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"Sampai Saat ini tatalaksana operatif merupakan pilihan dalam penatalaksanaan pada fistula para-anal. Penelitiian ini bertujuan mengetahui mengenai angka rekurensi, inkontinensia alvi, waktu penyembuhan, dan keluhan pasien setelah tatalaksana operatif. Metode penelitian adalah cross-sectional. Pada hasil rekurensi komplek fistula para-anal 4%, tidak ada yang mengalami inkontinensia alvi dengan waktu rata-rata penyembuhan 13,11 minggu. Rekurensi fistula paraanal sederhana 2,6% dan inkontinensi alvi 2,6%. Dengan waktu rata-rata penyembuhan 5,66 minggu. Tidak ditemukan rekurensi maupun inkontinensia alvi pada Abses anorektal yang ditatalaksana dengan waktu rata-rata penyembuhan 2.5 minggu. Rekurensi abses yang disertai oleh fistula para-anal 50 %, tidak ada yang mengalami inkontinensia alvi dengan waktu rata-rata penyembuhan 6.6 minggu. Keluhan pasien setelah operasi adalah lamannya waktu penyembuhan, rasa nyeri dan tidak nyaman terutama pada tatalaksanan dengan operasi teknik seton. Kesimpulan yang didapat adalah angka rekurensi dan inkontinensia yang sama apabila dibandingkan dengan kepustakaan.

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Until now the threatment of choise for Para-anal fistula still surgery. This study aims to identified the recurrence, incontinentia alvi, time to heal and patient complaining after surgery. The method of this study is cross-sectional. Patient with complex para-anal fistula had recurrence of 4%, no incontinentia alvi, time to heal 13,11 weeks. Patient with simple para-anal fistula had recurrence of 2,6%, incontinentia alvi 2,6%, time to heal 5,66 weeks. Patient with abses anorektal had no recurrence and incontinentia alvi, time to heal 2,5 weeks. The patient with abses with para-anal fistula had recurrence of 50 %, no incontinentia alvi, time to heal 6,6 weeks. The patient complaining mostly about long time to heal and paint after surgery. This study had same result that found in the literature."

"The work describes a new method of sphincter salvage in surgery of rectal cancer. Low tumors of the rectum are traditionally treated with amputation of the rectum. However, this operation is not well-received by patients, since it results in a permanent colostomy. By contrast, intersphincteric resection allows sphincter salvage even in low tumors and is now widely accepted among experts in the field of colorectal surgery. The book will describe the basics (pathology,physiology, radiology) as well as the surgical technique and its different modifications."

"ABSTRAKMeningkatnya keberadaan kaum gay disertai dengan perilaku seks anal yang tidak aman menjadi faktor resiko metode transmisi penularan HIV dan PMS. Salah satu upaya pencegahan penularan PMS dan HIV pada gay adalah penggunaan kondom dan lubrikan tambahan. Penelitian kuantitatif dengan desain crossectional ini bertujuan untuk mempelajari hubungan antara tingkat pengetahuan HIV, tipe pasangan, dan status HIV dengan sikap penggunaan kondom dan lubrikan tambahan pada gay di Kota Bogor. Data diperoleh dari kuesioner yang dikumpulkan dari 55 gay yang aktif seksual selama 6 bulan terakhir di Kota Bogor. Hasil: Terdapat hubungan signifikan antara tingkat pengetahuan dengan sikap penggunaan kondom dan lubrikan tambahan pada kaum gay. Hasil uji statistik diperoleh nilai p.0,000:?.0,05 . Tidak terdapat hubungan antara tipe pasangan dengan sikap p.0,735;?.0,05 . Tidak terdapat hubungan status HIV dengan sikap penggunaan kondom dan lubrikan tambahan pada kaum gay 0,276: ?.0,05 . Kesimpulan: Pengetahuan mempunyai hubungan dengan sikap. Saran: Perlu dikembangkan penelitian lanjutan tentang penggunaan kondom dan lubrikan tambahan.

