Supriyadi Hari Respati
Bagian Obgin FK UNS/ RSUD Dr. Moewardi, Jl. Kol. Sutarto 132 Surakarta
Articles
20
Documents
The Effect of Neoadjuvant Chemotherapy on HIF-1α Expression in Cervical Uterine Cancer

Indonesian Journal of Medicine Vol 3, No 2 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Uterine cervical cancer is one of the main causes of female death related to cancer. Neoadjuvant chemotherapy aims to reduce tumor mass to allow radical surgery. HIF-1α is thought to have a key role in the development of cancer and the main target for chemoprevention.Objective: This study aims to prove the effect of neoadjuvant chemotherapy on HIF-1α expression in uterine cervical cancer as an assessment parameter for chemotherapy response. Subjects and methods: The study was carried out in the Department of Obstetrics and Gynecology and the Pathology Department of Anatomy Dr. Moewardi - Faculty of Medicine, Sebelas Maret University, Surakarta. Thirty (30) cervical cancer samples that met the inclusion and exclusion criteria were examined for HIF-1α expression before and after giving 3 times neoadjuvant chemotherapy. Examination using immunohistochemical methods. Data analysis using t-test.Results: Mean HIF-1α expression before administration of neoadjuvant chemotherapy 5.10± 1.174 cell/field, after administration of neoadjuvant chemotherapy 4.00±1.174 cell/field with p=0.001.Conclusion: Neoadjuvant chemotherapy has an effect on reducing HIF-1α expression in uterine cervical cancer.Keywords: neoadjuvant chemotherapy, HIF-1α, uterine cervical cancerCorrespondence: Sri Sulistyowati. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret. Mobile: 08122968215. email: elis_spog@yahoo.co.id Indonesian Journal of Medicine (2018), 3(2): 119-124https://doi.org/10.26911/theijmed.2018.03.02.08

Korioamnionitis Sebagai Faktor Risiko Terjadinya Persalinan Preterm

Nexus Kedokteran Klinik Vol 2, No 1 (2013): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Background: Premature Rupture of Membranes (PROM) is one causes of fetal mortality and morbidity. Suspected chorioamnionitis is a major cause of preterm labor. Methods: This study was observational analytic cross-sectional approach. Sample of 694 study subjects that satisfy with inclusion and exclusion criteria were taken from the medical records of patients who gave birth in RSUD Dr. Moewardi. The data was analyzed using bivariate analysis and processed with Statistical Product and Service Solutions (SPSS) for Windows 20:00. Results: Chorioamnionitis is a risk factor 1.045 times to preterm delivery occur (OR = 1045; CI = 95%, 0737, 1483, p = 0804). Chorioamnionitis caused  death of neonatal mortality 1.554 times compared with norma pregnancy (OR = 1554; CI = 95%, 0790, 3057, p = 0.194). Chorioamnionitis 1.747 times risk factors for occur asphyxia in preterm labor and statistically significant (OR = 1747; CI = 95%, 1114, 2741, p = 0.014). Conclusions: There was no significant relationship between chorioamnionitis with preterm labor and chorioamnionitis with neonatal mortality. There is a significant relationship between chorioamnionitis with asphyxia. Keywords: PROM, Chorioamnionitis, preterm labor

Kadar Heat Shock Protein 70 pada Persalinan Prematur

Jurnal Kedokteran Brawijaya Vol 28, No 4 (2015)
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

Persalinan preterm merupakan masalah kesehatan bagi negara maju maupun berkembang, berperan besar peningkatan morbiditas dan mortalitas neonatus, serta sering berdampak kesehatan jangka panjang seperti celebral palsy, kebutaan, dan perkembangan psikomotorik. Menganalisis apakah terdapat perbedaan serta hubungan antara kadar HSP70 persalinan preterm dibandingkan kehamilan normal. Observasional analitik dengan rancangan potong lintang. Jumlah subyek penelitian 60 ibu hamil dibagi dua kelompok, persalinan preterm 30 ibu hamil dan kelompok kehamilan normal 30 ibu hamil. Pemeriksaan HSP70 dilakukan di laboratorium klinik Prodia. Analisa statistik dengan uji Chi-kuadrat. Berdasarkan karakteristik ibu pada kedua kelompok penelitian, pendidikan dan LILA (Lingkar Lengan Atas) berpengaruh terhadap kejadian persalinan preterm (Probability (p)=0,008 dan p=0,002). Ibu berpendidikan SD mengalami persalinan preterm sebanyak 6,6 kali lebih besar (Prevalence Ratio (PR)=6,682 dan p=0,029), sedangkan berpendidikan SMP berisiko mengalami persalinan preterm sebanyak 3 kali lebih besar (PR=3,27 dan p=0,054) dibanding SMA. Ibu berLILA kurang memiliki risiko persalinan preterm sebanyak 5,5 kali lebih besar dibanding ibu berLILA normal (PR=5,5). Ibu berkadar HSP70 yang tinggi berisiko mengalami persalinan preterm sebanyak 5,2 kali lebih besar dibanding kehamilan normal (PR=5,26 dan p=0,122). Ada perbedaan dan hubungan  antara kadar Heat Shock Protein 70 persalinan preterm dibandingkan kehamilan normal, namun didapatkan kesimpulan statistik yang tidak bermakna. LILA dan pendidikan berpengaruh bermakna terhadap kejadian persalinan preterm.Kata Kunci: Distres maternal, heat shock protein 70, persalinan preterm, lingkar lengan atas, pendidikanABSTRACT

