ABSTRAK Pelaksanaan program deteksi dini kanker serviks dengan metode IVA merupakan kebijakan pemerintah Republik Indonesia dalam upaya mengantisipasi dan menurunkan angka kejadian kanker serviks. Masih rendahnya cakupan deteksi dini kanker serviks pada tahun 2016 di Kabupaten Kampar yaitu hanya 1.165 orang wanita usia subur (wus) dari jumlah sasaran 110.236 orang atau hanya 6% dari target 100%. Tujuan penelitian ini adalah untuk mengetahui bagaimana pelaksanaan program deteksi dini kanker serviks dengan metode IVA. Metode penelitian yang di gunakan adalah metode Kualitatif dengan riset naratif. Analisis data yang di lakukan adalah content analysis dengan Triangulasi. Informan dalam penelitian ini berjumlah 12 orang. Hasil penelitian menunjukan bahwa pelaksanaan program deteksi dini kanker serviks dengan metode IVA sudah terlaksana tapi belum maksimal. Pelaksanaan program di laksanakan oleh Puskesmas serta posyandu dan bidan sebagai tenaga pelaksana hanya 31 orang yang sudah terlatih. Pembiayaan untuk kegiatan deteksi dini kanker serviks ini di bebankan pada Dana Bantuan Operasinal Kesehatan Puskesmas dan dana Jaminan Kesehatan Nasional. Bidan sebagai pelaksana sudah bekerja sesuai SOP yang di tetapkan walaupun masih belum maksimal karena adanya keterbatasan sarana yang ada. Peran linatas sektor baik vertical maupun horizontal sudah cukup baik. Tingkat pengetahuan tentang kanker serviks yang rendah, rasa malu, takut dan khawatir dari WUS sebagai sasaran IVA merupakan kendala yang masih di jumpai dan harus dapat di tanggulangi.

Background: Cervical cancer is the fourth most deadly cancer in the world, and it is caused by infection of high-risk subtypes of Human PapillomaVirus (HPV) in most cases. The aims of this study were to determine the prevalence oncogenic HPV in cervical cancer patients in Riau Province Indonesia and to determine the clinical manifestation of HPV in cervical cancer patients in Riau Province Indonesia. Methods: This research was a descriptive study conducted at Arifin Achmad General Hospital Riau from February to August 2018 which aimed to analyze HPV genotype prevalence oncogenic of cervical cancer patients. Results: This study showed out 86 of 110 women (78.1%) were found HPV positive, and the most common genotype of HPV was HPV 16 (38.2%). The average age of cervical cancer patient was 50 years old, and the average number of parities was 4 times. The majority of participants were married at the age before 20 years (77.3%) and had low educational background (64.5%). Vaginal bleeding happened in more than half of the participant as major clinical manifestation (72.7%), followed by fluor albus (72.7%), pelvic pain (60.2%) and fatigue (65.9%). Conclusions:The most common HPV genotype in Riau Province was HPV type 16 and the most common clinical symptoms of cervical cancer patient were vaginal bleeding, fluor albus, pelvic pain and fatigue.

ABSTRAKAcquired immunodeficiency syndrome (AIDS) adalah penyakit yang disebabkan oleh infeksi virus human immunodeficiency virus (HIV). AIDS dikarakteristikkan sebagai penyakit imunosupresif berat yang sering dikaitkan dengan infeksi oportunistik dan tumor ganas serta degenerasi susunan saraf pusat. Penyebaran HIV ini berkembang dengan cepat dan mengenai wanita dan anak-anak. AIDS menyebabkan kematian lebih dari 20 juta orang setahun. Tahun 2003 diperkirakan 700.000 bayi baru lahir terinfeksi HIV di seluruh dunia. Angka morbiditas dan mortalitas yang disebabkan oleh HIV semakin meningkat dan merupakan masalah kesehatan masyarakat yang paling penting di semua negara. Penggunaan obat antivirus seperti highly active antiretroviral therapy (HAART) dan persalinan berencana dengan seksio sesaria telah menurunkan angka transmisi perinatal mother to child trasmission (MTCT) penyakit ini dari 30% menjadi 20%. Manejemen antenatal, persalinan, dan perawatan pascasalin yang terkontrol dengan baik pada ibu hamil dengan HIV dapat mencegah transmisi perinatal. Kata kunci : AIDS, HAART, MTCT PREVENTION AND MANAGEMENT OF HIV INFECTION (AIDS) IN PREGNANCY ABSTRACT Acquired immunodeficiency syndrome (AIDS) is a disease which caused by human immunodeficiency virus (HIV).Characteristic of AIDS is due to severe immunosupresive disease which related to opportunistic infection, malignant tumour and central nervous system degeneration. HIV spread widely and mostly infect women and children. Mortality rate of AIDS are more than 20 million people per year. In 2003, 700,000 newborn were infected by HIV in the world. Morbidity and mortality rate of HIV are highly increase dan become an important public health problem in all around the world. Using of antiviral drugs like highly active antiretroviral therapy (HAART) and ceasarean labor has decreased the perinatal transmission (mother-to-child trasmission=MTCT) rate of this disease from 30% to 20%. The intensive control in management of antenatal care, labor and delivery for the pregnant women with HIV can prevent the perinatal transmission.

