Purpose: The ultimate goal of cytoreduction surgery is the complete removal of all visible tumors (complete cytoreductive surgery) or tumor residues <1 cm (optimal cytoreduction surgery). Following cytoreduction surgery in ovarian cancer, tumor residue is one of the most important prognostic factors. Oncologists strive to be able to predict the outcome of cytoreduction surgery during the presurgical period. The purpose of this study was to assess CCL5 as a modality for determining whether a patient could perform optimal cytoreduction surgery or not. Materials and Methods: This was an observational, analytic, and cross-sectional study of patients with ovarian cancer who underwent surgery at the Dr. Hasan Sadikin Bandung from 2019 to 2020. All of the patients had stage I-IV disease based on the International Federation of Gynecology and Obstetrics (FIGO) score. Results: In total, 72 patients were enrolled in this study, 31 of whom underwent suboptimal cytoreduction surgery and 41 underwent optimal cytoreduction surgery. The mean serum CCL5 level at suboptimal cytoreduction was 70,920.87 ± 36,362.966, while that at optimal cytoreduction was 43,244.95 ± 21,983.887. CCL5, as a predictor of suboptimal cytoreduction surgery, had a sensitivity of 61.3%, a specificity of 68.3%, and an accuracy of 65.7% (p = 0.012). Conclusion: Preoperative CCL5 serum levels can predict suboptimal cytoreduction surgery outcomes in patients with ovarian cancer.
Case presentation A case of a 57 years old woman came with the chief complaint of urinary incontinence since 20 years ago. After labor, she complained of urinary incontinence and left untreated. Physical examination and urethrocystoscopy revealed vaginal stone sized 90 × 70 mm and urethrovaginal fistula. We performed hysterectomy and vaginal stone removal, continued with fistula closure and vaginal repair. Up to 2 months follow up, no sign of urinary leakage and incontinence was found. Conclusion Vaginal stone is a rare Case that might be present in a case of long term urethrovaginal fistula with neglected contraceptive device.
Patient: Female, 19-year-old Final Diagnosis: Gestational thropoblastic neoplasia Symptoms: Bleeding Medication:— Clinical Procedure: Curettage Specialty: Obstetrics and Gynecology • Oncology Objective: Rare disease Background: Gestational trophoblastic disease (GTD) encompasses a group of disorders that arise from abnormal growth of trophoblastic tissue. The spectrum of GTD includes 2 major groups: benign and malignant. The benign form is a hydatidiform mole, either complete or partial; the malignant forms, referred to as gestational trophoblastic neoplasia (GTN), consist of invasive moles, choriocarcinomas, placental site trophoblastic tumors, and epithelioid trophoblastic tumors. Most patients who undergo evacuation of a hydatidiform mole by curettage have a disease-free period before a new tumor develops that can be considered malignant. In rare cases, metastasis occurs rapidly and manifests coincidentally before the hydatidiform mole can be evacuated. Case Report: A 19-year-old woman in Bandung City, West Java, Indonesia, was diagnosed with a molar pregnancy with early evidence of a mass in her vagina that was suspicious for stage II GTN. The early emergence of a vaginal mass was a rare case of early transformation of a molar pregnancy into GTN. Conclusions: Careful evaluation is warranted of patients with characteristics typical of an intrauterine molar pregnancy who have an early presentation of a vaginal mass because of the possibility that the diagnosis could be GTN.
Introduction Preeclampsia is a syndrome that occurs in pregnancy, characterized by hypertension, proteinuria and edema. Zinc and copper are micronutrients that play a role in the performance of several important enzymes in the human body, such as CuZnSOD and ACE2 enzymes that play a role in the pathogenesis of severe preeclampsia. Zinc also plays a role in the kallikrein-kinin system in the formation of bradykinin which then acts as a vasodilator. This study plans to compare the level of copper (Cu), Zink (Zn), and Cu/Zn ratio in preeclamtic and normal pregnancy women. Method The study recruited 30 pregnant women with severe preeclampsia who were treated at Dr. Hasan Sadikin Bandung and 30 normal pregnant women at one of the Independent Practice Midwives in the Cibabat area, which was conducted in the period September 2021 - November 2021. This research was an analytical observational study with a cross sectional study design. Cu and Zn levels were examined using inductively coupleds plasma mass spectrometry (ICP-MS). Chi Square, student’s t test, Mann Whitney and multivariat analysis were used for statistical analysis. Results The results of this study showed that the average Cu levels were higher in severe preeclampsia (mean: 2.149 vs. 2.116 mol/L, p=0.728). The median Zn level in the subjects with severe preeclampsia was higher than in normal pregnancies (58 vs 49 g/dL, p<0.001). The median Cu/Zn ratio in severe preeclampsia subjects was lower than in normal pregnancies (0.034 vs 0.063 g/dL, p=0.021). Conclusion Zn levels was significantly increased in the preeclampsia group, Cu levels was not significantly increased in the preeclampsia group and the ratio of Cu/Zn levels was significantly decreased in preeclampsia group compared to normal pregnancies.