Maternal, Obstetric, and Infant Factors and Their Associatio with the Risk of HIV Infection in Infants at Dr. Moewardi Hospital, Surakarta

Journal of Maternal and Child Health Vol 1, No 2 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Incidence of HIV infection by mother to child transmission has been increasing for the past few years. This study aimed to determine the association between maternal, obstetric, infant factors, and the risk of HIV infection in infant.Subjects and Method: This was an analytic observational study using case control design. This study was conducted at Dr. Moewardi Hospital, Surakarta. A total of 68 study subjects, consisting of 34 HIV infected infants, and 34 non HIV infected infants, were selected for this study by fixed disease sampling. The dependent variable was HIV infection. The independent variable included maternal nutrirional status, opportunistic infection, antenatal care, type of labor, birth weight, and prematurity. The data were collected by a set of questionnaire and analyzed using logistic regression model.Results: Maternal HIV opportunistic infection (OR= 10.09; 95% CI= 1.99 to 51.20; p=0.005) and pervaginam labor (OR=5.21; 95% CI=0.92 to 29.58; p=0.063) increase the risk of HIV infection in infant, and they were statistically significant. Maternal body weight (BMI<18.5)(OR=2.71; 95% CI=0.44 to 16.53; p=0.280), antenatal care <4 times (OR=1.94; 95% CI= 0.42 to 9.00; p=0.395), birth weight <2.500 gram (OR=1.09; 95%CI=0.19 to 6.05;p=0.924) and prematurity (OR= 1.65; 95% CI=0.36 to 7.61; p=0.523), each increased the risk of HIV infection but statistically non-significant.Conclusion: Maternal HIV opportunistic infection and pervaginam labor are strong and significant predictors for the risk of infant HIV infection. Health personnel should pay special attention on these significant risk factors when assisting birth delivery, in order to prevent HIV infection in infants.Keywords: maternal, obstetric, infant risk factors, HIV infection.Correspondences: Deni Nur Fauzia Rahmawati. Masters of Public  Health Program, Sebelas Maret University. Email: denierahmawati@gmail.comJournal Maternal  and Child Health (2016), 1(2): 73-82https://doi.org/10.26911/thejmch.2016.01.02.02

EXPRESSION OF HUMAN LEUKOCYTE ANTIGEN-E AND NATURAL KILLER CELLS IN INTRA UTERINE FETAL DEATH

Folia Medica Indonesiana Vol 53, No 4 (2017): December 2017
Publisher : Faculty of Medicine, Universitas Airlangga

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Abstract

Intra Uterine Fetal Death (IUFD) is one contributor to infant mortality. Human Leukocyte Antigen-E (HLA-E) and Natural Killer Cells (NK cells) are believed to play an important role towards IUFD associated with immune maladaptation. This study aimed to determine the expression of HLA-E and NK cells on trophoblast on IUFD and normal pregnancy. The study used cross sectional approach undertaken at Department of Obstetrics and Gynecology, Dr. Moewardi Hospital, Surakarta, networking hospitals, and Anatomic Pathology Laboratory of Faculty of Medicine, Sebelas Maret University. The number of samples were 32 subjects consisting of 16 subjects with normal pregnancy and 16 subjects with IUFD. The expression of HLA-E and NK cells on trophoblast of subjects who met the inclusion and exclusion criteria were examined using immunohistochemistry method and t-test statistical analysis. The mean value of HLA-E expression in the trophoblast of IUFD group was 17.30±6.69, in normal pregnancy was 57.06±32.04, with p=0.00 (p<0.05). The mean value of NK cell expression in trophoblast in IUFD group was 78.62±36.43, in normal pregnancy was 19.87±6.43, with p=0.00 (p<0.05). This study concluded that the expression of HLA-E was lower and NK cells wass higher in IUFD compared to those in normal pregnancy.