Background: Preeclampsia is a highly prevalent disease among pregnant women. In the event of hypertensive emergency, nifedipine, labetalol, and hydralazine are assigned as first-line therapies in preeclampsia. Further studies are needed to compare the effectiveness of these drugs to find the most cost-effective drug with minimal side effects. This study aimed to compare the effectiveness of these drugs in lowering blood pressure during hypertensive emergencies in severe preeclampsia. Methods: 60 pregnant women with severe preeclampsia were recruited in this multiple centre double-blind randomized clinical trial from May 2021 to April 2022 in Indonesia. The patients were divided equally into three groups and treated with three doses of nifedipine, labetalol, and hydralazine, respectively within one hour with 20 minutes interval. The effectiveness was measured based on systolic and diastolic blood pressures, and mean arterial pressure (MAP). The observation was carried out until five hours post-third dose administration.   Results: The blood pressure was reduced significantly after the administration of the first to the third dose of each antihypertensive (p<0.05). A single dose administration, four, one, and three patients had 20% MAP reduction in nifedipine, labetalol, and hydralazine group. Three, seven, and one patient had a failure of reaching 20% MAP reduction even after receiving the third dose. The effectiveness of the drugs to achieve 20% reduction of MAP could be ranked as follows: nifedipine>labetalol>hydralazine (57.49%, 42.13%, and 40.87%, respectively) for single dose and hydralazine>nifedipine>labetalol (111.3%, 85.12%, and 90.04%, respectively) for triple dose. Conclusions: Nifedipine is the most effective drug to reduce the blood pressure when single dose administration is used, but requires more doses to further reduce the blood pressure. Hydralazine is the most effective when the drug administration is maxed up to three doses within 60 minutes with 20 minutes interval. Thai Clinical Trials Registry (TCTR): TCTR20221014007 (14/10/2022)

Eclampsia and pre-eclampsia are the leading causes of death in pregnancy in Indonesia. Midwives are the first-line providers of maternal and child health services. Therefore, the knowledge and skills of a midwife regarding the initial management of pre-eclampsia and eclampsia are very important in order to reduce maternal mortality. Activities to optimize the role of midwives as first-line health providers in the initial management of preeclampsia and eclampsia cases are held online. This seminar was successfully held on September 25, 2020, with 417 participants. Most of the participants came from cities in Riau, but there were also those from the east such as Makassar and Denpasar. The series of events were in the form of a pretest, delivery of material by experts (obstetricians and gynecologists), post-tests, and question and answer sessions. There is an increase in the knowledge of midwives about the diagnosis and initial management of preeclampsia cases through this seminar which is assessed through increasing score of pretest to the post test. Eklampsia dan preeklamsia merupakan penyebab utama kematian pada kehamilan di Indonesia. Bidan merupakan pemberi pelayanan kesehatan ibu dan anak lini pertama. Oleh karena itu, pengetahuan dan keterampilan bidan mengenai tata laksana awal preeklamsia dan eklampsia sangat penting dalam menurunkan angka kematian ibu. Kegiatan untuk mengoptimalkan peran bidan sebagai tenaga kesehatan lini pertama dalam penanganan awal kasus preeklamsia dan eklampsia ini dilakukan secara daring. Seminar ini diselenggarakan pada tanggal 25 September 2020 dengan jumlah peserta 417 orang. Sebagian besar peserta berasal dari kota-kota di Riau, namun ada juga yang berasal dari timur seperti Makasar dan Denpasar. Rangkaian kegiatan terdiri dari sesi berupa pre-tes, penyampaian materi oleh para ahli (dokter kandungan dan ginekolog), post-test, dan sesi tanya jawab. Terdapat peningkatan pengetahuan bidan tentang diagnosis dan tata laksana awal kasus preeklamsia melalui seminar ini yang dinilai melalui peningkatan skor pada saat pre-tes ke post-tes.