Objective:The modality to detect ovarian cancer at an early stage is very limited. Early diagnosis determines the prognosis. This study aimed to develop a risk assessment tool for early detection of ovarian cancer using artificial intelligence. To accomplish this, the presence of ten signs and symptoms reported by patients with ovarian cancer was assessed. Methods: This study was carried out as a cohort study of patients diagnosed with suspected ovarian tumors undergoing cytoreduction operation at Hasan Sadikin Hospital, Bandung, from December 2019 to September 2020. Compared to ovarian cancer self-assessment through questionnaire, postoperative histopathology in patients with suspected ovarian tumors. The questionnaire proceeded by artificial intelligence is grouped into risk and no risk. Statistical analyses were done using Chi-Square and Exact Fisher Test. Result: In total, 115 patients included in this study. The differences were statistically significant in terms of the six variables (abdominal bloating, nausea/vomiting, decreased of appetite, fullness, menstrual disturbance, and weight loss) ovarian cancer self-assessment compared to postoperative histopathology with a tendency towards benign ovarian tumors (p<0.05), while there was no statistically significant difference in the four variables (abdominal enlargement, abdominal pain, urinating disturbance, and defecation disturbance) (p>0.05). According to the artificial intelligence grouping, fifty-five patients were at risk, and sixty patients were not at risk. The Fifty-five risk patients were related with postoperative histopathology diagnosis (with RR 0.682 and CI 95% 0.519-0.895). Conclusion: Risk assessments based on ovarian cancer self-assessment unfortunately were not comparable to postoperative histopathology as a single predictor. Ten variables in ovarian cancer artificial intelligence self-assessment for early detection needs improvement in adding another variable like tumor marker and ultrasonography assessment.
Tujuan: Pandemi COVID-19 memengaruhi semua bidang termasuk operasi karena sekitar 19% kematian akibat COVID-19 berhubungan dengan operasi elektif. Studi ini bertujuan untuk melihat pengaruh pandemi COVID-19 terhadap operasi elektif obstetri dan ginekologi (Obgin) di RSUP Dr. Hasan Sadikin (RSHS) Bandung, Indonesia. Metode: Studi ini menyajikan data retrospektif operasi elektif Obgin di RSHS selama dua tahun (Januari 2020 - Desember 2021) kemudian dilakukan analisis. Hasil: Angka pembatalan operasi tahun 2020 adalah 20 (3,6%) dari 561 jadwal operasi: 7 (1,3%) akibat COVID-19 dan 13 (2,3%) penyebab lainnya. Pembatalan operasi tahun 2021 sebanyak 48 (6,5%) dari 737 jadwal operasi: 35 (4,8%) akibat COVID-19 dan 13 (1,7%) penyebab lainnya. Penggunaan ruang rawat intensif (ICU) tahun 2020 (14/541) memiliki angka lebih rendah dibandingkan dengan tahun 2021 (7/689). Tidak ada penjadwalan operasi pada bulan April tahun 2020. Jumlah pembatalan operasi terbanyak terjadi pada periode Mei-Agustus 2021. Pasien yang terdiagnosis COVID-19 dengan komorbid cenderung memiliki nilai CT (cycle threshold) value lebih rendah dan penjadwalan ulang operasi lebih lama. Mortalitas terjadi pada pasien komorbid. Kesimpulan: Jumlah operasi elektif Obgin di RSHS tahun 2021 lebih banyak dibandingkan tahun 2020 meskipun lebih banyak jumlah pembatalan operasi akibat COVID-19. Penggunaan ruang intensif pasca operasi menurun pada tahun 2021. Rekomendasi prioritas operasi dibagi menjadi empat kelompok utama. Edukasi dan konseling mengenai risiko penundaan operasi dibandingkan risiko peningkatan mortalitas dan morbiditas perioperatif akibat COVID-19 perlu disampaikan. Impact Of Covid-19 Pandemic on the Implementation of Elective Obstetrics And Gynecologic Surgery at Dr. Hasan Sadikin Hospital in 2020-2021 Abstract Objective: The COVID-19 pandemic affects all fields, including surgery, as 19% of COVID-19 deaths correlate with elective surgery. This study aims to examine the effect of COVID-19 pandemic on obstetrics and gynecology elective surgery at Dr. Hasan Sadikin Hospital, Bandung, Indonesia. Methods: This study presented retrospective data on obstetrics and gynecologic surgery at Dr. Hasan Sadikin Hospital for two years (January 2020 - December 2021). Result: The number of surgery cancellations in 2020 was 20 (3.6%) out of 561 scheduled surgeries: 7 (1.3%) due to Covid-19 and 13 (2.3%) other causes. The surgery cancellations in 2021 was 48 (6.5%) of