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INDONESIA
ISM (Intisari Sains Medis) : Jurnal Kedokteran
Published by Universitas Udayana
ISSN : 25033638     EISSN : -     DOI : -
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology
Intisari Sains Medis is published by Medical Scientific Community, Indonesia. Intisari Sains Medis is an international, multidisciplinary, peer-reviewed, open access journal accepts papers for publication in all aspects of Science Digest, Medical Research Development, Research Medical Field and Theory. We also publish cases from third world country, that is considered very rare and special cases.
Arjuna Subject : -
Articles 68 Documents
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Search results for , issue "Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)" : 68 Documents clear
Perpanjangan hasil Polymerase Chain Reaction (PCR) pada pasien Acquired Immunodeficiency Syndrome (AIDS): laporan kasus Yoelius Wijaya Saputra; I Komang Parwata; Ni Komang Krisnawati
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (326.824 KB) | DOI: 10.15562/ism.v13i1.1316

Abstract

Background: Since its emergence in Wuhan in 2019, SARS-Cov-2 has become the virus that causes the ongoing pandemic situation. The number of infected humans continues to grow over time. Moreover, there is also the HIV virus which continues to be a global health problem. To date, the available data on the coinfection of SARS-Cov-2 with AIDS are limited. Case Presentation: This patient was found to have prolonged positive results on the Polymerase Chain Reaction (PCR) examination for 113 days. Female patient, aged 48 years, with complaints of shortness of breath since 3 days before admission to the hospital. Physical examination of the patient was compos mentis with a pulse rate of 113 beats per minute and a body temperature of 37.40C. On auscultation, crackles were found in both lung fields. The patient had anemia, leucocytosis, neutrophilia, lymphopenia, and elevated D-dimer. Conclusion: The destruction of CD4 and CD8 in AIDS patients can provide a protective effect against the inflammatory process and cytokine storm, but this milder symptom causes inadequate production of neutralizing antibodies. This low number of Neutralizing Antibodies causes prolonged PCR results in SARS-Cov-2 patients.   Latar Belakang: Sejak kemunculannya di Wuhan tahun 2019, SARS-Cov-2 telah menjadi virus yang menyebabkan situasi pandemik yang sedang berlangsung. Data manusia yang terinfeksi terus bertambah dengan sejalannya waktu. Disamping itu terdapat juga virus HIV yang terus menjadi masalah kesehatan global. Sampai saat ini, data yang tersedia tentang ko-infeksi penyakit SARS-Cov-2 dengan AIDS masih terbatas. Presentasi Kasus: Pada pasien ini ditemukan perpanjangan hasil positif pada pemeriksaan Polymerase Chain Reaction (PCR) selama 113 hari. Pasien perempuan, usia 48 tahun dengan keluhan sesak nafas sejak 3 hari sebelum masuk rumah sakit. Pemeriksaan fisik pasien compos mentis dengan laju nadi 113 kali permenit dan suhu tubuh 37,40 C. Pada auskultasi ditemukan ronchi di kedua lapang paru. Pasien mengalami anemia, leukositosis, neutrofilia, limfopenia, dan peningkatan D-dimer. Simpulan: Destruksi CD4 dan CD8 pada pasien AIDS dapat memberikan efek protektif terhadap proses inflamasi dan badai sitokin, akan tetapi gejala yang lebih ringan ini menyebabkan produksi Neutralizing Antibody yang terbentuk tidak adekuat. Jumlah Neutralizing Antibody yang kurang ini menyebabkan pemanjangan hasil PCR pada pasien SARS-Cov-2.
Case report: a rare case of ocular leptospirosis I Made Surya Dinajaya; Ida Ayu Ary Pramita; I Gusti Ayu Made Juliari; Ni Ketut Niti Susila; I Made Agus Kusumadjaja
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i1.1320

