetty; Athulya sreenivas; Anupama suresh Y; Anjali Suneel
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 2 April 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i2.2016

Abstract

Objective: To assess the maternal and perinatal outcome in pregnant women with HIV infection and the role of Antiretroviral therapy in reducing complications of pregnancy. Methods: A retrospective analysis was conducted on data from HIV-positive mothers receiving antenatal care at a tertiary care center between February 2015 and January 2020. The study examined various adverse pregnancy outcomes in relation to antiretroviral treatment. Statistical analysis employed chi-square and Fisher’s exact tests to determine differences in distribution proportions of patients on ART versus those not on ART across various antenatal and neonatal complications, with significance attributed to p-values <0.05. Results: A total of 155 patients were found to be HIV positive. Out of this 58 were diagnosed before pregnancy and 97 during pregnancy. Miscarriage was seen in one (0.6%) patient on ART and two (1.2%) not on treatment (p-value 0.6). Sixteen (10.3%) patients underwent medical termination of pregnancy (MTP); all were given HIV-positive status and they were all on ART (p-value <0.001). Anemia was seen in eighteen (11.6%) patients out of which 14(9%) were on ART (p-value 0.01). One (0.64%) woman had thrombocytopenia and she was on ART (p-value 1). Two (1.2%) patients on ART had diabetes mellitus (p-value 0.4). One (0.64%) patient who was on ART developed polyhydramnios (p-value 1). A total of 8 (5.16%) women had hypertensive disorders; out of which 4(2.58%) were on ART (p-value 1). 11(7.09%) patients who were on ART and 6(3.8%) not on ART had preterm labor (p-value 0.2). 12(7.74%) patients who were not on ART had intrauterine growth restriction (IUGR) and 2(1.29%) on ART had IUGR. A total of 6(3.87%) patients had Intrauterine fetal demise (IUFD), of which 3(1.93%) were on ART and 3(1.93%) were not (p-value 1). Pre-labour rupture of membranes (PROM) was observed in 2(1.29%) women on ART and 11(7.09%) patients not on ART (p-value 0.004). All women (100%) had CD4 counts more than 500. All (100%) babies delivered at our center received antiretroviral therapy either with oral Nevirepine. Almost half the women (51.6%) had vaginal delivery. Almost one-fourth, 41(26.4%) had a cesarean section. All caesareans were done given obstetric indications. There were no instrumental deliveries. Our study had a total of 122 live births. All 122(100%) babies were exclusively breastfed. None of the babies delivered in our center developed HIV on follow up which was done at 6 weeks and 6 months. Nine (5.8%) patients had infections. None of these women were on ART(p-value < 0.001). Conclusion: HIV infection during pregnancy is associated with various adverse outcomes, but ART plays a crucial role in mitigating these risks and preventing mother-to-child HIV transmission. Initiating ART in all HIV-positive mothers and their infants is essential regardless of HIV status. Keywords: anemia, ART, HIV, MTP, Perinatal outcome, PROM.
Body Composition Parameters, Adiponectin, Leptin and Adiponectin/Leptin Ratio are Correlated with LH/FSH Ratio in Women with PCOS but not in Women without PCOS Gita Pratama; Wiweko, Budi; Asmarinah; Widyahening, Indah Suci; Andraini, Trinovita; Hartanto Bayuaji; Andon Hestiantoro
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 1 January 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i1.2031

Abstract

Objective: To investigate the correlation between body composition parameters, adiponectin, leptin and the adiponectin/leptin ratio and the LH/FSH ratio in women with polycystic ovary syndrome (PCOS). Methods: A cross-sectional study was conducted at Reproductive Cluster Yasmin, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia, with sixty women with PCOS and sixty healthy women as controls (matched for age and BMI). Body composition parameters, including body weight, body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), percent body fat (PBF), visceral fat area (VFA), percent subcutaneous fat (PSF) and skeletal muscle mass (SMM), were measured; levels of fasting glucose, fasting insulin, testosterone, and sex hormone binding globulin (SHBG) were measured; and homeostatic model assessment for insulin resistance (HOMA-IR) values, anti-Mullerian hormone (AMH), free androgen index (FAI), Ferriman-Gallwey (FG) score, adiponectin levels, leptin levels, adiponectin/leptin ratio, LH, FSH and LH/FSH ratio were measured. Results: Body composition parameters (body weight, BMI, WC, WHR, PBF, VFA, PSF, SMM) were not significantly different between women with PCOS and controls. Fasting insulin (P<0.05), HOMA-IR (P<0.05), AMH (P<0.01), FAI (P<0.01), FG score (P<0.01) and LH/FSH ratio (P<0.05) were higher in PCOS women. Adiponectin (P<0.01) was lower in PCOS women, while leptin and the adiponectin/leptin ratio were not significantly different between groups. Most of body composition parameters, adiponectin, leptin and adiponectin/leptin ratio were correlated with HOMA-IR in both groups. SMM was positively correlated with the LH/FSH ratio, while body weight, BMI, WC, PBF, VFA, and PSF were inversely correlated with the LH/FSH ratio in PCOS patients but not in controls. WHR was not correlated in either group. Leptin (r=-0.278; P<0.05) was negatively correlated with the LH/FSH ratio only in the PCOS group. Adiponectin (r=0.394; P<0.01) and the adiponectin/leptin ratio (r=0.413; P<0.01) were also positively correlated with the LH/FSH ratio only in the PCOS group. AMH was correlated with the LH/FSH ratio, whereas testosterone level, FAI, FG score, fasting insulin level and HOMA-IR value were not correlated with the LH/FSH ratio in PCOS women. Conclusion: Most of the body composition parameters, leptin, adiponectin and the adiponectin/leptin ratio were significantly correlated with HOMA-IR in both groups. However, correlations of those parameters with LH/FSH ratio were found only in PCOS but not in women without PCOS. Adiponectin and leptin may play a significant role in the mechanism of neuroendocrine disorders in PCOS, which is characterized by an increased LH/FSH ratio. Keywords: adiponectin, adiponectin/leptin ratio, body composition, HOMA-IR, leptin, LH/FSH ratio, PCOS
Carbetosine, a Long-acting Oxytocin Agonist, as a Uterotonic in the Prevention of the Occurrence of Postpartum Bleeding Izaak, Revynca Petronella
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 1 January 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i1.2037

