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"[ABSTRAKLatar Belakang: Kualitas hidup dan fertilitas merupakan isu yang ingin ditangani pada kasus amenorhea primer, dan kedua masalah ini menjadi alasan utama pasien mencari pengobatan. Penundaan diagnosis dan tatalaksana dapat mempengaruhi masa depan jangka panjang pasien. Walaupun prevalensi amenorhea primer sangat jarang (<0.1%), belum didapatkan data di senter pelayanan rawat jalan poliklinik Endokrinologi-Reproduksi RSCM. Tujuan: Meneliti karakteristik pasien amenorhea primer yang ditemui di poliklinik endokrinologi RSCM selama tahun 2014. Metode: Telaah retrospektif rekam medik dengan desain studi deskriptif kategorik terhadap pasien amenore primer yang berobat jalan di poliklinik imunoendokrinologi-reproduksi RSCM selama tahun 2014. Hasil dan simpulan: Terdapat 57 subyek penelitian. Selama 1 tahun terdapat 74% kasus baru dan 26% kasus lama, mayoritas kasus rujukan (79%) dengan karakteristik: Usia pada awal kontrol 22 ± 5.9 tahun. Keluhan utama yang tersering ditemukan adalah belum menstruasi (91.2%). Keluhan penyerta lain berupa gangguan pertumbuhan seks sekunder (8.7%). Sebanyak 93% tidak memiliki riwayat operasi dan obatan. Setengah populasi (50%) pasien tidak pernah mengalami perdarahan haid. Indeks massa tubuh pasien sebesar 20.77±3.5 kg/m2. Sebanyak 22.8% pasien amenore primer berperawakan kecil, serta 56.14% pasien amenore primer tidak memiliki pertumbuhan seks sekunder. Sebanyak 98.3% pasien tanpa hirsutisme, pembesaran tiroid, galaktore atau massa inguinal. Sebanyak 68.5 % dengan genitalia eksterna normal. Sebanyak 56.2% pasien dengan hipoplasi uterus, dan 49.1% dengan hipoplasi ovarium. Amenore primer hipergonadotropin-hipogonadisme adalah profil lab yang tersering ditemukan (33.33%). Dari gambaran kariotipe tersering 38% adalah 46XX. Etiologi dasar pada yang tersering adalah disgenesis gonad (36.8%), diikuti kelainan pembentukan duktus muller (28.07%) dan kelainan sentral (15.79%). Tatalaksana yang dilakukan terhadap kasus amenore primer berupa, induksi haid 42.1% dengan terapi hormonal. Pasien yang mendapat terapi hormonal, 24.56% mengalami perdarahan sela; Pada 28% mengalami perubahan klasifikasi Tanner. Operasi penyesuaian jender dilakukan pada 5 kasus (11%).