Abstract

Background: Ocular leptospirosis is a rare condition. Transmission of leptospirosis is caused by the bacterium leptospira interrogans transmitted directly or indirectly from animals to humans (zoonosis). Ocular manifestations often caused by leptospirosis are conjunctivitis, keratitis, uveitis (anterior, intermediate, posterior, and panuveitis), complicated cataracts, choroiditis, papillitis, and macular edema. Uveitis is a latent manifestation of leptospirosis. Proper management can lead to a good prognosis of visual.Case Presentation: Male patient, 55 years old, with complaints of both red and blurry eyes since 5 days. Blurring comes slowly with pain, glare, and seeing shadows like spider webs. The patient's previous medical history was hospitalized because of Weil's disease. Examination of the anterior segment of both eyes revealed eyelid spasm, conjunctival injection, corneal infiltrate, keratic precipitate, and posterior synechiae on both eyes. While in the posterior segment found cells 4+ in the vitreous. The patient was treated with antibiotics and topical steroids, and visual acuity was improved.Conclusion: Leptospirosis uveitis can have various presentations during the acute and chronic phases of the disease. Even when ocular involvement is extensive and severe, most patients have a good visual prognosis with appropriate therapy. Timely diagnosis is essential to maximize the potential for visual acuity improvement and appropriate systemic monitoring and treatment of extraocular involvement in this potentially fatal condition. Good sanitation in the community plays an important role in preventing exposure to leptospirosis.
Karakteristik dan perjalanan penyakit pasien infark miokard akut dengan elevasi segmen ST (IMA-EST) tanpa tatalaksana reperfusi pada rumah sakit perifer Arina Papita Simanungkalit; Alice Inda Supit
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (307.045 KB) | DOI: 10.15562/ism.v13i1.1322

Abstract

Introduction: Acute myocardial infarction is coronary heart disease that causes an increase in length of stay in hospital and a high mortality rate. Reperfusion strategy is the main modality in treating ST-elevation myocardial infarction (STEMI), but a limitation in facilities and human resources in peripheral hospitals has made it impossible to do. This study aims to observe the characteristics and course of disease in patients diagnosed by STEMI without reperfusion strategy in peripheral hospitals.Method: This study is a descriptive observational study with a cross sectional research design--retrieving research data using the total sampling method, using secondary data from medical records at Ade M Djoen Sintang Public Hospital in March - December 2021.Results: 56 samples fulfilled inclusion and exclusion criteria, with the majority of the sample being male, the average age was 53 years. Most of the patients had the same complaint during their stay in the hospital, most of the patients were able to discharge from the hospital, and 57,14% of the patients were admitted back to the hospital with the same chief complaints after less than six months of follow-up.Conclusion: Management of patients with STEMI without a reperfusion strategy leads to remain of chief complaints and increase of readmission within 6 months follow-up after discharge. Latar Belakang: Infark miokard akut adalah suatu penyakit jantung koroner yang mengakibatkan peningkatan angka perawatan di rumah sakit dan angka kematian yang tinggi. Strategi reperfusi merupakan modalitas utama dalam penanganan infark miokard akut dengan elevasi segmen ST (IMA-EST), namun pada rumah sakit di perifer, keterbatasan sarana dan prasarana serta sumber daya manusia menyebabkan hal tersebut tidak memungkinkan. Tujuan penelitian ini adalah untuk mengetahui karakteristik dan perjalanan penyakit pasien yang terdiagnosis IMA-EST tanpa tatalaksana reperfusi di rumah sakit di perifer.Metode:  Penelitian ini merupakan penelitian observasional dengan desain penelitian potong lintang. Data penelitian diambil menggunakan metode total sampling, melalui data sekunder dari rekam medis selama periode Maret - Desember 2021 di Rumah Sakit Umum Daerah (RSUD) Ade M Djoen Sintang.Hasil: Terdapat 56 sampel yang memenuhi kriteria inklusi dan eksklusi, mayoritas sampel adalah laki-laki, rata-rata usia 53 tahun. Sebagian besar pasien mengakami keluhan yang menetap selama perawatan, sebagian besar boleh pulang dari rumah sakit. Dalam periode kurang dari 6 bulan, sebanyak 57,14% pasien masuk kembali ke rumah sakit dengan keluhan yang sama.Simpulan: Tatalaksana pasien dengan IMA-EST tanpa strategi reperfusi menyebabkan keluhan yang menetap selama perawatan dan peningkatan pasien masuk kembali ke rumah sakit dengan keluhan yang sama setelah 6 bulan dipulangkan dari rumah sakit.
Skor assessment of different neoplasias in the adnexa (ADNEX) untuk memprediksi keganasan ovarium di RSUP Sanglah Denpasar I Nyoman Gede Budiana; Ketut Suwiyoga; Tjokorda Gde Agung Suwardewa; Anom Suardika; Made Bagus Dwi Aryana; Heni Sunyoto
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i1.1328

