Objective: The global case fatality rate of coronavirus disease 2019 is 2.16% as announced by the World Health Organization. In Indonesia, according to the Ministry of Health, the number is even higher, reaching a 2.8% case fatality rate. D-dimer levels were found to affect coronavirus disease 2019 patient’s survival in several studies. The study aimed to determine whether the amount of D-dimer predicted survival in coronavirus disease 2019 patients. Materials and Methods: This research was performed in a retrospective cohort design and used survival analysis. From March 1, 2020, to August 31, 2020, the samples were collected from polymerase chain reaction-confirmed coronavirus disease 2019 patients at Mohammad Hoesin General Hospital in Palembang, South Sumatera, Indonesia. We used electronic medical records to obtain demographic (age and gender), coexisting condition, laboratory (coagulation and hematologic test), and outcome (non-survivors or survivors) data. The chi-square and Mann–Whitney tests were used to evaluate the results. The Kaplan–Meier method and the Mantel–Haenszel log-rank test were used to examine D-dimer levels and patient outcomes. Youden index was calculated to determine the optimal cut-off value of D-dimer. Results: There were 52 non-survivors and 235 survivors among the 287 patients who met the inclusion criterion. Non-survivors had D-dimer levels of more than 1.49 mg/L in 82.69% of cases. Males had lower cut-off compared to females (>1.49 mg/L vs. >2.2 mg/L). The researchers discovered a highly significant correlation between D-dimer levels and coronavirus disease 2019 mortality ( P = .001). The c-index analysis showed that D-dimer (0.79, 95% CI: 0.73-0.83) ability for mortality prediction was the second-best compared with other laboratory markers. Conclusion: D-dimer can be used as a predictor of coronavirus disease 2019 in-hospital mortality for early identification of coagulopathy.

Objective: To determine the amount of wasted blood and diagnosedAUB and determine amount of decrease in haemoglobinlevels by adjusting the examination of menstrual pictogramwith haemoglobin.Methods: Diagnostic test was conducted in the DepartmentObstetrics and Gynecology Dr. Mohammad Hoesin/Faculty ofMedicine Universitas Sriwijaya Palembang, start from January 2015through January 2017. Sample was obtained from 39 patients withabnormal uterine bleeding who meet the inclusion and exclusioncriteria. Frequency and distribution of data are described in tablesand cross analyze (cut-off point) to find cut points differencemenstrual pictogram and a decrease in haemoglobin levels usingROC curve. Accuracy is measured by the value of Kappa. Dataanalysis using SPSS version 21.Results: From 39 samples that obtained, majority characteristicsage > 35 years (59%), ideal BMI (59%) and multiparous(48.7%). From statistical analysis, there was significanceassociation between haemoglobin measurement toolsand menstrual pictogram (p = 0.063). Both measuring deviceshave compatibility in predicting the type of AUB (p = 0.047),with the degree of conformity is weak (Kappa = 0.232).Conclusion: Accuracy of menstrual pictogram examination andhaemoglobin has a weak degree of conformity, so menstrualpictogram examination can’t be used to determine a decrease inhaemoglobin levels. Menstrual pictogram menstruation only usedas an evaluation of therapeutic response.[Indones J Obstet Gynecol 2018; 6-3: 172-178]Keywords: abnormal uterine bleeding, haemoglobin, menstrual pictogram

Abnormal uterine bleeding (AUB) is defined as the abnormal bleeding from the uterine corpus in term of duration, volume, frequency and/or regularity. This condition occurs in 37% of adolescents and may affect the quality of life and increased hospitalization. Etiology is divided into structural and non-structural causes, known as PALM-COEIN. The most common etiology in adolescents is anovulatory menstruation due to immature hypothalamus-hypophysis axis. Diagnostic evaluation should include investigation in the etiology of AUB, anemia signs, and hemodynamic status. Treatment of AUB consists of hormonal and non-hormonal therapy. Therapy in adolescent is given based on the severity of bleeding, grading of anemia, and hemodynamic stability. Follow-up is required after therapy. Understanding AUB in adolescents can help clinicians deliver appropriate and comprehensive treatment. This review was aimed to explain about definition, epidemiology, etiology, pathophysiology, diagnosis, and treatment of abnormal uterine bleeding in adolescent.

Background. Disorder of sex development (DSD) is a congenital disorder associated with interference in chromosomes, gonads, or sexes anatomically. Individual affected with DSD can be recognized since birth due to external genital ambiguity. Sexual chromosome DSD occurred because sexual chromosome numeric or structural disorder. Mosaic karyotype 45X/46XY is among the rare sexual chromosome DSD with incidence less than 1:15,000 live births. DSD individuals are susceptible to stigmatization. This can cause stress, negative emotion, and social isolation. Therefore, DSD individual management should be done as optimal as possible. Case Presentation: Twelve years old girl complaining a bump arose from anterior side of her genital resembles male genital since 4 years prior to admission without micturition and defecation complains. Patient has not experienced menarche. On external genital examination, we found the normal female external genital such as mons pubis, pubic hair, labia majora, labia minora, hymen, perineum, but without clitoris which in this case it is replaced by a glans of penis, arising from  anterior commissure of labia majora area, with an urethral estuary. Before the management is done, patient underwent multidiscipline consultations and further examinations. Subsequently, it was approved that the joint conference formation consisting obstetric and gynecology, urologist, and pediatric endocrinologist to determine the optimal management for the patient. Conclusion: In this case, diagnosis was made with history taking, clinical examination, and supporting investigation such as ultrasound imaging and could be followed by biochemistry test, voiding cystourethrography or genitogram to determine next management. Counseling should be done in detail towards the family to know what action is best for the patient. Multidiscipline team was required to get the optimum result either in medical, ethical, or religious point of view. Surgery in this case was considered followed by long term therapy afterwards.

Background. Endometriosis is defined as the presence of endometrial-like tissue outside the uterus. The prevalence of endometriosis is not known with certainty because it is necessary to perform a laparoscopy to confirm the diagnosis of endometriosis and is usually found during examination for other indications. This study aims to explore the characteristics of endometriosis patients at Dr. Mohammad Hoesin General Hospital Palembang. Methods. This research is descriptive observational research. The research data were obtained from the medical records of endometriosis patients treated at Dr. Mohammad Hoesin General Hospital Palembang from 2018 to 2020. Results. Of the 105 sample data studied, the most distribution of endometriosis patients was in the reproductive age group (15-49 years) (99%), menarche 12-14 years (67.6%), the location of endometriosis in the ovaries (58.1%), status indoor workers (99%), marital status (85.7%), fertile (43.8%), and infertile patients (41.9%), the chief complaint of dysmenorrhea (66.7%), stage IV disease (63, 8%), nullipara (60%), surgical management (79%). Conclusion. Most of the characteristics of endometriosis patients were in the reproductive age group (15 – 49 years), menarche 12-14 years, endometriosis location in the ovary, indoor worker status, marital status, infertility, the main complaint of dysmenorrhea, stage IV disease, nullipara, surgical treatment.