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Abstrak :
Latar Belakang: Sindroma ovarium polikistik (SOPK) merupakan sebuah penyakti dengan prevalensi yang tinggi dan beban kesehatan yang besar. Hingga saat ini, penyebab SOPK masih belum jelas. Penelitian sebelumnya mengenai ekspresi reseptor vitamin D (VDR) pada pasien SOPK menunjukkan hasil yang menjanjikan namun belum terbukti secara jelas. Oleh sebab itu, diduga bahwa polimorfisme VDR berperan penting dalam kejadian dan beratnya gejala SOPK. Metode: Penelitian potong lintang dilakukan pada pasien SOPK dan wanita usia reproduktif non-SOPK sebagai kontrol pada November 2019 hingga 2021. Pasien hamil, menyusui, memiliki riwayat gangguan hormon adrenal, tiroid, maupun prolaktin, atau mengonsumsi obat hormonal dalam 6 bulan terakhir dieksklusi dari penelitian. Subjek penelitian direkrut secara konsekutif. Ekspresi VDR dinilai dari ekspresi mRNA VDR yang dinilai dengan pemeriksaan PCR. Polimorfisme VDR dinilai pada tiga titik regio penyandi gen, yakni rs7975232, rs11574113, dan rs11574114. Hasil: Sebanyak 80 pasien SOPK dan 80 pasien kontrol diikutsertakan dalam penelitian. genotip A/A pada regio rs7975232 dan genotip C/C pada regio rs11574113 lebih banyak didapatkan pada pasien dengan SOPK. Di sisi lain, genotip A/C pada regio rs7975232 dan genotip C/G pada regio rs11574114 lebih banyak didapatkan pada kelompok kontrol (p < 0,05). Tidak terdapat perbedaan ekspresi VDR pada pasien dengan polimorfisme yang berbeda (p > 0,05). Kesimpulan: Didapatkan polimorfisme gen penyandi VDR yang berbeda antara pasien SOPK dan non-SOPK. Tidak didapatkan perbedaan ekspresi VDR yang bermakna antara pasien SOPK dan non-SOPK. ......Background: Polycystic ovary syndrome (SOPK) is a disease with a high prevalence and a large health burden. Until now, the cause of SOPK is still unclear. Previous studies on vitamin D receptor (VDR) expression in PCOS patients have shown promising results but have not been clearly proven. Therefore, it is suspected that the VDR polymorphism plays an important role in the incidence and severity of PCOS symptoms. Methods: A cross-sectional study was conducted on PCOS patients and non-SOPK women of reproductive age as controls from November 2019 to 2021. Patients who were pregnant, breastfeeding, had a history of adrenal, thyroid, or prolactin hormone disorders, or had taken hormonal drugs in the last 6 months were excluded from the study. study. Research subjects were recruited consecutively. VDR expression was assessed from VDR mRNA expression assessed by PCR examination. VDR polymorphism was assessed at three points in the gene encoding region, namely rs7975232, rs11574113, and rs11574114. Results: A total of 80 PCOS patients and 80 control patients were included in the study. A/A genotypes in the rs7975232 region and C/C genotypes in the rs11574113 region were more common in patients with PCOS. On the other hand, the A/C genotype in the rs7975232 region and the C/G genotype in the rs11574114 region were more common in the control group (p < 0.05). There was no difference in VDR expression in patients with different polymorphisms (p > 0.05). Conclusions: Different polymorphisms of the VDR coding gene were found between PCOS and non-SOPK patients. There was no significant difference in VDR expression between PCOS and non-SOPK patients.