THE IMPACTS OF STIMULATION IN PROTRACTED LABOR TO CORTISOL LEVELS AND INCIDENCE OF POST-PARTUM BLUES

Folia Medica Indonesiana Vol 53, No 1 (2017): JANUARY - MARCH 2017
Publisher : Faculty of Medicine, Universitas Airlangga

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Abstract

Delivery, induction, stimulation, cesarean section with the aid of a vacuum extraction, for example, can reduce maternal confidence on the smooth delivery process, as well as improve postpartum stress. These stressors stimulate the HPA axis (hypothalamus-pituitary-adrenal), so that the adrenal cortex produces more cortisol hormone, it can increase postpartum blues. The objective of this study was to analyze the effect of delivery stimulation on protracted labor on cortisol levels and the occurrence of postpartum baby blues. This was an experimental study of non-randomized post-test control group. The subject of the study 30 patients in labor taken consecutive sampling, divided into 2 groups (normal delivery and stimulation) each group consist of 15 patients. In stimulation delivery group, it is examined of cortisol serum levels after five days and then continued for postpartum blues occurrence measurement. Statistical analysis using t-test for differences in levels of cortisol and chi square for analyzing the effect on the occurrence of post-partum blues (a=0.05). Mean  level of cortisol in delivery stimulation group is 40.29 ± 5.58, in normal delivery is 33.59 ± 11.17, with p=0.047, meaning there are significant differences both study groups. Stimulation delivery increases the occurrence of post-partum blues 5.50 times compared to normal delivery (OR=5.50 and p=0.028). Mean cortisol levels on post-partum blues higher at 42.90 ± 6.97 compared to no post-partum blues 30.14 ± 6.66, p=0:00, which means there are significant differences both groups. In conclusion, there was significant relationship between stimulation in protrated labor that increases cortisol serum level and post partum blues incidence.

EFFECT OF COGNITIVE BEHAVIORAL THERAPY FOR SEROTONIN LEVEL, DEPRESSION SCORE AND QUALITY OF LIFE IN CERVICAL CANCER PATIENTS

Folia Medica Indonesiana Vol 52, No 3 (2016): JULY - SEPTEMBER 2016
Publisher : Faculty of Medicine, Universitas Airlangga

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Abstract

Cervical cancer is the most common cause of death among gynaecological neoplasms. Management of advanced cervical cancer currently has not been able to improve the prognosis. Standard intervention therapy, chemotherapy and radiotherapy, as well as the emerging pain could lead to psychological stress till depression, thus reduce patients’ quality of life. CBT for psychological stress and depression is expected to improve the fruitfulness of standard therapy. Serotonin is a neurotransmitter which plays a role in the patophysiology of depression. The aim of this study is to analyze the effect of cognitive behavioral therapy on serotonin level, depression score and quality of life in advanced cervical cancer patient with experimental quasi pre and post test design methods. The samples are 15 subjects in both intervention and control groups. Intervention group was given CBT and standard therapy, while control group was given standard therapy only. Study was held in Department of Obstetric and Gynecologic Dr. Moewardi Hospital Surakarta and Prodia Laboratory, in January to March 2015. Independent variable was advanced cervical cancer patients underwent CBT intervention and dependent variables were serotonin level, depression score and quality of life score. The result, serotonin level and quality of life scores were higher after intervention compared with control, (219.43±33,42 vs 89.57±23.23) and (85.13±14.62 vs 41.86±7.24), respectively. Depression score was lower after intervention than without CBT intervention (11.20±4.94 vs 17.00±4.86) and statistically significant (p < 0.05). So, there were effects of cognitive behavioural therapy on serotonin level, depression score and quality of life score in cervical cancer patients and were statistically significant.

THE EFFECT OF REALITY THERAPY ON THE SEROTONIN LEVEL AND DEPRESSION SCORE IN CERVICAL CANCER PATIENTS

Nusantara Medical Science Journal Volume 2 No. 1 Januari - Juni 2017
Publisher : Fakultas Kedokteran Universitas Hasanuddin

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Abstract

ABSTRACT Introduction: Cervical cancer is cancer occurring in the cervix uteri, which is mostly caused by an  infection by human papillomavirus (HPV). Women  diagnosed with advanced cervical cancer suffer emotional stress that can  lead to depression. This condition causes decreasing quality of life, decreasing level of serotonin, and an increase in depression score. Giving reality therapy to patients is expected to have  positive effects. Methods: The  research was con- ducted through  an experiment with pre-test and post-test design. The research samples were15 subjects taken through consecutive sampling from the Polyclinic of Obstetrics and Gynecol- ogy of Dr. Moewardi Hospital Surakarta starting in March 2015. The analysis of serotonin level was conducted in Prodia Laboratory. The experimental data  was analyzed using a t-test (α =0.05).  Results: The average level of serotonin of the research subjects after receiving reality therapy was higher (223.59 + 41.20)  compared to that  before the  therapy (82.77  + 27.02). From  the t-test analysis with p = 0.00,  it was found that  the  average depression score after receiving  reality therapy is lower (11:40  + 4.80)  compared that  before the  therapy (17:33  +5:52).  Conclusion: There  was a significant increase in the  serotonin level and  a significant decrease in the  depression score as the  effect  of reality  therapy given  to patients with ad- vanced cervical cancer. Keywords: Serotonin, depression score, reality therapy, advanced cervical cancer 