Abstract

Introduction: Ovarian cancer is cancer of the female reproductive organs with the highest mortality and is in the third position of female cancer after mammary and cervical cancer. The mortality rate and survival rate of ovarian cancer is mainly determined by the stage at which ovarian cancer is diagnosed. Until now there is no method for early detection of ovarian cancer with good sensitivity and specificity. Assessment of different neoplasias in the adnexa (ADNEX) is a model proposed by international ovarian tumor analysis (IOTA) to help distinguish benign or malignant adnexa tumors.Methods: This study is a observational clinical test to find out the accuracy of ADNEX model to predict ovarian malignancy conducted at the Obstetric and Gynecology Outpatient Ward in Sanglah hospital, Denpasar from November 2019 to April 2020. Consecutive sampling was done and 88 sample was recruited with a diagnosis of ovarian tumors. Then the research sample was sent to the Pathology Anatomy laboratory of Sanglah Hospital for histopathological examination. This result would then be compared to the prediction results of the ADNEX model.Results: 35 samples of benign ovarian tumors and 53 samples of ovarian cancer were found with the ADNEX method. There were 46 samples with malignant tumor both by the ADNEX model and histopathology results, 7 samples of malignant tumor at histopathology result but benign by the ADNEX model, 6 samples of benign tumor according to histopathology but malignant using the ADNEX model, and 29 samples of benign tumor according to histopathology and the ADNEX model. Using cut off of 49,6%, the study reported a sensitivity level of 86.8%, specificity 82.6%, positive predictive value 88.5%, negative predictive value 80.6%, and 85.2% accuracy.Conclusion: The ADNEX model has a high level of specificity, sensitivity and diagnostic accuracy in diagnosing ovarian cancer and can be used in combination with other clinical markers for early detection of malignancy in ovarian tumors.  Pendahuluan: Kanker ovarium merupakan salah satu jenis kanker organ reproduksi wanita dengan mortalitas tertinggi dan berada pada posisi ke-tiga kanker perempuan setelah kanker mammae dan serviks. Angka mortalitas dan survival rate kanker ovarium sangat ditentukan oleh stadium saat kanker ovarium terdiagnosis. Hingga saat ini belum tersedia metode pemeriksaan untuk deteksi dini kanker ovarium dengan sensitivitas dan spesifisitas yang memadai. Assessment of different neoplasias in the adnexa (ADNEX) adalah model yang diajukan oleh International Ovarian Tumor Analysis (IOTA) untuk membantu membedakan tumor adnexa sebagai tumor jinak atau ganas. Metode: Penelitian ini merupakan penelitian observasional uji klinik untuk mengetahui akurasi model ADNEX untuk memprediksi keganasan ovarium yang dilakukan di Poliklinik Kebidanan dan Penyakit Kandungan RSUP Sanglah, Denpasar pada bulan November 2019 hingga April 2020. Sampling dilakukan secara consecutive dan didapatkan 88 orang dengan diagnosis tumor ovarium. Sampel penelitian dikirimkan ke laboratorium Patologi Anatomi RSUP Sanglah dan dilakukan pemeriksaan histopatologi untuk kemudian dibandingkan dengan hasil prediksi dari model ADNEX.Hasil: Dalam penelitian ini didapatkan 35 sampel dengan tumor jinak ovarium dan 53 sampel dengan kanker ovarium dengan menggunakan metode ADNEX. Terdapat 46 sampel dengan hasil pemeriksaan model ADNEX ganas dan hasil pemeriksaan histopatologi ganas, 7 sampel histologi ganas namun model ADNEX jinak, 6 sampel histopatologi jinak namun model ADNEX ganas, dan 29 sampel histopatologi jinak dan model ADNEX jinak. Hasil penelitian memperlihatkan tingkat sensitifitas 86,8%, spesifisitas 82,6%, nilai prediksi positif 88,5%, nilai prediksi negatif 80,6%, dan akurasi 85,2%.Simpulan: Model ADNEX memiliki tingkat spesifisitas, sensitivitas dan akurasi diagnostik yang tinggi dalam mendiagnosis kanker ovarium dan dapat digunakan bersama dengan penanda klinis lain untuk deteksi dini keganasan pada tumor ovarium.
Kadar heat shock protein 70 (HSP 70) yang tinggi pada serum ibu sebagai faktor risiko persalinan preterm Tjokorda G. A. Suwardewa; Ketut Surya Negara; Anak Agung Ngurah Anantasika; I Wayan Artana Putra; I Gde Sastra Winata; Piere Emanuel Yoltuwu
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i1.1329

