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"ABSTRAKTujuan: Mengetahui efektifitas dan keamanan dari AVM dibandingkan dengan kuret tajam pada penanganan abortus inkomplit di bawah usia kehamilan 12 minggu dengan melihat dari lama tindakan, proporsi tingkat kebersihan evakuasi sisa konsepsi 1 minggu pasca tindakan, proporsi gejala-gejala infeksi 1 minggu pasca tindakan dan proporsi komplikasi pada saat tindakan AVM dan kuret tajam.Metode: Penelitian ini merupakan penelitian kohort prospektif (observasional) dengan jumlahsampel 62 subjek yang berkunjung dengan abortus inkomplit ke UGD RSCM, RS Fatmawati dan RSUD Karawang terbagi dalam 31 subjek pada kelompok prosedur AVM dan 31 subjek pada kelompok prosedur kuret tajam. Data dikumpulkan melalui pencatatan waktu lama prosedur AVM dibandingkan kuret tajam, pemeriksaan klinis komplikasi selama prosedur berlangsung, pemeriksaan klinis kebersihan sisa konspesi 1 minggu pasca tindakan dan gejala-gejala infeksi 1 minggu pasca tindakan.Hasil: Sebanyak 62 subjek (masing-masing 31 subjek), dimana didapatkan rerata dan simpang baku prosedur AVM 17,65 ± 4,128 menit dan kuret tajam 22,26 ± 4,611 menit dengan p = 0,00 dan IK 95% -4,513(-6,837 s/d -2,389), bermakna secara statistik. Pada perbandingan proporsi tingkat kebersihan evakuasi sisa konsepsi 1 minggupasca tindakan didapatkan pada AVM 3,2% (n = 1) dan pada kuret tajam 6,5% (n = 2) terdapat sisa konsepsi dengan penilaian klinis, p = 0,554, RR = 1,034 dan IK95% 0,924-1,158 tidak memiliki perbedaan bermakna secara statistik. Pada perbandingan lainnya, tidak ditemukan gejala-gejala infeksi 1 minggu pasca prosedur dan komplikasi selama prosedur berlangsung pada prosedur AVM dan kuret tajam.Kesimpulan: AVM juga memiliki keunggulan dalam kebersihan sisa konsepsi namun tidak bermakna secara statitik dan memiliki keamanan yang setara dengan kuret tajam dari tingkat gejala infeksi dan komplikasi selama prosedur.

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ABSTRACTObjective: To acknowledge the effectiveness and safety of MVA compare with SC in management of incomplete abortion below 12 weeks of gestation which compare time to perform procedure, rates of evacuation and infection one week after procedure, and complication during MVA and SC procedureMethods: A prospective study with 62 subjects with complain incomplete abortion came to ER at RSCM, RS Fatmawati and RS Karawang, divided into 31 subjects on MVA group and 31 subjects on SC group. The data was documented on the time of MVA procedure compare to SC, clinical findings on complication during procedure, completed evacuation and infection symptoms one week after procedure.Results: Sixty two subjects (31 each group) with average time of procedure was 17,65 ± 4,128 minutes and SC was 22,26 ± 4,611 minutes with p = 0,00 and 95% CI; -4,513(-6,837 to -2,389 with significant statistically difference. The comparison of completed evacuation one week after procedure was 3,2% (n = 1) on MVA and 6,5% (n = 2) on SC with clinical findings, and p = 0,554, RR = 1,034 and 95% CI 0,924-1,158 with no statistically difference. On the other comparison, we didn't find any infection symptoms one week after procedure and complication during procedure on both of procedures.Conclusion: MVA has more effective than SC on the time of procedure in incomplete abortion with below 12 weeks of gestation. MVA has superiority from completed evacuation but no statistically difference and has equal safety to SC on clinical infection symptoms and complication during procedure."

