BackgroundPlacental soluble fms-like tyrosine kinase-1 (sFlt-1) which is an antagonist of vascular endothelial growth factor and placental growth factor (PIGF), is considered as one of etiology factors cause endothelial damage in preeclampsia due to increase of sFlt-1 level that change vascular endothelial integrity. This study aims to analyze the difference of sFlt-1 and PlGF concentration in severe preeclampsia and normal pregnancy, and the correlation between both in occurrence of severe preeclampsia.MethodThis is case control study involving 18 subjects with severe preeclampsia and 19 subjects with normal pregnancy as controls who met inclusion and exclusion criteria. Concentration of sFlt-1 and PlGF are measured with ELISA. Statistical analysis is performed with Chi square test, Fisher’s exact test, T test, Mann–Whitney test, and Spearman’s rank correlation test.ResultsThis study results in no significant difference in characteristics of gestational age, and parity in both study groups. Median concentration of sFlt-1 in severe preeclampsia is higher (20,524.75 pg/mL) compared with normal pregnancy (6820.4 pg/mL). Concentration of PlGF is lower in severe preeclampsia (47 pg/mL) compared with normal pregnancy (337 pg/mL). sFlt-1 concentration is higher in severe preeclampsia compared to normal pregnancy. PlGF concentration is lower in severe preeclampsia compared to normal pregnancy. Ratio of sFlt-1 and PlGF concentration is significantly correlated in both severe preeclampsia and normal pregnancy.ConclusionsThere is a significant negative correlation between the concentration of sFLt-1 and PlGF in normal pregnancy.

Objective: Low-risk gestational trophoblastic neoplasia (GTN) is generally treated with single agent chemotherapy and methotrexate (MTX) as a first-line therapy. Vitamin A helps to increase trophoblast cell regression, as well as to decrease β-hCG levels. Vitamin A also increases the effectiveness of MTX by inducing more malignant cell death than MTX alone. Therefore, the aim of the current study was to analyze the changes in β-hCG levels in low-risk GTN patients following vitamin A administration. Methods: This study was a randomized clinical trial, which examined initial serum vitamin A and β-hCG levels in GTN patients before and after three cycles of MTX therapy. Patients were given vitamin A supplementation of 6,000 IU (1.8 mg RAEs) per day, and the changes in serum β-hCG were observed after three cycles. Patients were grouped by β-hCG levels (decreased or stagnant). Results: A total of 32 low-risks GTN patients were divided into the intervention group (16 patients who received vitamin A supplementation) and the control group (16 patients who did not receive vitamin A supplementation). In the intervention group, the average initial β-hCG level was 170,949.3 ± 354,452.1 mIU/mL, and the average β-hCG post-cycle level was 1,611.9 ± 3,652.5 mIU/mL. In the control group, the average initial β-hCG level was 178,834.1 ± 2913844.6 mIU/mL, and the average β-hCG post-cycle level was 25,388.5 ± 58,437.7 mIU/mL. Conclusion: In patients with low-risk GTN who underwent MTX chemotherapy, the levels of β-hCG and the incidence of chemo resistance in the intervention group were lower than those in the control group. Older age may also influence the incidence of chemo resistance in GTN patients. Oral administration of 6,000 IU vitamin A could help to reduce β-hCG levels in low-risk GTN patients who receive MTX chemotherapy.