the 737 scheduled surgeries: 35 (4.8%) due to COVID-19 and 13 (1.7%) other causes. Use of intensive care rooms (ICU) in 2020 (14/541) was lower compared to 2021 (7/689). There was no surgery scheduled for April 2020. The highest number of surgery cancellations occurred in the period of May-August 2021. Patients diagnosed with COVID-19 and comorbidities tend to have lower CT (cycle threshold) values and longer surgery rescheduling. Mortality occurs in patients with comorbidities. Conclusion: The number of obstetrics and gynecologic surgery at Dr. Hasan Sadikin Hospital in 2021 was higher than in 2020, although the number of surgery cancellations due to COVID-19 was higher. Use of ICU after elective surgery decreased in 2021. Recommendations for elective surgeries priority during the COVID-19 pandemic were divided into four groups. Education and counseling regarding the risk of surgery delays compared to the risk of increased perioperative mortality and morbidity due to COVID-19 needed to be delivered. Key words: COVID-19, elective surgery, obstetrics, gynecology
Penelitian ini adalah untuk menganalisis peranan pemberian vaksin bacille calmette-guerin (BCG) terhadap proses regresi seluler pada lesi prakanker serviks uteri derajat rendah Metode: Penelitian ini merupakan penelitian eksperimental dengan rancangan pretest (IVA dan Histopatologi)-posttest (IVA dan Test HPV DNA) with control design di Poliklinik Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Desember 2017-Maret 2018. Hasil: Untuk pemeriksaan IVA bulan ke-0 pada kelompok BCG kategori positif sebanyak 9 (100.0%) sedangkan untuk pemeriksaan IVA bulan ke-3 pada kelompok BCG kategori positif sebanyak 3 (33.3%) dan negatif menjadi sebanyak 6 (66.7%), pemeriksaan tes HPV DNA bulan ke 12 pada kelompok BCG kategori positif HPV DNA High Risk tidak ditemukan (0 %). Hasil uji statistik pada kelompok perlakuan diperoleh nilai p<0.05. Untuk pemeriksaan IVA bulan ke-0 pada kelompok plasebo kategori positif sebanyak 9 (100.0%) sedangkan untuk pemeriksaan IVA bulan ke-3 pada kelompok plasebo kategori positif sebanyak 8 (88.9%) dan negatif menjadi sebanyak 1 (11.1%). pemeriksaan tes HPV DNA bulan ke 12 kelompok BCG kategori positif HPV DNA High Risk sebanyak 1 orang (11,1%). Hasil uji statistik pada kelompok kontrol diperoleh informasi nilai p>0.05. Kesimpulan: Terdapat peranan pemberian vaksin BCG terhadap regresi seluler lesi prakanker serviks derajat rendah. Kata Kunci: Vaksin BCG, pemeriksaan IVA, tes HPV DNA, lesi prakanker serviks derajat rendah. The effect of Bacille Calmette-Guerin vaccine on regression of cervical intraepithelial neoplasia-1
Background Preeclampsia involves an inflammatory response and vascular endothelial dysfunction. In COVID-19, there is also tissue damage and an inflammatory response that stimulates the formation of D-dimers and an increase in the neutrophil-to-lymphocyte ratio (NLR). These 2 parameters have become laboratory tests carried out both in preeclampsia and COVID-19. This study aimed to determine the relationship between D-dimer levels and NLR in patients with both COVID-19 and preeclampsia. Material/Methods This was an observational analytic study with a retrospective approach. The subjects were pregnant women with gestational age >20 weeks diagnosed with severe preeclampsia and had D-dimer and neutrophil-to-lymphocyte ratio (NLR) laboratory results at Hasan Sadikin Hospital Bandung during the period April 2020 to July 2021. We enrolled 31 COVID-19 patients with preeclampsia and 113 COVID-19 patients without preeclampsia. Results The mean level of D-dimer in COVID-19 patients with preeclampsia was 3.66±3.15 and in those with COVID-19 without preeclampsia it was 3.03±3.15 ( P <0.05). The mean NLR value in COVID-19 patients with preeclampsia was 7.22±4.30 and in COVID-19 patients without preeclampsia it was 5.47±2.20 (p<0.05). In the Spearman correlation test, the correlation coefficient was 0.159. Area under curve (AUC) D-dimer level was 64.9% (p<0.05) and NLR was 61.7% (p<0.05). Conclusions There was a significant difference ( P <0.05) in D-dimer and NLR between COVID-19 patients with preeclampsia and those without preeclampsia. There was also a weak positive relationship between D-dimer and NLR levels in COVID-19 patients with preeclampsia, which means that the higher the D-dimer level, the higher the NLR value in COVID-19 patients with preeclampsia.
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