"Latar Belakang: Penyebab utama gingivitis adalah akumulasi plak berisi mikroorganisme yang melekat kuat pada permukaan gigi dan tidak bisa hilang dengan dibilas. Oleh karena itu, perlu bantuan mekanis yaitu menyikat gigi dengan pasta gigi dan kimiawi yaitu berkumur dengan obat kumur untuk eliminasi plak. Penambahan bahan alami seperti propolis dalam pasta gigi dan obat kumur diharapkan efektif terhadap penyakit periodontal karena ada sifat antibakteri dan antiinflamasi. Tujuan: Menganalisis efek obat kumur dan pasta gigi propolis UI terhadap indeks plak, perdarahan papila, gingiva, dan koloni bakteri aerob dan anaerob serta membandingkannya dengan penggunaan pasta gigi dan obat kumur nonpropolis. Metode: Penelitian ini terdiri dari 18 subjek yang diinstruksikan untuk menyikat gigi dua kali sehari dan berkumur setelah sikat gigi menggunakan pasta gigi dan obat kumur yang ditentukan selama 14 hari. Pemeriksaan subjek dilakukan sebelum dan sesudah penggunaan pasta gigi dan obat kumur dengan mengevaluasi indeks plak, perdarahan papila, dan gingiva. Sampel plak diambil dari permukaan bukal gigi insisif atas sebelum dan sesudah perlakukan untuk dievaluasi kuantitas bakteri aerob dan anaerob. Data kemudian dianalisis secara statistik menggunakan uji Paired t-test, Wilcoxon, Independent T-test, atau Mann Whitney. Hasil: Terdapat perbedaan bermakna sebelum dan sesudah penggunaan obat kumur dan pasta gigi propolis terhadap indeks perdarahan papila (p = 0,007) dan jumlah bakteri anaerob (p = 0,028). Namun, tidak terdapat perbedaan bermakna terhadap indeks plak, gingiva, dan jumlah bakteri aerob (p≥0,05). Kesimpulan: Pasta gigi dan obat kumur propolis UI memiliki efek dalam mencegah dan menyembuhkan gingivitis sehingga dapat digunakan sebagai bahan aktif dalam obat kumur dan pasta gigi.Backgrounds: The main cause of gingivitis is the accumulation of plaque containing microorganisms which stays on the teeth surface and cannot be rinsed off. Therefore, mechanical cleaning like toothbrushing with toothpastes and chemical cleaning using mouthwashes are needed for plaque elimination. The addition of natural products which is propolis in toothpastes and mouthwashes is expected to have an effect towards periodontal disease because of its antibacterial and antiinflamation properties. Aim: to analyze the effect of mouthwashes and toothpastes containing propolis on plaque index (PI), papilary bleeding index (PBI), gingival index (GI), and colony of aerobic and anaerobic bacteria compare to the use of nonpropolis toothpastes and mouthwashes. Methods: Eighteen subjects were used in this study. Subjects were asked to brush their teeth twice a day and followed by gargling using propolis or nonpropolis toothpastes and mouthwashes for 14 days. The patients were examined before and after using toothpastes and mouthwashes to evaluate plaque index (PI), papilary bleeding index (PBI), and gingival index (GI). Plaque samples were collected from buccal surface upper incisors before and after using toothpastes and mouthwashes for aerobic and anaerobic bacterial counts. Data collected were analyzed statistically using Paired t-test or Wilcoxon and Independent T-test or Mann Whitney. Results: There was statistically difference between before and after in papilary bleeding index (p = 0.007) and anaerobic bacteria counts (p =0.028). Meanwhile, there were no statistically difference on plaque index, gingival index, and aerobic bacteria counts. (p≥0,05). Conclusion: The use of propolis toothpastes and mouthwashes at the same time have an effect against gingivitis so it can be used as an active property in toothpastes and mouthwashes."

