Eka R Gunardi
Faculty of Medicine Universitas Indonesia, Jakarta

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Journal : Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)

A Randomized FiveYear Comparative Study of Two LevonorgestrelReleasing Implant Systems: Norplant® Capsules and Jadena® Rods Biran Affandi; Rusdi S Ridwan; R Hasan M Hoesni; Thamrin Tandjung; TM Ichsan; Rizani Amran; Heriyadi Manan; Eka R Gunardi; Noor Pramana; Suryo Hadiyono; Widohariadi Widohariadi; Retno B Farid; Mardiah Taher
Indonesian Journal of Obstetrics and Gynecology Volume 4, No. 4, October 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (120.478 KB) | DOI: 10.32771/inajog.v4i4.447

Abstract

Objective: To provide a randomized comparison between Jadena® and Norplant® in terms of efficacy and acceptability among Indonesian women. Method: This study was a phase IV, open label, randomized, multicenter study throughout Indonesia. Subjects were Indonesian adult women who were randomized to receive Jadena® or Norplant® as their contraceptive method. The subjects were recruited from 6 large cities in Indonesia, such as Medan, Palembang, Jakarta, Semarang, Surabaya, and Makassar. Result: Of 600 subjects, 301 women getting to Jadena® and 299 women to Norplant® were enrolled between August 1998 and February 1999. The mean age was 29.8 (SD 5.3) years old, ranging from 18 to 40 years old. We did not find the pregnancy during the study. Non-pregnancy probability at the end of one year was similar between Jadena® (0.920 (SD 0.016)) and Norplant® users (0.916 (SD 0.084)). The continuation rates of Jadena® at one and three-year were 95.3% and 66.8%; whereas, the continuation rates of Norplant® was 94.3% at year-1 and 70.2% at year-3. Conclusion: The new two rod levonorgestrel subdermal system (Jadena®) showed similar efficacy with the old six capsule levonorgestrel subdermal system (Norplant®) in term of birth control. Both implant systems also have similar tolerability profile. Jadena® is easier to insert and remove than Norplant®. Keywords: birth control, efficacy, implant
The Association between Endometriosis Appearance during Laparoscopic Surgery and Pain Characteristic in Pelvic Endometriosis: HubunganTampilan Susukan Endometriosis pada saat Pembedahan Laparoskopik dengan Karakteristik Nyeri pada Endometriosis Pelvik Herbert Situmorang; Renny Lestari; Eka R Gunardi
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 2 April 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (57.869 KB) | DOI: 10.32771/inajog.v7i2.831

Abstract

Abstract Objective: To evaluate the correlation between the American Society of Reproductive Medicine (ASRM) score in endometriosis and severity pelvic pain in a group of women with endometriosis. Method: A total of 131 patients with pelvic pain who: conduct laparoscopy for diagnosis and therapy of endometriosis, have pain symptoms>3 months, and absence of pelvic anomalies. Dysmenorrhea, deep dyspareunia, dyschezia, dysuria, and chronic pelvic pain were evaluated using a 10-point visual analogue scale. The data was collected by assessing the medical record, and retrospective analysis was performed. Disease stage according to the American Society of Reproductive Medicine, the presence of adhesion, lesion type (Deep Infiltrating Endometriosis (DIE) or without DIE), and severity of pain symptoms were analysed by Spearman analysis. Different VAS between DIE vs non DIE group was analysed by Mann-Whitney analysis. Result: Stage IV endometriosis accounts for 79.4%. Based on the macroscopic appearance, ovarian endometriosis accounts for 92.4%, peritoneal endometriosis 82.4%, DIE was 40.5%, and adenomyosis was 19.1%. There was significant correlation between total ASRM, ovarian endometriosis, peritoneal lesion, Douglas pouch obliteration, adnexal adhesion score and VAS dysmenorrhea (r=0.303; 0,187; 0,203; 0,278; 0,266, p<0.05). There was significant VAS difference of DIE vs non DIE group; the difference was on dyspareunia (5.18±2.4 and 4.58±1.0, p<0.001] and dyschezia [5.28±2.2 and 4.86±0.7,p<0.001] Conclusion: There was a positive correlation between ovarian endometriosis score and severity of dysmenorrhea. There was also a difference in the degree of endometriosis-associated pain between DIE and non DIE group. Keywords: endometriosis, deep infiltrating endometriosis, dysmenorrhea, dyspareunia, dyschezia Abstrak Tujuan: untuk mencari hubungan antara skor endometriosis ASRM dan karakteristik nyeri pelvik pada pasien endometriosis Metode: Sebanyak 131 pasien dengan nyeri pelvik yang menjalani laparoskopi untuk diagnosis dan terapi endometriosis, memiliki nyeri > 3 bulan, dan tidak mengalami kelainan organ pelvis. Dilakukan evaluasi terhadap dismenorea, dyspareunia dalam, diskezia, dysuria, dan nyeri pelvic kronik dengan menggunakan nilai 1-10 dari skala analog visual. Penelitian ini dilakukan di Rumah Sakit Umum Pusat Rujukan Nasional Dr. Cipto Mangunkusumo, Jakarta. Stadium endometriosis berdasarkan American Society of Reproductive Medicine, kejadian adhesi, jenis lesi (ada Endometriosis Susukan Dalam/ESD atau tanpa ESD), dan derajat keparahan nyeri dianalisis dengan analisis Spearman. Perbedaan skala nyeri antara ESD dan non ESD dianalisis dengan metode Mann-Whitney. Hasil: Sebanyak 79,4% pasien tergolong ke dalam endometriosis stadium IV. Berdasarkan tampilan makroskopik, endometriosis ovarium terdapat pada 92,4%, endometriosis peritoneal 82,4%, ESD 40,5%, dan adenomiosis pada 19,1%. Terdapat korelasi positif bermakna antara skor ASRM total, sub-skorkista endometriosis, endometriosis superfisial, obliterasi kavum douglas, dan adhesia dneksa dengan VAS dismenorea (r=0,303; 0,187; 0,203; 0,278; 0,266, p<0,05). Pada kelompok ESD dan tanpa ESD, didapatkan perbedaan VAS dismenorea, dispareunia dalam, diskezia, dan nyeri pelvic kronik yang bermakna (6,13±1.7 dan 5,95±1,7, p = 0,560 ; 5,18±2.4 dan 4,58±1,0, p < 0,001; 5,28±2,2 dan 4,86±0,7 , p < 0,001; 2,20±2,8 dan 0,60±1,8, p <0,001) Kesimpulan:Terdapat korelasi positif bermakna antara skor ASRM dengan VAS dismenorea. Terdapat perbedaan VAS dismenorea, dyspareunia dalam, diskezia, dan nyeri pelvic kronik pada kelompok ESD dan tanpa ESD Kata kunci: endometriosis, endometriosis susukan dalam, dismenorea, dispareunia dalam, diskezia
Identification of microorganisms in vaginal swab and peritoneal fluid of women with endometriosis: Identifikasi Mikroorganisme pada Swab Vagina dan Cairan Peritoneum pada Wanita dengan Endometriosis Wachyu Hadisaputra; Johny Judio; Eka R Gunardi
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 4 October 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (100.325 KB) | DOI: 10.32771/inajog.v6i4.847