Abstrak :
ABSTRAK
Latar belakang : Robekan perineum tingkat III dan IV dapat menimbulkan berbagai morbiditias seperti disfungsi organ panggul, dispareni, nyeri kronik, dan masalah psikososial yang mengganggu kualitas hidup perempuan. Audit terhadap tatalaksana robekan perineum perlu dilakukan sebagai dasar perbaikan panduan pelayanan klinis dan pelayanan di rumah sakit. Tujuan : mengetahui insidensi dan mengaudit tatalaksana robekan perineum tingkat III dan IV di Rumah Sakit Cipto Mangunkusumo pada tahun 2011-2014 berdasakan panduan Royal College of Obstetricians and Gynecologist (RCOG) tahun 2015. Metode : Studi deskriptif dengan desain potong lintang dilakukan dengan menggunakan data persalinan di RSUPN Cipto Mangunkusumo dari tahun 2011 sampai dengan 2014. Kesesuaian tatalaksana robekan perineum tingkat III dan IV dinilai berdasarkan kehadiran konsulen, tempat memperbaiki, penggunaan anestesi, metode jahitan, bahan jahitan, antibiotik pasca operasi, kateter 1 kali 24 jam, penggunaan analgetik dan laksantia. Subjek yang memenuhi minimal 7 dari 9 kriteria, dianggap mendapatkan tatalaksana yang sesuai dengan panduan RCOG. Hasil : Dari tahun 2011 sampai dengan 2014, insidensi robekan perineum berturutturut adalah sebesar 3,54; 4,34; 3,95; dan 1,77%. Tatalaksana robekan perineum tingkat III dan IV pada studi ini didapatkan sesuai pada 57,8% subjek. Ketidaksesuaian ditemukan pada komponen tempat operasi, operator oleh ahli, dan penggunaan kateter urin 1 kali 24 jam pasca tindakan Kesimpulan : Insidensi robekan perineum derajat 3 dan 4 didapatkan masih tinggi. Masih terdapat tatalaksana robekan perineum derajat III dan IV yang belum sesuai dengan standar RCOG. ABSTRACT
Background : OASIS may lead to several morbidities i.e pelvic organ dysfunction, dysparenia, chronic pain, and psychosocial problems leading to impaired quality of life of women. Audit of OASIS management is needed to improve the clinical guideline and practice of OASIS management in a hospital. Objective : To determine the incidence of OASIS and assess the case management at Cipto Mangunkusumo National Hospital during 2011-2014 using the criteria stated in the Royal College of Obstetricians and Gynecologist (RCOG) guideline 2015. Methods : A cross-sectional descriptive study was conducted using the delivery database in Cipto Mangunkusumo Hospital, a tertiary referral university hosptal in Jakarta, Indonesia during 2011-2014. The OASIS management of each subjects were assessed based on 9 items listed at RCOG 2015 guideline of OASIS management (consultant presence during repair, place of repair, use of anesthesia, methods of suturing, suturing material, use of post-operative antibiotic, use of urinary catheter 24 hour after surgery, use of laxative agent. Result : During 2011-2014, the incidence of OASIS were respectively 3,54; 4,34; 3,95; and. 1,77%. As many as 57,8% subjects with OASIS were approproately managed according to RCOG guideline. Surgery performed at delivery suite, surgery performed by resident (not an expert), and not using postoperative foley catheter were the items that frequently missed in the management. Conclusion : We found a relatively high incidence of OASIS in our hospital. There was several items included in RCOG guideline that should improved in our hospital.;Background : OASIS may lead to several morbidities i.e pelvic organ dysfunction, dysparenia, chronic pain, and psychosocial problems leading to impaired quality of life of women. Audit of OASIS management is needed to improve the clinical guideline and practice of OASIS management in a hospital. Objective : To determine the incidence of OASIS and assess the case management at Cipto Mangunkusumo National Hospital during 2011-2014 using the criteria stated in the Royal College of Obstetricians and Gynecologist (RCOG) guideline 2015. Methods : A cross-sectional descriptive study was conducted using the delivery database in Cipto Mangunkusumo Hospital, a tertiary referral university hosptal in Jakarta, Indonesia during 2011-2014. The OASIS management of each subjects were assessed based on 9 items listed at RCOG 2015 guideline of OASIS management (consultant presence during repair, place of repair, use of anesthesia, methods of suturing, suturing material, use of post-operative antibiotic, use of urinary catheter 24 hour after surgery, use of laxative agent. Result : During 2011-2014, the incidence of OASIS were respectively 3,54; 4,34; 3,95; and. 1,77%. As many as 57,8% subjects with OASIS were approproately managed according to RCOG guideline. Surgery performed at delivery suite, surgery performed by resident (not an expert), and not using postoperative foley catheter were the items that frequently missed in the management. Conclusion : We found a relatively high incidence of OASIS in our hospital. There was several items included in RCOG guideline that should improved in our hospital.;Background : OASIS may lead to several morbidities i.e pelvic organ dysfunction, dysparenia, chronic pain, and psychosocial problems leading to impaired quality of life of women. Audit of OASIS management is needed to improve the clinical guideline and practice of OASIS management in a hospital. Objective : To determine the incidence of OASIS and assess the case management at Cipto Mangunkusumo National Hospital during 2011-2014 using the criteria stated in the Royal College of Obstetricians and Gynecologist (RCOG) guideline 2015. Methods : A cross-sectional descriptive study was conducted using the delivery database in Cipto Mangunkusumo Hospital, a tertiary referral university hosptal in Jakarta, Indonesia during 2011-2014. The OASIS management of each subjects were assessed based on 9 items listed at RCOG 2015 guideline of OASIS management (consultant presence during repair, place of repair, use of anesthesia, methods of suturing, suturing material, use of post-operative antibiotic, use of urinary catheter 24 hour after surgery, use of laxative agent. Result : During 2011-2014, the incidence of OASIS were respectively 3,54; 4,34; 3,95; and. 1,77%. As many as 57,8% subjects with OASIS were approproately managed according to RCOG guideline. Surgery performed at delivery suite, surgery performed by resident (not an expert), and not using postoperative foley catheter were the items that frequently missed in the management. Conclusion : We found a relatively high incidence of OASIS in our hospital. There was several items included in RCOG guideline that should improved in our hospital.