This work provides consensus guidance regarding clinical diagnosis and early medical management of endometriosis within Asia. Clinicians with expertise in endometriosis critically evaluated available evidence on clinical diagnosis and early medical management and their applicability to current clinical practices. Clinical diagnosis should focus on symptom recognition, which can be presumed to be endometriosis without laparoscopic confirmation. Transvaginal sonography can be appropriate for diagnosing pelvic endometriosis in select patients. For early empiric treatment, management of women with clinical presentation suggestive of endometriosis should be individualized and consider presentation and therapeutic need. Medical treatment is recommended to reduce endometriosis-associated pelvic pain for patients with no immediate pregnancy desires. Hormonal treatment can be considered for pelvic pain with a clinical endometriosis diagnosis; progestins are a first-line management option for early medical treatment, with oral progestin-based therapies generally a better option compared with combined oral contraceptives because of their safety profile. Dienogest can be used long-term if needed and a larger evidence base supports dienogest use compared with gonadotropin-releasing hormone agonists (GnRHa) as first-line medical therapy. GnRHa may be considered for first-line therapy in some specific situations or as short-term therapy before dienogest and non-steroidal anti-inflammatory drugs as add-on therapy for endometriosis-associated pelvic pain.
Background: Musa balbisiana Colla, known as Jantung Pisang Klutuk/Pisang Batu, is considered as a traditional food that can increase breast milk production. Little is known about its benefit in Indonesia. Thus, to examine the impact of musa balbisiana colla on the production of breast milk is needed.Objective: This study aims to examine the effect of the extract of banana flower (Musa balbisiana Colla) to increase milk production of breastfeeding mothers.Methods: This was a quasy-experimental study with pre-posttest control group design. This study was conducted in the working area of the Health Center (Puskesmas) of Pesantren II in January – February 2017. There were 16 respondents were recruited by accidental sampling, divided to intervention group (8 respondents) and control group (8 respondents). Randomization was performed to select the respondent in each group. The quantity of milk production was measured based on the volume of milk production, while the quality of milk production was based on the levels of prolactin in early (pre) and late (post) using Electro chemilumi-nescence Immunoassay (ECLIA) method. Independent t-Test was used to analyze the data.Results: Findings showed that the mean of the volume of the breast milk production in the experiment group was 470.681 ml, and in the control group was 364.650 ml with SD 113.502. While the mean of prolactin levels in the experiment group was 35.337 nanogram, and in the control group was -38.381 nanogram. There was a significant effect of consuming Musa balbisiana Colla extract on the volume of breast milk production (p-value 0.003) and prolactin levels (p-value 0.001) (<0.05).Conclusion: There was a significant effect of banana flower (Musa balbisiana Colla) extract on breast milk production and prolactin level in breastfeeding mothers. The findings of this study could be used to be alternative daily menu for postpartum mothers and a solution for midwives to deal with those who have inadequate production of breast milk and low prolactin levels.
Approximately 38-63% of primiparous postpartum mothers experience lactation insufficiency, which has an impact on not breastfeeding their babies. The purpose of this study was to determine the characteristics and factors associated with postpartum mothers' milk production at the Public Health Center of Semarang City. This type of research is observational and cross-sectional design. The population of all postpartum women in Semarang City in October 2021, was taken by cluster random sampling at 8 selected health centers and a sample of 124 postpartum women. Methods of collecting data were questionnaires and data analysis with chi-square. The results of the research are the characteristics of mothers with an average age of 28 years, 56.5% of secondary education, 40% of primiparous parity, 59% of normal BMI, 92.7% of normal LILA, average age of the baby was 7 days, 82.3% of moderate anxiety level, 99.2% off good staff support, 58.9% of good surveillance worker support, 91.1% of good family support, 82.3% of more calorie intake of 2200 kcal, 62.1% of 1600 ml more fluid intake. There was a relationship between anxiety, family support, health volunteer support, calorie and fluid intake with breast milk production (p-value <0.05). There was no relationship between the support of health workers with postpartum mothers' milk production (p = 0.166). Mother’s psychological condition while breastfeeding, support from family, and health insurance are important things in increasing breast milk production as a continuation of breastfeeding and exclusive breastfeeding. In addition, calorie and fluid intake need to be considered to maintain the adequacy of mother's milk.
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