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ABSTRACTThe increasing amount of MSM with unsafe attitude of anal sex risk factor for HIV transmission and Sexual Transmitted Disease STD . One of the efforts to prevent transmission of HIV and STD is the use of condom and additional lubricant. This quantitative cross sectional study aimed to examine the correlation of knowledge, type of partner, and HIV status with attitude in using condom and additional lubricant in MSM in Bogor. Data were obtained from questionnaires collected from 55 MSM who sexually active during the last 6 months in Bogor. The result indicates a significant correlation between the level of knowledge with attitude in using condom and additional lubricant in MSM in Bogor p.0,000 .0,05 . There is no correlation between type of partner and attitude of using condom and additional lubricant p.0,735 .0,05 . There is no correlation between HIV status and attitude of using condom and additional lubricant 0,276 .0,05 . The study concludes that there is correlation between knowledge and attitude of using condom and additional lubricant. This study suggest to conduct futher research about the use of condom and additional lubricant."

"Anal sex is the most risky sex intercourse for transmitting HIV infection. Due to fragile anal mucous-membrane (as compared to vaginal mucous-membrane), the receptive anal intercourse would give a higher probability for passing the virus to the blood circulation. To prevent this transmission, the condom use is a must. This study was conducted for the purposes of identifying factors related to condom use during anal sex among gays in Denpasar dan Ujung Pandang, in 2002. This cross-sectional study used a secondary data borrowed from BSS (Behavioral Sentinel Surveillance) done in Denpasar dan Ujung Pandang, in 2002, by Health Research Center, the University of Indonesia and HIV/AIDS Prevention and Control Project. The study population was gay community committing anal sex and residing in Denpasar dan Ujung Pandang during the past 1 year in the year of 2002. The total sample collected was 155 individuals; 82 from Denpasar (52.9%) and 73 from Ujung Pandang (47, 1%). The study result showed that the proportion of gay that did not always use condom during intercourse was 87.1%. Based on multivariate analysis, it was found that the gays lacking of HIV knowledge had a probability to avoid using condom 10.8 times higher than knowledgeable gays (95% CI: 1.4-83.2). Gays who like each other were 5.8 times at higher possibility to avoid condom as compared to gays doing sex for money (95% CI: 2.1-15.6). Other variables in the study, i.e. age, education, occupation, marital status, number of sex partners, relationship status, STD's history, source of HIV information, were not found to be associated with condom use. It is recommended to develop health promotion concerning STDs, HIV/AIDS and the importance of condom use for prevention among gays, through peer group education (supported by leaflet, booklet and interactive media). It is also important to develop cooperation with potential partners, like gay community, NGOs, massage parlors to do continue promotion and small group discussion about HIV/AIDS, how to use condom and lubricants correctly in the gathering places. For HIV researchers, a qualitative study would be useful to conduct in order to understand more deeply factors influencing the condom use."

"Latar Belakang: Berdasarkan hasil program MDGs, di dunia infeksi baru HIV lebih rendah 35% jika dibandingkan tahun 2000 sementara di Asia infeksi baru HIV menurun 8% dibandingkan tahun 2005 namun di Indonesia infeksi baru HIV justru meningkat 48% pada tahun 2013 jika dibandingkan tahun 2005. Kementerian Kesehatan mengestimasi hingga 2025, jumlah infeksi baru HIV banyak terjadi pada populasi LSL. Penyebaran HIV pada populasi LSL karena rendahnya persepsi berisiko, tingginya multipartner seks, penggunaan napza suntik dan rendahnya penggunaan kondom. Metode: Penelitian kuantitatif dan menggunakan data Survei Terpadu Biologis dan Perilaku tahun 2013. Dengan analisis regresi logistik berganda akan dilihat besar risiko persepsi berisiko tertular HIV dengan penggunaan kondom saat seks anal terakhir. Hasil: Odds ratio pada yang berpersepsi berisiko tertular HIV 2,18 kali untuk menggunakan kondom saat seks anal terakhir dibandingkan dengan yang berpersepsi tidak berisiko (95% CI 0,93 ? 5,11). Odds ratio pada yang berpersepsi berisiko tertular HIV 1,84 kali untuk menggunakan kondom saat seks anal terakhir dibandingkan dengan yang berpersepsi tidak berisiko (95% CI 0,72 - 4,74) pada kondisi pengetahuan yang sama, menjadikan televisi sebagai sumber informasi yang sama, kebiasaan membawa kondom yang sama, dan tergabung dalam komunitas yang jumlah anggotanya sama. Kesimpulan: Persepsi berisiko tertular HIV meningkatkan kemungkinan responden untuk menggunakan kondom saat seks anal terakhir.