BackgroundPreeclampsia is a major cause of morbidity and mortality, both maternal and perinatal. The etiology and pathophysiology of preeclampsia remain unknown. Research shows the implantation of the placenta in preeclampsia occurs due to incomplete angiogenic imbalance as one of the preeclampsia pathogenesis. PlGF is angiogenic protein which is synthesized in placenta by mRNA PlGF. When damage occurs, mRNA will be released from cell and form cell-free mRNA. This study aims to analyze the differences between the PlGF mRNA expression in severe preeclampsia and normal pregnancy as well as to measure the relationship between cell-free mRNA and levels of PlGF with the incidence of severe preeclampsia.MethodsThe method used in this study is an observational analytic study with cross-sectional design. Blood samples were obtained from patients with preeclampsia and normal pregnancies as the controlling factors in accordance with inclusion and exclusion criterias. Examination of the PlGF level was measured by ELISA method and mRNA PIGF expression was measured by RT-PCR. Physical and laboratory examinations of patients were recorded and collected as data. Calculations were done by statistical analysis.ResultsMean of the cell-free mRNA PlGF expression level in severe preeclampsia is 2.2983 ng/mL within the scale of 1.96–2.83 ng/mL and deviation standard of 0.1897. Using Pearson Analysis Test, the result shows that there is a positive correlation between cell-free mRNA expression and PlGF protein level in severe preeclampsia, with r = 0.640 dan p < 0.004.ConclusionThere is no difference between expression of cell-free mRNA PlGF in severe preeclampsia serum and normal pregnancy. There is a significant correlation between expression of cell-free mRNA and PlGF protein level in severe preeclampsia.

Objective: To analyze sFlt-1 and sFlt-1 mRNA levels in severe preeclampsia and normal pregnancy, and the correlation between both in occurrence of severe preeclampsia. Methods: This is a cross-sectional analytic observational study involving 18 subjects with severe preeclampsia and 19 subjects with normal pregnancy as controls who met inclusion and exclusion criteria. Levels of sFlt-1 and sFlt-1 mRNA were measured with ELISA and RT PCR. Statistical analysis was performed with Chi square test, Fisher's exact test, T-test, Mann-Whitney test, and Spearman's rank correlation test. Results: This study showed no significant difference (p>0.05) in the characteristics of maternal age, gestational age, and parity in both study groups. Mean level of sFlt-1 mRNA in severe preeclampsia was higher (6.3404 pg/mL) compared to its level in normal pregnancy (5.9701 pg/mL). There was an insignificant (p>0.05) positive correlation between sFlt-1 mRNA and sFlt-1 levels in normal pregnancy, and an insignificant (p>0.05) negative correlation between both levels in severe preeclampsia. Conclusions: sFlt-1 mRNA levels in severe preeclampsia are higher than its level in normal pregnancy. There is no correlation between sFlt-1 mRNA level and sFLt-1 protein level in severe preeclampsia. There is an insignificant positive correlation between sFlt-1 mRNA and sFlt-1 levels in normal pregnancy, and an insignificant negative correlation between both levels in severe preeclampsia.

Background: Anemia is a condition in which the hemoglobin is below the normal value. According to Riskesdas, anemia in toddlers in 2018 was 38.5%. Many factors cause anemia in toddler, such as gender, birth weight, history of premature birth, history of exclusive breastfeeding, nutritional status and mother's education. Purpose: This study aims to determine the description of the risk factors for the incidence of anemia in toddler.Methods: This study uses secondary data in the form of a cohort with a total sampling of 53 toddler in Cirebon Regency. The analysis used in this research is univariate analysis. Results: In this study, it was shown that Toddler with anemia were seen from risk factors, namely female sex as much as 55.2%. Normal birth weight is 57.4%. Good nutritional status (BB/U) was 55.1% and Toddler short nutritional status (TB/U) were 66.6%. Those who do not have a history of exclusive breastfeeding are 60.8%, and have a history of being premature as much as 60% and with a mother's education not attending school as much as 100%Conclusion: Female gender, Toddler with short nutritional status and a history of premature birth and mothers with low education are more likely to experience anemia than other risk factors. Suggestion It is necessary to provide counseling to parents of toddlers regarding risk factors for the incidence of anemia in toddlers, especially in toddlers with female gender and toddlers experiencing stunting. Keywords: Anemia, Toddler, Risk Factor ABSTRAK Latar belakang: Anemia adalah suatu kondisi di mana hemoglobin berada dibawah nilai normal. Menurut Riskesdas anemia pada balita tahun 2018 yaitu sebesar 38,5%. Banyak faktor yang menyebabkan anemia pada balita, seperti jenis kelamin, berat badan lahir, riwayat prematur, riwayat ASI Eklusif, status gizi dan pendidikan ibu.Tujuan: Penelitian ini bertujuan untuk mengetahui gambaran faktor risiko kejadian anemia pada balita.Metode: Penelitian ini menggunakan data sekunder berupa kohort dengan total sampling sebanyak 53 balita di Kabupaten Cirebon. Analisis yang digunakan pada penelitian ini adalah analisis univariat.Hasil: Dalam penelitian ini menunjukan bahwa balita yang mengalami anemia dilihat dari faktor risiko yaitu jenis kelamin perempuan sebanyak 55,2%. Berat badan lahir normal yaitu 57,4%. Status gizi baik (BB/U) sebanyak 55,1% dan balita status gizi pendek (TB/U) yang mengalami anemia sebanyak 66,6%. Yang tidak memiliki riwayat ASI eklusif sebanyak 60,8%, dan memiliki riwayat prematur sebanyak 60% serta dengan pendidikan ibu tidak sekolah sebanyak 100%Kesimpulan: Jenis kelamin perempuan, balita dengan status gizi pendek dan memiliki riwayat prematur serta ibu yang berpendidikan rendah lebih banyak yang mengalami anemia dibandingkan faktor risiko lainnya.Saran perlu dilakukan penyuluhan pada orang tua balita mengenai faktor risiko kejadian anemia pada balita terutama pada balita dengan jenis kelamin perempuan dan balita yang mengalami stunting. Kata kunci : Anemia, Balita, Faktor Risiko