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ABSTRACTBackground : Quality of life and fertility are the two main issues to be handled in cases of primary amenorhea, as they become the main reasons for patients to seek medical care. Delay in diagnosis and treatment may affect the patient in the long term. Prevalence of primary amenorrhea is very rare (<0.1%) and there is minimal data on our reproductive endocrinology clinic at RSCM. Aim: To study the characteristics of primary amenorrhea patients at the reproductive endocrinology outpatient clinic during 2014. Methods: retrospective medical record review with cathegorical descriptive study to patients at reproductive-imunoendocrinology outpatient clinic during 2014. Results and conclusion: There were 57 study subjects. During 1 year there wer e74% new cases and 26% old cases with majority of referred casess(79%) with characteristics as such. Age at first control was 22 ± 5.9 years old. The most frequent chief complaint were no menstruation (91.2%). Other frequent complaint were disorder of secondary sex characteristics (8.7%). As much as 93% did not have history of surgery nor medication. Half of the cases (50%) never had menstruation. Body mass index mean was 20.77±3.5 kg/m2. As much as 22.8% patients were short-statured with 56.14% with no signs of secondary sex characteristics growth. Mostly (99.3%) patients had no hirsutism, thyroid enlargement nor inguinal. Normal external genitalia was found at 68.5% cases. 56.2% patient had uterus hipoplasia, and 49.1% with hipoplasia of the ovaries. Most often laboratory profile found was hypergonadotropin-hypogonadism (33.3%). Most frequent karyotpe were 46XX (38%). Most frequent etiology of primary amenorrhe in this study is gonadal dygenesis (36.8%) and mullerian dysgenesis/agenesis, and central disorders (15.79%). Most frequent etiology found was gonadal dysgenesis (36.8%), mullerian dysgenesis (28.07%) and central disorder (15.79%). Hormonal therapy was the most frequent treatment (42.1%). on patient with hormones, 24.6% had breakthrough bleeding, 28% had Tanner stage changes, and 11% had gender change. ;Background : Quality of life and fertility are the two main issues to be handled in cases of primary amenorhea, as they become the main reasons for patients to seek medical care. Delay in diagnosis and treatment may affect the patient in the long term. Prevalence of primary amenorrhea is very rare (<0.1%) and there is minimal data on our reproductive endocrinology clinic at RSCM. Aim: To study the characteristics of primary amenorrhea patients at the reproductive endocrinology outpatient clinic during 2014. Methods: retrospective medical record review with cathegorical descriptive study to patients at reproductive-imunoendocrinology outpatient clinic during 2014. Results and conclusion: There were 57 study subjects. During 1 year there wer e74% new cases and 26% old cases with majority of referred casess(79%) with characteristics as such. Age at first control was 22 ± 5.9 years old. The most frequent chief complaint were no menstruation (91.2%). Other frequent complaint were disorder of secondary sex characteristics (8.7%). As much as 93% did not have history of surgery nor medication. Half of the cases (50%) never had menstruation. Body mass index mean was 20.77±3.5 kg/m2. As much as 22.8% patients were short-statured with 56.14% with no signs of secondary sex characteristics growth. Mostly (99.3%) patients had no hirsutism, thyroid enlargement nor inguinal. Normal external genitalia was found at 68.5% cases. 56.2% patient had uterus hipoplasia, and 49.1% with hipoplasia of the ovaries. Most often laboratory profile found was hypergonadotropin-hypogonadism (33.3%). Most frequent karyotpe were 46XX (38%). Most frequent etiology of primary amenorrhe in this study is gonadal dygenesis (36.8%) and mullerian dysgenesis/agenesis, and central disorders (15.79%). Most frequent etiology found was gonadal dysgenesis (36.8%), mullerian dysgenesis (28.07%) and central disorder (15.79%). Hormonal therapy was the most frequent treatment (42.1%). on patient with hormones, 24.6% had breakthrough bleeding, 28% had Tanner stage changes, and 11% had gender change. , Background : Quality of life and fertility are the two main issues to be handled in cases of primary amenorhea, as they become the main reasons for patients to seek medical care. Delay in diagnosis and treatment may affect the patient in the long term. Prevalence of primary amenorrhea is very rare (<0.1%) and there is minimal data on our reproductive endocrinology clinic at RSCM. Aim: To study the characteristics of primary amenorrhea patients at the reproductive endocrinology outpatient clinic during 2014. Methods: retrospective medical record review with cathegorical descriptive study to patients at reproductive-imunoendocrinology outpatient clinic during 2014. Results and conclusion: There were 57 study subjects. During 1 year there wer e74% new cases and 26% old cases with majority of referred casess(79%) with characteristics as such. Age at first control was 22 ± 5.9 years old. The most frequent chief complaint were no menstruation (91.2%). Other frequent complaint were disorder of secondary sex characteristics (8.7%). As much as 93% did not have history of surgery nor medication. Half of the cases (50%) never had menstruation. Body mass index mean was 20.77±3.5 kg/m2. As much as 22.8% patients were short-statured with 56.14% with no signs of secondary sex characteristics growth. Mostly (99.3%) patients had no hirsutism, thyroid enlargement nor inguinal. Normal external genitalia was found at 68.5% cases. 56.2% patient had uterus hipoplasia, and 49.1% with hipoplasia of the ovaries. Most often laboratory profile found was hypergonadotropin-hypogonadism (33.3%). Most frequent karyotpe were 46XX (38%). Most frequent etiology of primary amenorrhe in this study is gonadal dygenesis (36.8%) and mullerian dysgenesis/agenesis, and central disorders (15.79%). Most frequent etiology found was gonadal dysgenesis (36.8%), mullerian dysgenesis (28.07%) and central disorder (15.79%). Hormonal therapy was the most frequent treatment (42.1%). on patient with hormones, 24.6% had breakthrough bleeding, 28% had Tanner stage changes, and 11% had gender change. ]"