Recombinant vascular endothelial growth factor 121 decreases vascular cell adhesion molecule-1 in murine pre-eclampsia model placenta

Universa Medicina Vol 35, No 3 (2016)
Publisher : Faculty of Medicine, Trisakti University

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Abstract

BackgroundPreeclampsia is one of the major contributors to maternal and fetal morbidity and mortality. Imbalance of soluble Fms-like tyrosine kinase (sFlt-1) as anti-angiogenic factor and vascular endothelial growth factor (VEGF) as pro-angiogenic factor plays a role in the pathogenesis of preeclampsia. Endothelial dysfunction in preeclampsia causes vascular cell adhesion molecule-1 (VCAM-1) to be expressed on its surface. This study aims to evaluate the effect of recombinant VEGF-121 on VCAM-1 expression in the placenta of a murine preeclampsia model. Methods An experimental analytical study conducted from February until March 2016 in the Biomedical Laboratory, Faculty of Veterinary Medicine, Airlangga University. The study sample consisted of 30 pregnant mice, divided into three groups, i.e. 10 normal pregnant mice, 10 mice with preeclampsia model and 10 mice with preeclampsia model and recombinant VEGF-121 therapy. All animals were subjected to immunohistochemical examination of VCAM-1 expression in their placentas. The results were assessed semiquantitatively according to a modified Remmele method. Data analysis was done using one-way ANOVA and Tukey’s multiple comparisons method. ResultsMean VCAM-1 expression in normal (0.97 ± 0.54%) murine placentas, compared with placentas (2.94 ± 0.96%) of murine preeclampsia models (p=0.000), while mean VCAM-1 expression in placentas of murine preeclampsia models with VEGF intervention was 2.14 ± 0.68% (p=0.030).Conclusion Recombinant VEGF-121 can reduce VCAM-1 expression in placentas of murine preeclampsia models. The present study has shown the potential benefits of VEGF therapy, justifying serious consideration of this therapeutic approach for use in women with preeclampsia.

Peran Magnesium Sulfat dalam Menurunkan Kadar TNF-α dan IL-1β pada Bayi Prematur

Jurnal Kedokteran Brawijaya Vol 29, No. 4 (2017)
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

Prematuritas menyebabkan mortalitas dan morbiditas neonatus yaitu cerebral palsy (CP), gangguan kognitif dan gangguan tingkah laku. Sitokin proinflamasi TNF-α dan IL-1β diduga secara signifikan meningkat pada bayi prematur. Magnesium sulfat (MgSO4) diduga dapat sebagai neuroprotektor terhadap otak janin, melindungi jaringan terhadap aktivitas radikal bebas, sebagai vasodilator dari vasculature otak dan menurunkan sitokin proinflamasi. Penelitian ini bertujuan untuk mengetahui peran MgSO4 terhadap kadar TNF-α dan IL-1β pada bayi prematur, menggunakan metode observasional analitik, cross sectional yang dilakukan pada bulan Januari-Desember 2015 di RSUD Dr. Moewardi Surakarta dan laboratorium Prodia Jakarta. Subjek penelitian berjumlah 40 yang memenuhi kriteria inklusi dan eksklusi dibagi menjadi 2 kelompok yaitu 20 subjek kelompok persalinan prematur yang mendapat MgSO4 dan 20 subjek kelompok persalinan prematur tidak mendapat MgSO4. Semua subjek dilakukan pemeriksaan kadar TNF-α dan IL-1β pada serum dari darah tali pusat bayi pada saat lahir dengan menggunakan metode ELISA. Data dianalisis menggunakan uji t. Rerata kadar serum TNF-α pada kelompok persalinan prematur yang diberikan MgSO4 (2,24±0,56ng/mL) dan rerata kadar serum TNF-α pada persalinan prematur yang tidak diberikan MgSO4 (2,80±0,85ng/mL) dengan p=0,01 (p<0,05). Rerata kadar serum IL-1β pada kelompok persalinan prematur yang diberikan MgSO4 (0,49±0,22ng/mL) dan rerata kadar serum IL-1β pada persalinan prematur yang tidak diberikan MgSO4 (0,71±0,28ng/mL) dengan p=0,01 (p<0,05). Magnesium Sulfat berperan menurunkan kadar serum TNF-α dan IL-1β pada bayi prematur.