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Background: Based on the MDGs program result, in the world new infections of HIV is reduce 35% than 2000, in Asia new infections of HIV declined 8% compared 2005 but new infection of HIV at Indonesia had been increased 48% in 2013 compared to 2005. The Ministry of Health estimates, by 2025 the number of new infections of HIV will increase at the population of MSM. The spread of HIV at the population of MSM because low of risk perception, high multipartner sex, injecting drugs and low of condom use.

Methods: Qualitative and using data Integrated Biological and Behavioural Survey 2013. With multiple logistic regression analysis will be known odds ratio risk perception of HIV infections to condom use at last anal sex.

Result: Odds ratio for the risk perception of HIV infections 2.18 times to use condoms during last anal sex compared with no risk perception (95% CI 0.93 to 5.11). Odds ratio for the risk perception of HIV infections 1.84 times to use condoms during last anal sex compared with no risk perception (95% CI 0.72 to 4.74) in the same state of knowledge, to television as the same resources , the same habit of bringing condoms, and members of the community the same number of members.

Conclusion: The risk perception of infected HIV increases the likelihood of respondents to use condom at last anal sex."

"Latar Belakang: Reseptor ACE2 tidak hanya terdapat pada paru-paru, tetapi juga pada saluran pencernaan yang memungkinkan terjadinya infeksi SARS-COV-2 pada enterosit, menimbulkan manifestasi klinis gastrointestinal, dan terdeteksinya RNA virus pada pemeriksaan swab anal. Studi lain di seluruh dunia menunjukkan hasil yang berbeda-beda serta belum didapatkan penelitian serupa di Indonesia. Tujuan: Penelitian ini bertujuan untuk mengetahui luaran klinis infeksi COVID- 19 pada pasien yang dilakukan swab anal, mendapatkan hubungan hasil pemeriksaan PCR SARS-CoV-2 swab anal dengan manifestasi klinis gastrointestinal dan derajat keparahan pada pasien COVID-19 di Indonesia. Metode: Merupakan cabang penelitian dari penelitian utama yang berjudul “Nilai RT-PCR Swab Anal untuk Diagnosis COVID-19 pada Orang Dewasa di Indonesia”. Penelitian ini merupakan studi analitik dengan desain potong lintang. Sampel penelitian merupakan pasien COVID-19 yang menjalani rawat inap di RSUPN dr. Cipto Mangunkusumo (RSCM), RS Mitra Keluarga Depok, RS Mitra Keluarga Kelapa Gading, dan RS Ciputra selama periode April 2020 sampai dengan Januari 2021. Dikumpulkan data demografi, manifestasi klinis, derajat keparahan, dan hasil swab anal PCR SARS-CoV-2.Hasil: 136 subjek penelitian dengan swab nasofaring positif dianalisis. 52 pasien (38,2%) dengan swab anal PCR SARS-CoV-2 positif dan 84 pasien (61,8%) dengan swab anal negatif. Manifestasi klinis saluran cerna tersering, yaitu: mual-muntah 69 pasien (50,7%), nafsu makan menurun sebanyak 62 pasien (45,6%), dan nyeri perut sebanyak 31 pasien (22,8). Terdapat 114 pasien (83,8%) tergolong dalam derajat ringan-sedang dan 22 pasien (16,2%) tergolong dalam berat-kritis. Terdapat hubungan yang bermakna secara proporsi statistik antara variabel hasil pemeriksaan PCR SARS-CoV-2 swab anal dengan manifestasi klinis gastrointestinal berupa keluhan diare atau mual-muntah (nilai p 0,031). Tidak terdapat hubungan yang bermakna secara proporsi statistik antara variabel hasil pemeriksaan PCR SARS-CoV-2 swab anal dengan derajat keparahan (nilai p 0,844).Simpulan: Terdapat hubungan antara hasil pemeriksaan PCR SARS-CoV-2 swab anal dengan manifestasi klinis gastrointestinal berupa keluhan diare atau mual- muntah dan tidak terdapat hubungan antara variabel hasil pemeriksaan PCR SARS- CoV-2 swab anal dengan derajat keparahan infeksi COVID-19.

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Background: ACE2 receptor is not only found in the lungs, but also in the digestive tract, which allows the occurrence of enterocyte infection, gastrointestinal clinical manifestations, and detection of viral RNA on anal swab PCR. Studies around the world show various results, yet there has been no similar study to be found in Indonesia.