"Badan Koordinasi Keluarga Berencana Nasional (BKKBN) telah mensosialisasikan metode kontrasepsi LAM (Lactation Amenorrhea Method) untuk memenuhi kebutuhan kontrasepsi yang efektif dan aman pasca persalinan. Hasil data SDKI 2007 menunjukkan bahwa di beberapa daerah memiliki median amenorrhea laktasi lebih lama namun median pemberian ASI eksklusif cukup pendek.Penelitian ini bertujuan untuk mengetahui pengaruh pemberian ASI eksklusif terhadap amenorrhea laktasi di Indonesia setelah dikontrol oleh faktor ibu dan faktor keluarga. Penelitian ini menggunakan data sekunder SDKI 2007. Populasi dalam penelitian ini adalah ibu yang memiliki bayi usia 0 ? 6 bulan. Jumlah sampel yang ada untuk analisis adalah 2104 bayi. Analisis dilakukan dengan metode life-table, uji logrank dan regresi cox.Hasil penelitian menunjukkan bahwa ibu yang memberikan ASI eksklusif memiliki masa amenorrhea lebih lama. Efektivitas LAM pada dua bulan pertama adalah 85,59% dan pada bulan keenam adalah 45,80%. Pada enam bulan pertama pasca persalinan, ibu yang tidak memberikan ASI eksklusif 1,3 (95%CI: 1,1 ? 1,7) kali lebih cepat untuk mengalami menstruasi kembali dibandingkan ibu yang memberikan ASI eksklusif, setelah dikontrol dengan frekuensi pemberian ASI, penggunaan kontrasepsi dan paritas ibu. Oleh karena itu, BKKBN perlu meningkatkan promosi metode kontrasepsi lain disamping metode LAM serta mengefektifkan LAM pada dua bulan pertama pasca persalinan.

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Bureau of National Family Planning (BKKBN) has determined contraception method LAM (Lactation Amenorrhea Method) to fulfill the needs of an effective and safety postpartum contraception. Data result from DHS 2007 shown there was inconsistency between median lactation ammenorhea with median of exclusive breastfeeding in several region.This research has goal to know the influence of exclusive breastfeeding against lactation amenorrhea in Indonesia after controlled by maternal factors and household factors using secondary data DHS 2007. Population is mothers who have infants within range of ages 0 - 6 months. The analysis using 2104 infants as a sample, while the analysis were life-table, logrank test and cox regression.Result shows that mother who gives exclusive breastfeeding having longer amenorrhea. LAM effectiveness within first 2 months are 85,59% and 45,80% at the sixth month. Within a sixth month of postpartum, mothers who have not give exclusive breast feeding were 1,3 times faster to have menstruation compared with mothers who give exclusive breastfeeding (95%CI: 1,1 - 1,7) controlled by breastfeeding frequency, contraception usage and mothers parity. Therefore, BKKBN needs to increase the promotion of other contraception method instead of LAM. The highest effectiveness of LAM is at the first two months postpartum. It is recomended to undertaken an extended study (mother?s cohort study) to measure exclusive brestfeeding accurately."

"Latar belakang: Amenore primer merupakan gangguan pada siklus menstruasi wanita. 11,1% wanita remaja menunjukkan keluhan ginekologi terkait menstruasi. Prevalensi kasus amenore primer terjadi pada 0,1–2% wanita usia reproduksi.Amenore primer dapat disebabkan sex reversal female (kromosom 46XY) atausindrom Turner (45X). Abnormalitas perkembangan genitalia eksterna merupakanmanifestasi dari gangguan kromosom. Belum ada penelitian yang mengkaji hubungan antara presentasi genitalia eksterna dengan genotip kromosom seks pada pasien amenore primer di Rumah Sakit Cipto Mangunkusumo (RSCM), Jakarta.Tujuan: Mengetahui tampilan genitalia eksterna pada pasien amenore primer di RSCM, Jakarta dan hubungannya dengan kejadian ambiguitas genitalia. Metode: Penelitian ini dilakukan desain studi dengan potong lintang secara retrospektif menggunakan rekam medis pasien amenore primer DepartemenObstetri dan Ginekologi RSCM periode Januari tahun 2018-2020. Data diolahmenggunakan program Statistical Package for the Social Sciences (SPSS) versi 20.Uji hipotesis akan dilakukan menggunakan uji Chi-Square atau Fisher’s exact test.Hasil: 65 rekam medis amenore primer yang melakukan analisa genetika berhasil dikumpulkan. 90,77% (n=59) kasus amenore primer bergenitalia eksterna normal dan 9,23% (n=9) bergenitalia ambigu. Seluruh kasus genitalia ambiguberkarakteristik pembesaran klitoris dengan 1 kasus juga diamati phallus genital. Hanya 53,8% kasus yang memiliki kromosom perempuan normal, 46XX. Hubungan signifikan didapatkan antara ambiguitas genitalia eksterna danabnormalitas kromosom seks (p=0,042) Simpulan: Terdapat hubungan yang signifikan antara ambiguitas genitalia eksterna serta tidak normalnya hasil analisa kromosom seks pada pasien amenore primer di Departemen Obstetri dan Ginekologi RSCM periode Januari tahun 2018-2020.

