Background: Cervical cancer ranks fourth of all cancers in women worldwide and linked to human papillomavirus (HPV) infection. Despite the evidence of methods for cervical cancer prevention, such as pap smear test and HPV vaccination, most of the women remain unscreened and never get HPV vaccination. Most cervical cancer cases are not diagnosed early enough, leading to poor outcomes. This study aims to examine the association of risk factors with cervical cancer incidence in Dr. Soetomo Hospital Surabaya and also records the patients’ knowledge of cervical cancer preventions, history of HPV vaccination, and pap smear screening test.Methods: This is a case-control study. Questionnaires were given to 60 newly diagnosed cervical cancer patients and 60 non-cervical cancer patients at The Gynecologic-Oncology Clinic of Dr. Soetomo Hospital Surabaya in the period of March 2016 until August 2016. The analysis was made using bivariate and multivariate logistic regression analysis.Results: The bivariate logistic regression analysis confirmed that parity more than two times (p=0.001), history of birth control pills consumption more than 10 years (p=0.04), passive smoking (p=0.001) and not knowing that cervical cancer can be prevented (p=0.001) were significantly associated to the incidence of cervical cancer. The multivariate logistic regression analysis confirmed that not knowing that cervical cancer can be prevented (OR=6.85), the history of passive smoking (OR=4.04), parity more than two times (OR=2.89) and history of birth control pills consumption more than 10 years (OR=6.52) were the independent factors that were associated with the cervical cancer incidence.Conclusions: Parity more than two times, history of birth control pills consumption more than 10 years, history of passive smoking, not knowing that cervical cancer can be prevented and never having a pap smear test were the factors associated with cervical cancer incidence.

ABSTRAK Objectives: To report one malignant Brenner tumor (MBT) case in Dr. Soetomo Hospital, Surabaya, Indonesia, that underwent therapy from August 2016 to August 2017. Case report: A woman aged 62 years underwent total abdominal hysterectomy and bilateral salphingo-oophorectomy surgery with histopathologic results of malignant Brenner Tumor. From immunohistochemical examination the expression of p63 was positive. The patient had been treated with Paclitaxel carboplatin chemotherapy for 5-cycles, with the results of the last postchemotherapy evaluation showing no recidive mass. Conclusion: There was only one case of malignant ovarian Brenner Tumor in Dr Soetomo Hospital, Surabaya, Indonesia, in 2014-2016. The diagnosis can only be based on anatomic pathology examination. The specific tumor markers for malignant Brenner tumors have so far not been found. Keywords: Malignant Brenner Tumor; epithelial ovarian tumor; p63. Tujuan: Melaporkan satu kasus pasien dengan tumor Brenner di RSUD Dr. Soetomo, Surabaya, Indonesia, yang menjalani terapi dari bulan Agustus 2016 hingga Agustus 2017. Laporan kasus: Seorang wanita berusia 62 tahun menjalani histerektomi abdominal total dan operasi salphingo-ooforektomi bilateral dengan hasil histopatologis Tumor Brenner ganas. Dari pemeriksaan imunohistokimia, ekspresi p63 didapatkan positif. Pasien telah dirawat dengan kemoterapi Paclitaxel carboplatin selama 5 siklus, dengan hasil evaluasi post-kemoterapi terakhir tidak menunjukkan massa residif. Simpulan: Hanya terdapat satu kasus Tumor Brenner ovarium ganas di RSUD Dr Soetomo, Surabaya, Indonesia, antara 2014-2016. Diagnosis hanya dapat didasarkan pada pemeriksaan patologi anatomi. Penanda tumor spesifik untuk tumor Brenner ganas sejauh ini belum ditemukan. Kata kunci: Tumor Brenner ganas; tumor epitel ovarium; p63

Objective: To analyze the effect of curcumin in VEGF expression on Rattus norvegicus cervical cancer cell xenograft model.Methods: An experimental study with randomized post test only control group design. The subjects were Rattus norvegicus (Sprague Dawley), inoculated with He-la cervical cancer cells from American Type Culture Collection (ATCC) processed in stem cell laboratory Institute of Tropical Disease (ITD) Airlangga University. 5x106 of He-La cells were injected subcutaneously in dorsal flank area of Rattus norvegicus. After 30 days of observation we performed histopathological examination of xenograft tissue and randomized into 2 groups which were given curcumin orally 1000 mg/kg (curcumin group) vs. no therapy (control group). After another 30 days the xenograft tissue was dissected and underwent immunochemistry examination for VEGF expression.Results: 32 samples of Rattus norvegicus were divided into 2 groups, In curcumin group the VEGF median expression was 2,2 (0,3-7,6) and in control group the VEGF median expression was 6,6 (1,2-12). There was a statistically significant difference with p value =0,009 with Mann Whitney test (p<0,05).Conclusion: VEGF expression in Rattus norvegicus xenograft model of cervical cancer was suppressed by giving Curcumin 1000 mg/kgBB orally.