Objective: This study aims to determine the clinical outcome of COVID-19 patients with gastrointestinal manifestations who were tested by anal swab, the relationship between anal swab PCR for SARS-CoV-2 test result with gastrointestinal clinical manifestations as well as the severity of COVID-19 patients in Indonesia.

Methods: This research is a branch of study titled. The Value of Anal Swab RT- PCR for COVID-19 Diagnosis in Adult Indonesian Patients. This is an analytical study with cross-sectional design. Samples were obtained from hospitalized COVID-19 patients at RSUPN dr. Cipto Mangunkusumo (RSCM), Mitra Keluarga Hospital Depok, Mitra Keluarga Kelapa Gading Hospital, and Ciputra Hospital from April 2020 to January 2021. Demographic data, clinical manifestations, severity, and SARS-CoV-2 PCR anal swab were collected.

Results: 136 subjects with positive nasopharyngeal swab were analyzed. Result showed that 52 patients (38.2%) had positive anal swabs PCR SARS-CoV-2 and 84 patients (61.8%) had negative anal swabs. Common gastrointestinal clinical manifestations were: nausea and vomiting in 69 patients (50.7%), anorexia in 62 patients (45.6%), and abdominal pain in 31 patients (22.8). There were 114 patients (83,8%) classified as mild-moderate and 22 patients (16,2%) as severe-critical. There was a statistically significant relationship between anal swab PCR for SARS- CoV-2 test result with gastrointestinal clinical manifestations (diarrhea or nausea- vomiting) (p value 0.031). There was no statistically significant relationship found between anal swab PCR for SARS-CoV-2 test result with the severity of COVID- 19 infection (p value 0.844).

Conclusions: There is a relationship between anal swab PCR SARS-CoV-2 test result with gastrointestinal clinical manifestations (diarrhea or nausea-vomiting) and there is no relationship between anal swab PCR SARS-CoV-2 test result with severity of COVID-19 infection."

"[ABSTRAKLatar belakang dan tujuan : Hubungan seksual anal reseptive usia muda pada LSL meningkatkan penularan infeksi Human Immunodeficiency Virus (HIV), infeksi Human Papilloma Virus (HPV), dan infeksi menular seksual lainnya sehingga dapat menimbulkan abnormalitas sitologi anus. Kekerapan hubungan seksual anus pada LSL menyebabkan trauma berulang pada anus juga menimbulkan abnormalitas sitologi anus. Hal ini menyebabkan LSL rentan menderita kanker anus. Penelitian ini dilakukan untuk mengetahui kemungkinan terdapatnya hubungan antara coitarche, kekerapan hubungan seksual anal receptive dan infeksi HIV terhadap abnormalitas gambaran sitologi anus dengan anal pap smear. Metode: Penelitian ini berdesain potong lintang pada 99 LSL di Puskesmas Pasar Rebo, Jakarta Timur. Dilakukan wawancara tentang coitarche, kekerapan hubungan seksual anal receptive, dan jumlah pasangan. Juga pemeriksaan fisis, pemeriksaan serologis HIV dan pengambilan spesimen anal swab untuk pemeriksaan sitologi anus. Hasil: Proporsi gambaran abnormal sitologi adalah 15,2% dan seluruhnya ASCUS, tidak ditemukan LSIL dan HSIL. Gambaran abnormal sitologi anus berdasarkan kelompok usia coitarche dan kelompok pasangan seksual anal receptive seumur hidup terbanyak adalah usia coitarche >19 tahun dan pasangan seumur hidup < 24 orang. Gambaran abnormal sitologi anus pada kelompok berdasarkan jumlah pasangan dalam 3 bulan terakhir dan kekerapan hubungan seksual perminggu adalah sebanding. Pada 51 SP HIV positif didapatkan 17,6% ASCUS dan pada 48 SP HIV negatif didapatkan 12,5% ASCUS. LSL dengan gambaran klinis kutil peri anus ditemukan 30,3% ASCUS (RP 5,30; 95%IK 1,6417,19) Kesimpulan: Tidak terdapat perbedaan bermakna antara usia coitarche, kekerapan hubungan seksual anal receptive, dan infeksi HIV dengan abnormalitas sitologi anus.