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Background: Primary amenorrhea is a disorder of a woman's menstrual cycle. 11.1% of adolescent women showed gynecological complaints related tomenstruation. The prevalence of primary amenorrhea cases occurs in 0.1–2% of women of reproductive age. Primary amenorrhea can be caused by female sex reversal (chromosome 46XY) or Turner syndrome (45X). Abnormalities in the development of external genitalia are a manifestation of chromosomal disorders. There are no studies that have examined the relationship between external genitalia presentation and sex chromosome genotypes in primary amenorrhea patients at Cipto Mangunkusumo Hospital (RSCM), Jakarta. Goal: Finding the characteristic the appearance of external genitalia in primary amenorrhea patients at RSCM, Jakarta and its relationship with the incidence of genital ambiguity Method: This study was conducted with a retrospective cross-sectional study design using the medical records of primary amenorrhea patients from the Department of Obstetrics and Gynecology RSCM January 2018-2020. Data were processed using the Statistical Package for the Social Sciences (SPSS) program version 20. Hypothesis testing will be carried out using the Chi-Square test or Fisher's exact test. Result: 65 medical records of primary amenorrhea that performed genetic analysis were collected. 90.77% (n = 59) cases of primary amenorrhea with external genitalia were normal and 9.23% (n = 9) had ambiguous genitalia. All cases of ambiguous genitalia were characterized by clitoral enlargement with 1 case also observed for the genital phallus. Only 53.8% of cases had a normal female chromosome, 46XX. There was a significant relationship between external genital ambiguity and sex chromosome abnormalities (p = 0.042). Conclusion: There is a significant relationship between external genital ambiguity and abnormal results of sex chromosome analysis in primary amenorrhea patients in the Obstetrics and Gynecology Department of RSCM for the period January 2018-2020 (p<0,05)."

"Lupus Eritematosus Sistemik LES merupakan penyakit autoimun kronik yang ditandai dengan adanya autoantibodi yang menyerang antigen sendiri. Kasus LES setiap tahunnya mengalami peningkatan. LES pada anak berkontribusi sebesar 15-20 dari keseluruhan penderita. Penyakit ini dapat menyerang berbagai sistem organ. Komplikasi endokrinopati berupa gangguan pubertas yang cukup sering terjadi pada anak. Hingga saat ini belum ada penelitian mengenai gangguan pubertas pada anak LES di Indonesia. Penelitian ini bertujuan untuk mengetahui prevalensi dan faktor-faktor yang berhubungan dengan terjadinya amenore pada anak LES. Penelitian dilakukan menggunakan desain potong lintang pada pasien anak perempuan usia 11-18 tahun di Poliklinik Alergi dan Imunologi dan Poliklinik Endokrinologi Rumah Sakit Cipto Mangunkusumo Kiara. Terdapat 25 subjek yang diikutsertakan. Hasil penelitian dilakukan analisis statistik menggunakan uji Chi-square dan uji Fisher. Prevalensi pubertas terlambat terjadi pada satu subjek 4 ; IK95 = -0,04-0,12 dan amenore terjadi pada dua belas subjek 48 ; IK95 = 0,27-0,69. Tidak terdapat hubungan yang bermakna antara amenore dengan durasi penyakit p=1,000; PR=1,05, aktivitas penyakit p=1,000; PR=0,86, durasi kortikosteroid p=0,673; PR=1,23, dan jenis terapi p=0,198; PR=0,55. Hasil penelitian tidak bermakna karena besar sampel tidak memenuhi jumlah minimal. Dari hasil tersebut, belum dapat disimpulkan bahwa tidak terdapat hubungan antara amenore terhadap durasi penyakit, aktivitas penyakit, durasi kortikosteroid, dan jenis terapi.