Abstract

Introduction: Preterm birth defined as parturition that occurs less than 37 completed weeks of gestation is still being a big problem in obstetrics, especially in perinatology. Preterm delivery is one of the most common causes of neonatal morbidity and mortality. This study examined serum HSP 70 levels as a risk factor for preterm delivery.Method: The research design was analytic with a case-control method at Sanglah Hospital from February to June 2021. The samples were divided into two groups which are in the case group was 30 samples and the control group was 30 samples. In both groups, HSP 70 levels were collected by taking 5cc of blood sample from cubital vein. Furthermore, the examination was carried out using the enzyme-link immunosorbent assay (ELISA) method at Biomedik Terpadu Laboratory service.Result: Based on the data on the characteristics of the subjects, respectively maternal age, gestational age, BMI, and parity there was no significant differences between two group. Serum HSP levels were significantly different between the two groups with OR 4.030 (95%CI: 1,372-11,84; p-value 0.01). The cut-off value for serum HSP 70 levels was 12.85 ng/ml, with a sensitivity of 70%, specificity of 63.3%, and an area under the curve (AUC) value of 0.807 (95% CI 0.697 – 0.916, p-value <0.001).Conclusion: This study revealed that high levels of HSP 70 in serum is a risk factor of preterm labor. High blood serum levels of HSP 70 could be a reference in determining high risk of preterm labor in pregnant women.  Pendahuluan: Persalinan preterm didefinisikan kelahiran sebelum usia gestasi kurang dari 37 minggu masih menjadi masalah besar dalam bidang obstetri khususnya dibidang perinatologi. Persalinan preterm merupakan salah satu penyebab utama tingginya angka morbiditas dan mortalitas neonatus. Penelitian ini meneliti mengenai kadar HSP 70 pada serum ibu sebagai faktor risiko persalinan preterm.Metode: Rancangan penelitian yang digunakan adalah analitik dengan metode kasus-kontrol, dilakukan di RSUP Sanglah pada periode Februari 2021 sampai Juni 2021. Sampel dibagi menjadi 2 kelompok yakni kelompok kasus sebanyak 30 sampel dan kontrol 30 sampel. Pada kedua kelompok, pemeriksaan kadar HSP 70 dilakukan melalui pengambilan sampel darah 5 ml pada vena cubiti. Selanjutnya dilakukan pemeriksaan dengan metode enzyme-link immunosorbent assay (ELISA) di Unit Laboratorium Biomedik Terpadu.Hasil: Data karakteristik subyek yaitu usia ibu, usia kehamilan, IMT dan jumlah paritas, tidak ditemukan adanya perbedaan bermakna. Kadar serum HSP yang tinggi berbeda bermakna antara kedua kelompok dengan nilai OR 4.030 (IK 95%: 1,372-11,84; nilai p 0.01). Nilai cut off kadar serum HSP 70 sebesar 12.85 ng/ml, dengan sensitifitas sebesar 70%, spesifisitas 63,3%, dan nilai area under the curve (AUC) sebesar 0,807 (IK 95% 0,697 – 0,916, nilai p <0,001).Simpulan: Penelitian ini menunjukkan bahwa kadar HSP 70 yang tinggi pada serum ibu sebagai faktor risiko kejadian terjadinya persalinan preterm. Nilai kadar HSP 70 yang tinggi dapat menjadi suatu acuan dalam menentukan risiko tinggi kejadian persalinan preterm pada ibu hamil.
Kadar IL-10 plasma berkorelasi positif dengan kadar IgM anti PGL-1 pada narakontak serumah pasien kusta tipe multibasiler Ida Ayu Uttari Priyadarshini; Nyoman Suryawati; Luh Made Mas Rusyati
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (448.663 KB) | DOI: 10.15562/ism.v13i1.1334