Penelitian ini dilakukan dengan jenis penelitian deskriptif dan dengan rancangan penelitian cross sectional yaitu cara pendekatan, observasi atau pengumpulan data dimana pengumpulan data tersebut dilakukan pada saat yang bersamaan Hasil: Karakteristik kematian maternal terbanyak adalah usia reproduksi (88,8%), paritas terbanyak adalah multipara (58,3%), berpendidikan cukup tinggi (94,5%), seluruh pasien kematian maternal memiliki kontak antenatal dengan tenaga kesehatan (100%) namun sebagian besar hanya melakukan kontak antenatal <8 kali (74,4%), dan penyebab terbanyak dari kematian adalah hipertensi dalam kehamilan (63,9%) Kesimpulan: Kematian maternal berkaitan dengan kontak antenatal yang kurang adekuat. Kontak antenatal yang tidak adekuat menyebabkan penanganan pasien dengan risiko tinggi menjadi kurang baik, terutama pasien dengan faktor risiko preeklampsia Kata Kunci: Kematian maternal, kontak antenatal

Background: Congenital anomaly is a disease of structural or functional alteration since birth. The cause of congenital anomaly is genetic, environtment, and unknown. The cause of congenital anomaly is unknown, made congenital anomaly is difficult to detect. Therefore, the objective of this study was to identify the suspectable risk factors of congenital anomaly.

Tujuan penelitian ini adalah untuk mengetahui bagaimana hubungan kualitas hidup dan kebutuhan perawatan paliatif pada pasien kanker ginekologi. Metode. Subjek penelitian ini adalah seluruh pasien kanker ginekologi yang dirawat di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan November-Desember 2018. Penelitian ini merupakan studi analitik dengan rancangan cross sectional. Data yang diperoleh dianalisis secara bivariat dengan menggunakan chi square dengan α = 0,05, untuk mengetahui hubungan antara kualitas hidup dengan kebutuhan perawatan paliatif. Hasil. Karakteristik subjek terbanyak berusia > 50 tahun (65,67%), pendidikan dasar (70,15%), ibu rumah tangga (89,55%), pendapatan di atas upah minimum regional (61,19 %), tujuan rawat inap kemoterapi (47,76%) dan tipe kanker karsinoma serviks (43,28%). Subjek penelitian dengan skor paliatif ≥ 4 sebanyak 25 orang (37,31%). Keluhan yang terbanyak adalah berat badan turun dan tidak nafsu makan (86,57 %). Kualitas hidup pasien kategori baik sebanyak 29 orang, sedang 36 orang, dan kurang 2 orang. Kualitas hidup pasien kanker ginekologi berhubungan dengan kebutuhan perawatan paliatif dengan nilai signifikansi p 0,004. Simpulan. Kualitas hidup berhubungan dengan skor paliatif. Semakin rendah skor paliatif maka kualitas hidup semakin baik.