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Systemic Lupus Erythematosus SLE is a chronic autoimmune disease characterized by autoantibodies that attack self antigen. The case of SLE each year has increased. SLE in children contributes 15 20 of all patients. This disease can attack various organ systems. Complications of endocrinopathy in the form of pubertal disorders are quite common in children. Until now, there has been no research on pubertal disorders in children with SLE in Indonesia.

This study aims to determine the prevalence and associated factors of amenorrhea in children with SLE. This study was a cross sectional study in girls aged 11 18 years at Allergy and Immunology Polyclinic and Endocrinology Polyclinic of Cipto Mangunkusumo Kiara Hospital. There are 25 subjects included.

The result of the research was statistical analysis using Chi square test and Fisher test. The prevalence of delayed puberty occurs in one subject 4 IK95 0,04 0,12 and amenorrhea occurs in twelve subjects 48 IK95 0,27 0,69. There was no significant association between amenorrhea with disease duration p 1,000 PR 1,05, disease activity p 1,000 PR 0,86, corticosteroid duration p 0,673 PR 1,23, and type of therapy p 0,198 PR 0,55.

The results were not significant because the sample size did not meet the minimum amount. From these results, it can not be concluded yet that there is no association between delayed puberty and amenorrhea with disease duration, disease activity, corticosteroid duration, and type of therapy."

"ABSTRAKAmenore postpartum adalah periode akhir kehamilan perempuan sampai waktu iamulai menstruasi kembali. Ini adalah periode ketidaksuburan sementara. Periodeamenore postpartum merupakan peristiwa penting bagi reproduksi dalam rentanghidup perempuan. Tujuan penelitian ini adalah mengetahui hubungan statusmenyusui ibu dengan amenore postpartum. Menggunakan data sekunder SDKI2012 dengan desain studi crossectional, dengan jumlah sampel sebesar 1171responden. Pada analisis multivariat dengan regresi Cox pada status menyusui ibuyang berinteraksi dengan penggunaan kontrasepsi non hormonal terhadapamenore postpartum didapatkan nilai PR 2,18 (95% CI: 1,22-3,89). Inimenunjukkan pentingnya ibu untuk terus menyusui dan menggunakan kontrasepsinon hormonal setelah melahirkan sebagai salah satu upaya untuk menjaga jarakkelahiran yang baik pada periode postpartum.

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ABSTRACTPostpartum amernorrhea is the end period of pregnancy women until she startedthe menstruating again. This is just temporary infertility period. Postpartumamenorrhea period is an important event of women’s reproductive life span. Theobjective of this study was to determine the relationship of maternal lactatingstatus with postpartum amenorrhea. Using IDHS 2012 secondary data’s withcrossectional design study, with 1171 respondents. In multivariate analysis withCox regression maternal lactating status which is interacting with non-hormonalcontraception use against postpartum amenorrhea showed the PR is 2,18 (95% CI:1,22-3,89). It’s showed how importance the mothers must continuingbreastfeeding and using a non-hormonal contraception after delivering as a way tomade a good spacing in the postpartum period."