Abstract

Introduction: A healthy person who contacts people diagnosed with leprosy can be at a high risk of being infected with leprosy with a predominance of the subclinical stage. The MB type infection has a 4-10 times greater risk of developing into a clinical form. Early detection of subclinical leprosy is important so that it can play a role in the process of eliminating leprosy. If it is not screened, most of the subclinical stage leprosy can develop into the clinical stage and can cause physical deformities. Phenolic glycolipid-1 (PGL-1) is a specific antigen for M.leprae and Interleukin-10 (IL-10) is an anti-inflammatory cytokine that shows the body's immune response. Research on the relationship between levels of IL-10 and IgM anti-PGL-1, especially in Bali, has not been carried out, so this study aims to find a relationship between levels of IL-10 and levels of IgM anti-PGL-1 in household contacts of multibacillary leprosy patients. Methods: This research is an analytical observational study with a cross-sectional and was carried out in February-May 2021 at the Dermatology and Venereology Polyclinic and Clinical Pathology Laboratory, Sanglah Hospital Denpasar, and the Leprosy reference laboratory, Tropical Diseases Center, Universitas Airlangga. Samples aged 18-65 years were selected through Consecutive Sampling according to inclusion and exclusion criteria. The sample was taken from venous blood and then checked for levels of PGL-1 and IL-10. Data analysis using SPSS version 23. The results were considered significant if p<0.05. Results: The mean level of IgM anti-PGL-1 in the contact group vs. the non-contact group was 863.07 ± 789.04 u/ml vs 247.75 ± 161.60 u/ml. The mean levels of IL-10 in the contact and non-contact groups were 121.09 ± 144.11 pg/ml and 46.04 ± 11.27 pg/ml. There was a significant difference in levels of IL-10 and IgM anti-PGL-1 in the contact group and non-contact groups (p<0.05) and a weak positive relationship (r=0.296, p=0.02) between levels of IL-10 and anti-PGL-IgM. 1. Conclusion: The levels of IgM anti-PGL-1 and IL-10 in the contacts were higher than in the non-contacts with a significant difference.   Pendahuluan: Narakontak merupakan salah satu kelompok dengan risiko tinggi terinfeksi kusta dengan dominansi stadium subklinis. Pada infeksi tipe MB memiliki resiko 4-10 kali lebih besar berkembang menjadi bentuk klinis. Deteksi dini pada penyakit kusta subklinis ini menjadi penting sehingga dapat berperan dalam proses eliminasi kusta. Jika dibiarkan sebagian besar kusta stadium subklinis dapat berkembang menjadi kusta klinis dan dapat menimbulkan deformitas pada fisik. Phenolic glycolipid-1 (PGL-1) merupakan antigen spesifik untuk M. leprae dan Interleukin-10 (IL-10) merupakan sitokin anti-inflamasi yang menunjukkan respon imun tubuh. Penelitian mengenai hubungan antara kadar IL-10 dan IgM anti PGL-1 khusunya di Bali belum dilakukan, sehingga penelitian ini bertujuan mencari hubungan antara kadar IL-10 dengan kadar IgM anti PGL-1 pada narakontak serumah pasien kusta tipe multibasiler. Metode: Penelitian merupakan studi observasional analitik dengan pendekatan potong lintang dan dilaksanakan bulan Februari-Mei 2021 di Poliklinik Kulit dan Kelamin dan Laboratorium Patologi Klinik, RSUP Sanglah Denpasar dan laboratorium rujukan Leprosy, Tropical Diseases Centre, Universitas Airlangga. Sampel berusia 18-65 tahun dipilih melalui Consecutive Sampling sesuai kriteria inklusi dan eksklusi. Sampel dilakukan pengambilan darah vena kemudian diperiksa kadar PGL-1 dan IL-10. Analisis data menggunakan SPSS versi 23. Hasil dianggap signifikan jika p<0,05. Hasil: Rerata kadar IgM anti PGL-1 kelompok narakontak vs bukan narakontak sebesar 863,07 ± 789,04 u/ml vs 247,75 ± 161,60 u/ml. Rerata kadar IL-10 kelompok narakontak dan bukan narakontak sebesar 121,09 ± 144,11 pg/ml dan 46,04 ± 11,27 pg/ml. Terdapat perbedaan signifikan pada kadar IL-10 dan IgM anti PGL-1 pada kelompok narakontak dan bukan narakontak (p<0.05) serta hubungan positif lemah (r=0,296, p=0,02) antara kadar IL-10 dengan IgM anti PGL-1. Simpulan: Kadar IgM anti PGL-1 dan IL-10 pada narakontak lebih tinggi dari non narakontak dengan perbedaan yang signifikan.
Profil penggunaan kontrasepsi di klinik Nurjaya, Kabupaten Badung, Bali Ida Bagus Arjuna; I Made Darmayasa
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (291.066 KB) | DOI: 10.15562/ism.v13i1.1347