Abstract

Objective: To evaluate the comparative effect of carbetocin vs. other uterotonic agents in the prevention of the occurrence of postpartum bleeding. Methods: Medical search engines like Pubmed, Google Scholar, and Cochrane are used for literature searches. The year period covered by the literature is 2013–2023. “Carbetocin” or “long-acting oxytocin” and “uterotonic” are the essential words, together with “post-partum hemorrhage” or “post-partum bleeding.” Data analysis was performed using the RevMan 5.4 application. Results: This study involved 12 clinical trials with a total sample of 32,312 people. Based on forest plot analysis, it was found that patients receiving carbetocin therapy had a risk of developing postpartum bleeding of 0.42 times compared to those receiving other uterotonic agents (misoprostol and oxytocin) (OR: 0.42; 95% CI: 0.26-0.68; p<0.0004; with heterogeneity p<0.00001, I2 85%) Conclusion: With its effectiveness and efficacy, carbetocin can be considered one modality that can prevent postpartum hemorrhage. In addition, it can benefit women at risk of having a major obstetric hemorrhage. Keywords: carbetocin, uterotonic, meta-analysis, clinical trial
CA-125 Examination as a Predictor the Resectability of Advanced Stage of Ovarian Cancer Muhammad, Syamel; Rudy Setiawan, Muhammad; Savannah, Aisha
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 2 April 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i2.2081

Abstract

Objective: To describe the prompt and successful treatment of an extrauterine pregnancy case in a tertiary-level hospital in Indonesia. Methods: We report a case of prompt and successful management of unruptured tubal pregnancy in the dr. Soetomo General Hospital Surabaya. Results: A 32-years-old woman presented with lower abdominal pain and vaginal bleeding one days before admission. She was sexually active, used no contraceptives, and had a history of one miscarriage. On examination, she was hemodynamically stable. A bimanual exam revealed cervical motion tenderness and pain. A high human chorionic gonadotropin (hCG) level (1,725 IU/L) and a left-sided mass, highly suspected as an extrauterine gestational sac confirming a 6 week, 1 days age of pregnancy without sign of free fluid in the abdomen nor fetal heart rate on ultrasound, prompted diagnostic laparoscopy. We found a tubal pregnancy located on the ampullae of the left fallopian tube with minimal hemoperitoneum (50 ml). A chromopertubation test was done to ensure a patent right fallopian tube, so we did a salpingectomy. The patient recovered well and was discharged home on day 2 post-procedure. Conclusion: Early diagnosis is vital and feasible to prevent morbidity and mortality in women with ectopic pregnancy. All sexually active women complaining painful abdomen or vaginal bleeding must be examined for an ectopic pregnancy to enable early diagnosis and prompt treatment. A laparoscopic surgery done by a trained individual provided a safe and minimally invasive intervention to this case. Keywords: case report, ectopic pregnancy, laparoscopy, salpingectomy, tubal pregnancy
Polymorphism specific Allele Frequencies on Cervical Cancer Salih Saihood, Anwar; Jabbar Hussein , Khawlah; Sharif , Yasamin Hamza
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 3 Jully 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i3.2093

Abstract

Objective: To evaluate the correlation of allele frequencies of IL-6 polymorphisms between healthy women and cervical cancer patients.Methods: The study involved gynecologists diagnosing abnormal cervical tissue in 100 women aged 17-60. Each woman provided two tissue samples: one for pap smear analysis and one for genetic research, along with a blood sample for IL-6 polymorphism analysis. Traditional polymerase chain reaction (PCR) was used for genetic analysis to confirm diagnoses. Allele-specific PCR (AS-PCR) was utilized to identify allelic polymorphisms. Pap smears identified cervical intraepithelial neoplasia (CIN) II and III, characterized by dysplastic cells and mitotic figures.Results: The diagnostic PCR data demonstrated that 36% of participants were HPV-infected, with the greatest infection rates (50%). The AS-PCR reported that the IL-6 (rs1800795) gene detected at 174 G/C position was presented with GG, GC, and CC genotypes. Conclusion: The result showed a significant alteration in the IL-6 (rs1800795) gene, strongly correlating with cervical cancer based on human papillomavirus infection.Keywords: cervix cancer, human papillomavirus, interleukin-6 polymorphism, genetic analysis.

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