Abstract

Abstract Objective: to discover correlation between microorganisms found in vaginal swab culture and in peritoneal fluid culture from laparoscopy in reproductive age women diagnosed with endometriosis. Methods: This cross sectional study was conducted in Bunda Hospital and YPK Hospital, Central Jakarta. Thirty one subjects was includedby consecutive sampling. Data were analyzed using SPSS 20.0 for Windows. Bivariate analysis was used to identify the correlation between independent and dependent variable. Results: From 31 subjects with mean age 34.42+5.056 years old, 87.1% were infertile. Vaginal swab culture was found positive in 83.9% subjects while peritoneal fluid culture was found positive only in 9.6% subjects. There was moderate correlation between chronic pelvic pain and positive vaginal swab culture (r=0.601; p=0.001), but weak correlation between Ca125 and vaginal swab culture (r=0.440; p=0.010). Peritoneal fluid culture had significant inverse correlation with left tubal patency (r=-0.346; p=0.047). There was weak correlation between vaginal swab culture and peritoneum fluid culture with correlation coefficient of 0.13. Conclusion: Most of bacteria found in vaginal swab culture and peritoneal fluid culture were the ones found in gastrointestinal tract. However, vaginal swab and peritoneal fluid culture were not sufficient to prove the hypothesis that infection has a role in pathogenesis of endometriosis. Therefore, advance and more complete examination such as LPS and PCR might be needed to be done in the future research with cohort study, to overcome the limitation of this study. Keywords: endometriosis, ascending bacterial contamination, vaginal swab, peritoneal fluid, culture Abstrak Tujuan : Membuktikan adanya korelasi antara mikroorganisme yang ditemukan pada hasil kultur bilasan vagina dengan mikroorganisme yang ditemukan pada cairan peritoneum hasil laparoskopi perempuan usia reproduksi yang terdiagnosis endometriosis Metode :Penelitian ini menggunakan desain penelitian analitik poltong lintang yang bertujuan untuk melihat adanya hubungan korelasi serta mengetahui tingkat korelasi antara mikroorganisme kultur bilasan vagina dengan mikroorganisme pada cairan peritoneum pasien endometriosis. Hasil: Hasil kultur bilasan vagina dari 31 subjek penelitian yang diteliti, mikroorganisme terbanyak adalah Enterococcus faecalis (32.3%), Eschericia coli (29.1%), dengan 16.1 % dengan hasil kultur negatif. Sedangkan dari hasil kultur bilasan peritoneum terdapat 3 subjek (9.6%) dengan hasil positif yaitu dengan jenis bakteri Eschericia coli, Enterococcus faecalis, dan Pseudomonas. Terdapat korelasi lemah antara hasil kultur bilasan vagina dengan kultur bilasan peritoneum (r 0.13). Terdapat korelasi sedang antara kultur positif bilasan vagina dengan nyeri pelvik kronis, korelasi lemah antara kultur positif bilasan vagina dengan nilai Ca 125, dan korelasi lemah antara kultur positif cairan peritoneum dengan tuba kiri yang non paten. Kesimpulan: Sebagian besar bakteri dari bilasan vagina dan bilasan peritoneum pada pasien endometriosis memiliki hasil bakteri dari organ pencernaan. Terdapat korelasi lemah antara hasil kultur bilasan vagina dengan kultur bilasan peritoneum pada pasien endometriosis. Kata kunci: endometriosis, kontaminasi bakteri asenden, kultur, bilasan vagina, cairan peritoneum