Abstract

Background: Contraceptive services are a series of activities, including the provision of education, counseling, medical eligibility screening, provision of contraception, installation or revocation, and handling side effects or complications in an effort to prevent pregnancy. According to BKKBN, active birth control participants among Couples of Childbearing Age (CCA) in 2020 amounted to 67.6%. Bali is ranked 7th, with a participation rate of 66.9%. The pattern of choosing the type of contraceptive in 2020 showed that most acceptors chose to use injectable methods, followed by pills. There aren't many similar studies targeting private clinics. It is very interesting to conduct a study on the pattern of contraceptive use in Nurjaya Clinic, one of the private clinics in Bali that also organizes contraceptive programs. Methods: This study is a descriptive epidemiology survey. The sample in this study is secondary data in the form of a register of contraceptive acceptors in Nurjaya Clinic from November 2020 to October 2021. The instruments used in this study are patients' register data and data analysis techniques using univariate analysis that is calculated in percentages and presented in a table and narrated. Results: The use of injectable contraceptives is still the main choice of CCA in Nurjaya Clinic, with users at 78.5% of all contraceptive acceptors, followed by other methods, namely IUD at 13.9%, birth control pills at 6%, and implants at 1.6%. Injectable contraceptives were also the top choice in every age group, 92.6% in the 21year old age group, 74.2% in the 21 to 35-year-old age group, and 82.8% in the 35-year-old age group. Conclusion: The most widely used contraception use in Nurjaya Clinic is injectable contraceptives for all of the age groups of <21 years, 21-35 years, or >35 years.   Latar Belakang: Pelayanan kontrasepsi adalah serangkaian kegiatan meliputi pemberian KIE, konseling, penapisan kelayakan medis, pemberian kontrasepsi, pemasangan atau pencabutan, dan penanganan efek samping atau komplikasi dalam upaya mencegah kehamilan. Menurut BKKBN, peserta KB aktif di antara Pasangan Usia Subur (PUS) tahun 2020 sebesar 67,6%. Bali menempati peringkat 7 dengan tingkat keikutsertaan KB sebesar 66,9%. Pola pemilihan jenis alat kontrasepsi pada tahun 2020 menunjukkan bahwa sebagian besar akseptor memilih menggunakan metode suntik, diikuti oleh pil. Masih sedikitnya penelitian serupa yang menargetkan klinik swasta, sangat menarik untuk dilakukan suatu penelitian mengenai gambaran penggunaan kontrasepsi di Klinik Nurjaya sebagai salah satu klinik swasta di Bali yang turut menyelenggarakan program KB. Metode: Penelitian merupakan survei epidemiologi deskriptif. Sampel dalam penelitian ini merupakan data sekunder berupa register akseptor KB di Klinik Nurjaya bulan November 2020 hingga Oktober 2021. Instrumen yang digunakan dalam penelitian ini adalah data register pasien serta teknik analisis data menggunakan analisis univariat yang dihitung persentasenya serta disajikan dalam bentuk tabel dan dinarasikan Hasil: Penggunaan kontrasepsi suntik masih menjadi pilihan utama PUS di Klinik Nurjaya, dengan pengguna sebesar 78,5% dari seluruh akseptor kontrasepsi, diikuti metode lainnya yaitu IUD 13,9%, pil KB 6%, dan implan 1,6%. Kontrasepsi suntik juga menjadi pilihan utama pada seluruh kelompok usia yaitu 92,6% pada kelompok usia 21 tahun, 74,2% pada kelompok usia 21-35 tahun, dan 82,8% pada kelompok usia 35 tahun. Kesimpulan: Penggunaan kontrasepsi paling banyak digunakan di FKTP swasta Klinik Nurjaya adalah KB suntik, baik pada kelompok usia <21 tahun, 21-35 tahun, maupun >35 tahun.
Potensi terapi kombinasi Liver Growth Factor (LGF) dan Adrenomedullin (ADM) sebagai harapan baru penatalaksanaan Azoospermia Non-Obstruktif (ANO): tinjauan pustaka Ni Made Dian Hartaningsih; I Putu Yuda Prabawa; Benediktus Bosman Ariesta Gusti Putu; Dwijo Anargha Sindhughosa; Ida Bagus Amertha Putra Manuaba; I Gusti Ngurah Pramesemara
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i1.1363