Case series Patients: Female, 34-year-old • Female, 36-year-old Final Diagnosis: Leiomyoma Symptoms: Pregnancy Medication: — Clinical Procedure: Myomectomy Specialty: Obstetrics and Gynecology Objective: Unusual setting of medical care Background: No standard guidelines have been specified for a cesarean myomectomy, and several centers remain divided on the justification to perform this procedure, especially for large fibroids. Only a few case reports have been published of cesarean myomectomy for large fibroids. Here, we report 2 cases of successful cesarean myomectomies for large fibroids (>15 cm) during the 38 th week of pregnancy. Case Reports: We encountered 2 primigravida patients, aged 34 and 36 years, respectively, with large fibroids >15 cm in diameter. Using the Pfannenstiel incision, we performed cesarean myomectomies in both patients at term pregnancy. The surgeries were performed by a gynecologic oncologist in a tertiary hospital. Both patients experienced a postoperative decrease in hemoglobin but neither required a blood transfusion. Three days after the operation, the patients were discharged from the hospital in good condition. One year later, the patients and their babies continued to be in good health. The patients did not experience chronic pelvic pain or menstrual abnormalities. Neither patient is currently planning another pregnancy. Conclusions: Based on our report, it may be assumed that cesarean myomectomy for a large fibroid (even for fibroids >15 cm in diameter) is safe if performed by experts in a tertiary hospital. Further larger studies of cesarean myomectomy of large fibroids are required to confirm the safety of this procedure.

Ovarian cancer is often called as the silent killer because the symptoms appear when the stage is advanced. This study aimed to compare the identification of malignant ovarian tumor by RMI examination and abdominal pelvic CT scan to pathology examination as gold standard. This was a cross-sectional study. The data were obtained through medical records of a suspected malignant ovarian tumor patients who performed surgery at Dr. Soetomo General Hospital, Surabaya from January 2017 to December 2018. Among 64 patients, there were 56% of patients aged 41-60 years, 53% had a normal BMI, 56% multipara, and 56% not yet menopause. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CA-125 diagnostic test were 80.85%, 17.65%, 73.1%, and 25%, respectively. RMI examination had a sensitivity of 82.98% and a specificity of 41.18%. Whereas, abdominal CT scan had a sensitivity of 87.23% and a specificity of 47.1%. Examination of RMI combined with abdominal pelvic CT scan had a sensitivity and specificity of 100% and 40%, respectively. RMI examination combined with abdominal pelvic CT scan gave better results in diagnosing ovarian malignancies.

Objective: To evaluate the pattern of antibiotic use incesarean section `by obstetricians in Surabaya, Indonesia.Methods: This was a descriptive observational study witha cross-sectional method. Study data were obtained fromonline interviews using electronic forms. This study useda total sampling method taken from obstetricians andgynecologists in Surabaya, Indonesia. The primary outcomeof this study was a pattern of antibiotic use, includingprophylactic use, selection of antibiotics, the timing ofadministration, additional antibiotics during and aftersurgery, and consideration of choice.Results: The majority of antibiotics used in CS are in linewith the guidelines. The types of prophylactic antibiotics(iv) used are varied; the majority were cefazoline (74.5%),ceftriaxone (14.5%), and cefotaxime (11.6%). Most antibioticswere administered <30 minutes before surgery. 2.5% ofobstetricians routinely added antibiotics during a cesarean,while 33% were based on a particular condition such asprolonged surgery, massive bleeding, or risk of infections.The selection of antibiotics by obstetricians was based onprotocols followed in the hospital (44.5%).Conclusion: This study demonstrates that most obstetriciansutilized antibiotic prophylaxis appropriately and followedguidelines for Cesarean Section.Keywords: antibiotic, cesarean section, maternal health,obstetricians.AbstrakTujuan: Untuk mengevaluasi pola penggunaan antibiotikpada seksio sesarea oleh dokter kandungan di Surabaya,Indonesia.Metode: Ini merupakan studi deskriptif observasionaldengan metode pengambilan data potong lintang. Datastudi diperoleh dari wawancara online dengan menggunakanformulir elektronik. Studi ini menggunakan total samplingdari dokter obstetri dan ginekologi di Surabaya, Indonesia.Hasil utama dari penelitian ini adalah pola penggunaanantibiotik, termasuk penggunaan profi laksis, pemilihanantibiotik, waktu pemberian, antibiotik tambahan selamadan setelah operasi, dan pertimbangan pilihan antibiotiktersebut.Hasil: Mayoritas antibiotik yang digunakan pada seksiosesarea sesuai dengan pedoman. Jenis antibiotik profi laksis(iv) yang digunakan bervariasi, mayoritas adalah cefazoline(74,5%), ceftriaxone (14,5%), dan cefotaxime (11,6%).Sebagian besar antibiotik diberikan <30 menit sebelumoperasi. 2,5% dokter kandungan rutin menambahkanantibiotik saat operasi sesar, sedangkan 33% didasarkanpada kondisi tertentu seperti operasi yang berkepanjangan,perdarahan masif, atau risiko infeksi. Pemilihan antibiotikoleh dokter kandungan berdasarkan protokol yang diikutidi rumah sakit (44,5%).Kesimpulan: Studi ini menunjukkan bahwa sebagian besardokter kandungan menggunakan profi laksis antibiotikdengan tepat dan mengikuti pedoman untuk operasi seksiosesaria.Kata kunci: antibiotik, dokter kandungan, kesehatan ibu,operasi sesar.