"Latar Belakang: Amenorea primer adalah kondisi di mana seorang perempuan belum mengalami haid pada usia 14 tahun, yang disertai dengan tidak tampaknya pertumbuhan serta perkembangan tanda-tanda seks sekunder, atau kondisi di mana seorang perempuan yang belum mengalami haid pada usia 16 tahun meski telah didapatkan pertumbuhan dan perkembangan yang normal dari tanda-tanda seks sekunder. Pada penderita Amenorea primer seringkali berakibat munculnya masalah kejiwaan seperti depresi, gangguan mood, sulit tidur, dan kegelisahan. Saat ini, belum terdapat program tatalaksana yang bersifat komperhensif untuk penderita amenorea primer yang melibatkan harapan dan perasaan penderita amenorea primer. Tujuan: Penelitian ini bertujuan untuk mengeksplorasi lebih dalam pengalaman penderita amenorea primer, memahami pandangan penderita amenorea primer terhadap keadaan yang dialaminya, memahami kebutuhan penderita amenorea primer dan memahami pandangan penderita amenorea primer terhadap tatalaksana yang saat ini dilakukan sehingga pendekatan tatalaksana terhadap penderita amenorea primer dapat optimal. Metode: Penelitian ini menggunakan pendekatan fenomenologi interpretatif, dengan wawancara mendalam, observasi langsung, dan catatan lapangan terhadap penderita amenorea primer di Poliklinik Departemen Ilmu Kebidanan dan Kandungan Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo pada bulan Mei 2018-Mei 2019. Hasil: Terdapat lima partisipan, usia bervariasi dari 21-28, dengan rerata 24 tahun. Tiga partisipan (60%) terdiagnosis dengan sindroma Turner, satu partisipan (20%) dengan DSD, dan satu partisipan (20%) dengan MRKH. Penderita amenorea primer cenderung merasakan perbedaan dengan perempuan lainnya, tidak menutup diri dengan lingkungan sekitar, tidak puas dengan perkembangan organ seks sekunder, mengalami masalah dengan partner, dan harapan terhadap pengobatan yang dilakukan, yaitu; ingin mendapatkan haid, terbebas dari obat, pertumbuhan organ seks yang normal, dan keinginan memiliki keturunan. Kesimpulan: Amenorea primer cenderung memiliki dampak negatif bagi penderitanya, terutama dalam segi kepercayaan diri. Penderita amenorea primer usia reproduktif cenderung tidak memiliki masalah dalam melakukan pekerjaan sehari-hari. Dengan mengetahui pandangan dan harapan penderita amenorea primer, tentunya tenaga medis dapat melakukan penatalaksanaan dengan pendekatan yang lebih komprehensif. Dibutuhkan tambahan variasi kasus atau sampel untruk dapat memenuhi aspek transferabilitas data.

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Background: Primary amenorrhea is a condition in which a woman has not experienced menstruation at the age of 14 years, accompanied by no apparent growth and development of secondary sex signs, or a condition in which a woman has not experienced menstruation at the age of 16 despite growth and development normal from secondary sex signs. Primary amenorrhea often results in psychiatric disorders such as depression, mood disorders, insomnia, and anxiety. To date, there is no comprehensive treatment program that involves the hope and feelings of those with primary amenorrhea Objective: This study aims to explore more in the experience of primary amenorrhoea sufferers, understand the views of primary amenorrhoea sufferers on their condition, understand the needs of primary amenorrhoea sufferers and understand the views of primary amenorrhoea sufferers on the current management so that the management approach for patients with primary amenorrhea can be optimal. Methods: This study uses an interpretative phenomenology approach, with in-depth interviews, direct observation, and field notes on primary amenorrhoea sufferers at the Polyclinic of the Department of Midwifery and Gynecology at the Cipto Mangunkusumo National Center General Hospital in MAy 2018-May 2019. Results: There were five participants, ages varied from 21-28, with a mean of 24 years. Three participants (60%) were diagnosed with Turner syndrome, one participant (20%) with DSD, and one participant (20%) with MRKH. Primary amenorrhoea sufferers tend to feel the difference with other women, were not satisfied with the development of secondary sex organs, experienced problems with their partners. Their hope for the treatment included wanting to have menstruation, be free from medical therapy, develop secondary sex organs, and desire to have children. Conclusions: Primary amenorrhea tends to have a negative impact on sufferers, especially in terms of self-confidence. Primary amenorrhea sufferers of reproductive age tend not to have problems in doing daily work. By knowing the views and expectations of primary amenorrhoea sufferers, of course medical personnel can carry out management with a more comprehensive approach. Additional variations of cases or samples are needed to meet the aspects of data transferability."