Abstract

Non-Obstructive Azoospermia (NOA) is caused by the failure of spermatogenesis process. This case becomes the highest prevalence, 95% of the total azoospermia. Therapeutic modalities in use today such as invasive techniques, hormonal therapy, and gene therapy are less effective in the treatment of azoospermia. In addition, the overall therapeutic modalities also have serious side effects such as infection, testicular atrophy, nerve damage and other side effects. Referring to the problems above, non-obstructive azoospermia is an urgent health issue and requires effective and efficient management with minimal side effects, as the combination of Liver Growth Factor (LGF) and Adrenomedullin (ADM). LGF is able to regenerate spermatogenesis after spermatogonia testicular stem cell damage. LGF also works specifically by stimulating germinal cells without changes in somatic cells. The motility of reactivation could be improved by combining the ADM into therapy, which bind to specific receptors, and the result of increasing the cAMP / PKA and NO that are important in the regulation of cilia’s movement. Combination LGF and ADM are potential to create new therapeutic candidates in the management of non-obstructive azoospermia, which can be immediately implemented as effective and efficient therapy. Azoospermia Non-Obstruktif (ANO) adalah azoospermia yang disebabkan kegagalan proses spermatogenesis dan merupakan kasus dengan prevalensi tertinggi (95% dari total azoospermia). Modalitas terapi yang digunakan sampai saat ini seperti teknik invasif, terapi hormonal, dan terapi gen terbukti belum efektif dalam tatalaksana azoospermia. Selain itu, keseluruhan modalitas terapi ini juga memiliki efek samping serius yang perlu diwaspadai seperti infeksi, testis atropi, kerusakan saraf, serta efek samping lainnya. Merujuk pada permasalahan diatas, azoospermia non-obstruktif merupakan masalah kesehatan yang mendesak dan membutuhkan tatalaksana yang efektif dan efisien dengan efek samping yang minimal seperti dengan kombinasi terapi LGF dan ADM. LGF mampu meregenerasi testis dan mereaktivasi spermatogenesis setelah kerusakan sel punca spermatogonia. LGF juga bekerja secara spesifik dengan menstimulasi sel-sel germinal tanpa menyebabkan perubahan pada sel-sel somatis. Motilitas sperma hasil reaktivasi spermatogenesis kemudian ditingkatkan dengan mengkombinasikan ADM kedalam terapi dimana berikatan pada reseptor-reseptor spesifik sehingga berefek pada peningkatan cAMP/PKA dan NO yang penting dalam pengaturan kibasan flagella. Perpaduan antara terapi LGF dan ADM ini sangat berpotensi menciptakan kandidat terapi baru dalam penatalaksanaan NOA yang efektif dan efisien. 

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