"[ABSTRAK Pendahuluan Metastasis KGB pada keganasan kolorektal merupakan penentu independen faktor prognosis dan tatalaksana lanjutan Saat ini sistem baku penentuan stadium keganasan kolorektal adalah menurut sistem TNM dengan melihat jumlah KGB yang positif anak sebar Klasifikasi Jepang KJ menentukan stadium keganasan kolorektal dengan melihat distribusi metastasis KGB parakolika pararektal intermediate dan pangkal arteri mesenterika tanpa melihat jumlah KGB nya Metode Studi pendahuluan ini melakukan analisis terhadap 15 pasien keganasan sigmoid dan rektum yang menjalani pembedahan di RSCM dan RSUP Fatmawati periode September Oktober 2015 Dilakukan penilaian histopatologi terhadap spesimen tumor aspek yang dinilai adalah jumlah KGB yang positif anak sebar dan distribusi metastasis KGB Berdasarkan hasil tersebut dilakukan penentuan stadium menurut sistem TNM dan Klasifikasi Jepang serta dilakukan analisis kesesuaian Hasil dan pembahasan Didapatkan ge 12 KGB dari semua sampel Menurut sistem TNM terdapat 7 pasien stadium II 3 pasien stadium IIIb dan 5 pasien stadium IIIc sedangkan pada Klasifikasi Jepang terdapat 7 pasien stadium II 1 pasien stadium IIIa dan 7 pasien stadium IIIb Kecocokan antara kedua sistem klasifikasi dalam mendapatkan stadium II adalah 46 67 Penentuan stadium IIIa KJ dan stadium IIIa b TNM dengan kecocokan sebesar 6 7 Kecocokan sebesar 13 3 dalam menentukan stadium IIIb KJ dan stadium IIIc TNM Analisis kesesuaian terhadap kedua sistem klasifikasi didapatkan nilai Kappa sebesar 49 3 Kategori Sedang dengan P value 0 04 Kesimpulan Pada studi pendahuluan ini didapatlkan tingkat kesesuaian antara kedua sistem klasifikasi dalam menentukan stadium keganasan sigmoid dan rektum dengan kategori sedang Klasifikasi Jepang dapat dijadikan salah satu pertimbangan Diperlukan sampel yang lebih besar untuk meningkatkan akurasi tingkat kesesuaian Kata kunci metastasis KGB kolorektal sistem TNM Klasifikasi jepangPendahuluan Metastasis KGB pada keganasan kolorektal merupakan penentu independen faktor prognosis dan tatalaksana lanjutan Saat ini sistem baku penentuan stadium keganasan kolorektal adalah menurut sistem TNM dengan melihat jumlah KGB yang positif anak sebar Klasifikasi Jepang KJ menentukan stadium keganasan kolorektal dengan melihat distribusi metastasis KGB parakolika pararektal intermediate dan pangkal arteri mesenterika tanpa melihat jumlah KGB nya Metode Studi pendahuluan ini melakukan analisis terhadap 15 pasien keganasan sigmoid dan rektum yang menjalani pembedahan di RSCM dan RSUP Fatmawati periode September Oktober 2015 Dilakukan penilaian histopatologi terhadap spesimen tumor aspek yang dinilai adalah jumlah KGB yang positif anak sebar dan distribusi metastasis KGB Berdasarkan hasil tersebut dilakukan penentuan stadium menurut sistem TNM dan Klasifikasi Jepang serta dilakukan analisis kesesuaian Hasil dan pembahasan Didapatkan ge 12 KGB dari semua sampel Menurut sistem TNM terdapat 7 pasien stadium II 3 pasien stadium IIIb dan 5 pasien stadium IIIc sedangkan pada Klasifikasi Jepang terdapat 7 pasien stadium II 1 pasien stadium IIIa dan 7 pasien stadium IIIb Kecocokan antara kedua sistem klasifikasi dalam mendapatkan stadium II adalah 46 67 Penentuan stadium IIIa KJ dan stadium IIIa b TNM dengan kecocokan sebesar 6 7 Kecocokan sebesar 13 3 dalam menentukan stadium IIIb KJ dan stadium IIIc TNM Analisis kesesuaian terhadap kedua sistem klasifikasi didapatkan nilai Kappa sebesar 49 3 Kategori Sedang dengan P value 0 04 Kesimpulan Pada studi pendahuluan ini didapatlkan tingkat kesesuaian antara kedua sistem klasifikasi dalam menentukan stadium keganasan sigmoid dan rektum dengan kategori sedang Klasifikasi Jepang dapat dijadikan salah satu pertimbangan Diperlukan sampel yang lebih besar untuk meningkatkan akurasi tingkat kesesuaian Kata kunci metastasis KGB kolorektal sistem TNM Klasifikasi jepang;ABSTRACT Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification, Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification]"