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ABSTRACTBackground and aim: Anal receptive intercourse at younger age among MSM could increase transmission of HIV infection, HPV infection, and other sexually transmitted disease and could cause abnormalities of anal cytology. Frequent anal receptive intercourse in MSM would cause repeated trauma to anus and this process accelerate anal cytology abnormalities. This will put MSM at high risk of anal cancer. The aim of this study is to analyze the relationship among coitarche, frequency of anal receptive intercourse in MSM and HIV infection to anal cytology abnormalities using anal Papsmear. Methods: This is a cross sectional study in 99 MSM at puskesmas Pasar Rebo, Jakarta Timur. Interview about coitarche, frequency of anal receptive intercourse, number of sexual anal receptive patner, physical examination, HIV serology, anal swab specimens for anal cytology examination were done. Results: The proportion of the abnormal cytology was 15.2% and all were ASCUS. Neither LSIL nor HSIL were found. Abnormal cytology based on coitarche, were found more in the > 19 years age group. Abnormal cytology based on lifetime anal receptive sexual patner numbers, were more in < 24 patners. Abnormal anal cytology based on number of sexual patners in the past 3 months and frequency of weekly sexual intercourse wereequal. In 51 MSM with HIV positive group there was 17.6% ASCUS and in 48 MSM with HIV negative group there was 12.5% ASCUS. In MSM with perianal wart, 30.3% were ASCUS (PR 5.30; 95%CI 1.64-17.19) Conclution: There is no significant difference between coitarche age, frequency of anal receptive intercourse, and HIV infection with abnormal anal cytology. ;Background and aim: Anal receptive intercourse at younger age among MSM could increase transmission of HIV infection, HPV infection, and other sexually transmitted disease and could cause abnormalities of anal cytology. Frequent anal receptive intercourse in MSM would cause repeated trauma to anus and this process accelerate anal cytology abnormalities. This will put MSM at high risk of anal cancer. The aim of this study is to analyze the relationship among coitarche, frequency of anal receptive intercourse in MSM and HIV infection to anal cytology abnormalities using anal Papsmear. Methods: This is a cross sectional study in 99 MSM at puskesmas Pasar Rebo, Jakarta Timur. Interview about coitarche, frequency of anal receptive intercourse, number of sexual anal receptive patner, physical examination, HIV serology, anal swab specimens for anal cytology examination were done. Results: The proportion of the abnormal cytology was 15.2% and all were ASCUS. Neither LSIL nor HSIL were found. Abnormal cytology based on coitarche, were found more in the > 19 years age group. Abnormal cytology based on lifetime anal receptive sexual patner numbers, were more in < 24 patners. Abnormal anal cytology based on number of sexual patners in the past 3 months and frequency of weekly sexual intercourse wereequal. In 51 MSM with HIV positive group there was 17.6% ASCUS and in 48 MSM with HIV negative group there was 12.5% ASCUS. In MSM with perianal wart, 30.3% were ASCUS (PR 5.30; 95%CI 1.64-17.19) Conclution: There is no significant difference between coitarche age, frequency of anal receptive intercourse, and HIV infection with abnormal anal cytology. , Background and aim: Anal receptive intercourse at younger age among MSM could increase transmission of HIV infection, HPV infection, and other sexually transmitted disease and could cause abnormalities of anal cytology. Frequent anal receptive intercourse in MSM would cause repeated trauma to anus and this process accelerate anal cytology abnormalities. This will put MSM at high risk of anal cancer. The aim of this study is to analyze the relationship among coitarche, frequency of anal receptive intercourse in MSM and HIV infection to anal cytology abnormalities using anal Papsmear. Methods: This is a cross sectional study in 99 MSM at puskesmas Pasar Rebo, Jakarta Timur. Interview about coitarche, frequency of anal receptive intercourse, number of sexual anal receptive patner, physical examination, HIV serology, anal swab specimens for anal cytology examination were done. Results: The proportion of the abnormal cytology was 15.2% and all were ASCUS. Neither LSIL nor HSIL were found. Abnormal cytology based on coitarche, were found more in the > 19 years age group. Abnormal cytology based on lifetime anal receptive sexual patner numbers, were more in < 24 patners. Abnormal anal cytology based on number of sexual patners in the past 3 months and frequency of weekly sexual intercourse wereequal. In 51 MSM with HIV positive group there was 17.6% ASCUS and in 48 MSM with HIV negative group there was 12.5% ASCUS. In MSM with perianal wart, 30.3% were ASCUS (PR 5.30; 95%CI 1.64-17.19) Conclution: There is no significant difference between coitarche age, frequency of anal receptive intercourse, and HIV infection with abnormal anal cytology. ]"