Program prolanis adalah program yang bertujuan untuk pemeliharaan kesehatan bagi peserta BPJS kesehatan yang menderita penyakit kronik. Puskesmas Sidodadi Bengkulu Tengah sebelumnya telah menjalankan program ini, namun dalam pelaksanaannya masih belum optimal dikarenakan banyaknya peserta yang tidak rutin berkunjung dan memeriksakan kesehatannya. Jumlah lansia dengan penyakit kronik diantaranya DM dan Hipertensi di Puskesmas Sidodadi Bengkulu Tengah terdata masih tinggi. Oleh karena itu untuk mengoptimalkan program prolanis di Puskesmas Sidodadi Bengkulu Tengah diadakan pengabdian masyarakat. Pengabdian masyarakat ini bertujuan untuk menjalankan program prolanis pada pasien lansia dengan DM dan hipertensi melalui edukasi dan pemeriksaan kesehatan agar pasien dapat mencapai kualitas hidup yang lebih optimal. Metode yang digunakan pada pengabdian ini adalah edukasi melalui penyuluhan dan pemeriksaan kesehatan yang difokuskan pada lansia. Penyuluhan yang dilakukan pada pasien lansia dengan penyakit kronik DM dan hipertensi berjalan dengan baik dan materi yang disampaikan mudah dipahami oleh peserta. Hasil pemeriksaan kesehatan terhadap 60 peserta diketahui 40% lansia menderita DM, 60% lansia menderita hipertensi, dan 50% peserta mendapatkan pengobatan akibat keluhan penyakit. Untuk mendukung terlaksananya program prolanis di Puskesmas Sidodadi Bengkulu Tengah diharapkan program prolanis melalui edukasi dan pemeriksaan kesehatan rutin ini dapat terus dilanjutkan dan ditingkatkan sehingga para peserta dapat terus mengontrol perkembangan penyakit setiap bulannya dan mendapatkan pengetahuan untuk menerapkan pola hidup yang sehat.
Study question It has been established that radiotherapy can increase the risk of adverse pregnancy outcomes. However, there is currently no consensus on the effective sterilizing dose for adulthood uterine radiotherapy. Summary answer Uterine fertility preservation methods should be guided by the age of the patient receiving radiotherapy and the actual dose of radiation exposure to the uterus. What is known already Many experts have suggested that a high dose of radiation to the uterus is a reason to counsel patients against future pregnancy. There are major limitations to the current literature regarding off-target radiation damage to the uterus. One study reported a relative risk of 9.1 for stillbirth and neonatal death after 10 Gy doses. Study design, size, duration Case report and review of the literature before December 2020 Participants/materials, setting, methods A case report of a 36-year-old female with three cancers and received repeated high-dose radiotherapy of 66 Gy and 50 Gy to the pelvis. We used a dose-volume histogram, the most widely used tool to calculate the radiation distribution within a volume of interest of the patient during radiotherapy. We determined that her uterus may have received the highest uterine radiation dosage for full-term live birth in current literature. Main results and the role of chance Due to iatrogenic ovarian failure, she could only use donor eggs. After endometrium preparation for 18 days, the endometrium reached 8.7 mm with a triple-line appearance. We transferred two cleavage-staged embryos and one of them implanted successfully. The course of the pregnancy was uneventful. Finally, the patient gave birth to a healthy baby via Cesarean section at 38 5/7 weeks of gestation. Limitations, reasons for caution It should be noted that the success of our case may not apply to all patients with cancer after they have received RT. We should inform patients about the increased risk of preterm birth, low birth weight infants, uterine rupture, and neonatal death. Wider implications of the findings: The patient’s age and the dose of RT exposure to the uterus are important factors for the prognosis of a future pregnancy. More well-designed studies will be needed to allow future standard guidelines for uterine fertility preservation. Trial registration number TMU-JIRB N20204149
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