Menopause is a physiological change when the menstrual period ends due to the ovaries' termination of estrogen and progesterone production. Menopausal women experience several things in their transition phase such as clinical changes. These clinical changes can directly or indirectly affect the quality of life of an individual. Sociodemographic characteristics can also have a role in menopause symptoms. This literature review aimed to see from the previous study regarding the role of sociodemographic factors on menopause symptoms and whether menopause symptoms affect the quality of life. It was found that education, economic status, and occupation play a role in menopause symptoms. It can directly or indirectly affect how an individual perceives menopause and how to cope when symptoms arise.

Objective:This study aimed to find out the clinical profile of menopause women aged 45-65 years old in Batam, Makassar, and Surabaya. Methods: This study was an observational descriptive study using total sampling. This research was obtained from primary data, which obtained from women aged 45-65 years using an instrument in the form of a questionnaire. During the data collection period from February to July 2022 with a total of 75 menopause sample. The clinical changes data collected was menopause symptoms which assessed using Menopause Rating Scale (MRS). The data analyzed using Microsoft® Excel 2021 and presented in a form of table and diagram. Result: The most prevalent symptoms experienced by the sample of menopause women in Batam, Makassar, and Surabaya were physical and mental exhaustion as much as 63 samples (84%), followed by joint and muscular discomfort as much as 61 samples (81,33%), and sexual problems with a total of 52 samples (69,33%). Conclusions: The starting age of menopause of most of the sample were 45-55 years old. Most of the sample experienced physical and mental exhaustion and they experienced mild symptoms due to sociodemographic factors. Based on this research, it was found that education plays an important role to increase the awareness of menopause women regarding the symptoms and how to cope with it. Profil Klinis Wanita Menopause di Batam, Makassar, dan Surabaya Abstrak Tujuan: Penelitian ini bertujuan untuk mengetahui profil klinis dari wanita perimenopause dan menopause berumur 45-65 tahun di Batam, Makassar, dan Surabaya. Metode: Penelitian ini merupakan penelitian deskriptif observasional dengan menggunakan total sampling. Penelitian ini diperoleh dari data primer yang diperoleh dari wanita usia 45-65 tahun dengan menggunakan kuesioner. Selama periode pengumpulan data dari Februari sampai Juli 2022, terdapat 75 sampel menopause. Data perubahan klinis yang digunakan adalah gejala menopause yang dinilai menggunakan Menopause Rating Scale (MRS). Data dianalisis menggunakan Microsoft® Excel 2021 dan disajikan dalam bentuk tabel dan diagram. Hasil: Gejala yang paling banyak dialami sampel wanita menopause di Batam, Makassar, dan Surabaya adalah kelelahan fisik dan mental sebanyak 63 sampel (84%), diikuti ketidaknyamanan sendi dan otot sebanyak 61 sampel (81,33%), dan masalah seksual sebanyak 52 (69,33%) sampel. Kesimpulan: Usia dimulainya menopause pada sebagian besar sampel adalah 45-55 tahun. Sebagian besar sampel mengalami gejala kelelahan fisik dan mental dan gejala yang dialami ringan karena faktor sosiodemografi. Berdasarkan penelitian ini ditemukan bahwa pendidikan berperan penting dalam meningkatkan kesadaran wanita menopause terkait gejala yang muncul dan cara mengatasinya. Kata kunci: Menopause, Kualitas hidup menopause, Skala Penilaian Menopause, Gejala menopause, Perimenopause