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Latar belakang: Masa remaja adalah bentuk peralihan dari masa anak-anak menuju dewasa yang diiringi oleh munculnya fase pubertas. Pada perempuan, fase ini ditandai oleh karakteristik seks primer berupa proses menstruasi dan berkembangnya karakteristik seks sekunder seperti payudara dan rambut pubis yang muncul di usia 11-13 tahun. Dalam beberapa kasus ditemukan keterlambatan onset pada karakteristik seks tersebut, hal ini disebut dengan amenore primer. Kelainan ini dapat dikaitkan dengan adanya abnormalitas pada kromosom seks. Keterlibatan kromosom Y menjadi suatu indikator yang penting. Diagnosis yang tepat dengan melakukan penapisan etiologi diharapkan dapat menunjukkan tata laksana yang sesuai. Tujuan: Mengetahui hubungan antara karakteristik seks sekunder dengan jenis kromosom seks pasien amenore primer di Rumah Sakit Cipto Mangunkusumo Jakarta. Metode: Sebuah studi potong lintang yang dilakukan pada 65 subjek amenore primer yang dipilih secara non-randomized consecutive sampling di RSCM serta telah memenuhi kriteria inklusi dan menapis kriteria eksklusi yang telah ditetapkan. Data yang dianalisis berasal dari informasi pada rekam medis pasien amenore primer periode Januari 2018-2020. Hasil: Sebagian besar subjek memiliki karakteristik seks sekunder yang tidak berkembang, pada payudara (52,3%) maupun rambut pubis (58,5%). Dari analisis kromosom, didapatkan 84,6% sampel tanpa kromosom seks Y dan 15,4% sampel dengan kromosom seks Y. Nilai p yang didapat tidak menunjukkan adanya hubungan yang signifikan secara statistik antara karakteristik seks sekunder mencakup pertumbuhan payudara (p=0,174) dan rambut pubis (p=0,729) terhadap jenis kromosom seks pasien amenore primer di RSCM. Simpulan: Tidak ditemukan hubungan yang signifikan (p>0,05) antara karakteristik seks sekunder dengan jenis kromosom seks pasien amenore primer di Rumah Sakit Cipto Mangunkusumo Jakarta. 

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Background: Adolescence is a form of transition from childhood to adulthood accompanied by the emergence of the puberty phase. In women, this phase is characterized by primary sex characteristics in the form of the menstrual process and the development of secondary sex characteristics such as breasts and pubic hair that appear at the age of 11-13 years. In some cases, there is a delay in onset of these sex characteristics, called primary amenorrhea. This disorder can be associated with an abnormality on the sex chromosomes. The involvement of the Y chromosome is an important indicator. Correct diagnosis by performing etiological screening is expected to show appropriate treatment. Aim: To determine the correlation between secondary sex characteristics and sex chromosome type of primary amenorrhea patients at Cipto Mangunkusumo Hospital, Jakarta. Methods: A cross sectional study conducted on 65 primary amenorrhea subjects selected by non-randomized consecutive sampling in RSCM who has met the inclusion criteria and filtered by the exclusion criteria. The data analyzed came from information in the medical records of primary amenorrhea patients. Results:Most of the subjects have undeveloped secondary sex characteristics, both breast (52.3%) and pubic hair (58.5%). From chromosome analysis, this study discovered 84.6% samples without Y-chromosome related and 15.4% samples with Y-chromosome related. The p value obtained did not show a statistically significant correlation between secondary sex characteristics including breast growth (p = 0.174) and pubic hair (p =0.729) on the sex chromosome type of primary amenorrhea patients at RSCM. Conclusions: There is no significant correlation (p>0.05) between secondary sex characteristics and the sex chromosome type of primary amenorrhea patients at Cipto Mangunkusumo Hospital, Jakarta.

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"Dermatitis Seboroik DS merupakan kelainan inflamatorik kronik pada kulit dengan karakteristik plak eritematosa dan skuama kekuningan berminyak pada area tubuh yang banyak mengandung kelenjar sebasea, termasuk kulit kepala. DS umum terjadi pada 1-5 populasi dan menimbulkan dampak negatif terhadap kualitas hidup. Sekresi sebum, yang merupakan salah satu faktor DS, memiliki laju yang bervariasi sesuai dengan usia seseorang di mana mencapai puncak pada tiga bulan pertama kehidupan, masa pubertas, dan usia dewasa 30-60 tahun. Tujuan penelitian ini yaitu mengetahui korelasi usia dan skor keparahan DS. Penelitian ini menggunakan desain cross-sectional dan mendapatkan sampel dengan metode consecutive sampling sebanyak 87 pasien Poliklinik Kulit dan Kelamin RSCM. Usia diukur berdasarkan tanggal lahir pada kartu identitas dan skor keparahan DS diukur menggunakan seborrheic dermatitis area severity index SDASI. Berdasarkan uji normalitas data dan uji korelasi Spearmann yang dilakukan, didapatkan hasil yang menunjukkan bahwa korelasi usia dan skor keparahan DS tidak signifikan p=0,495 ; r=0,074. Rerata usia dalam median yaitu 29,25 12,67-69,75 tahun, sedangkan rerata skor keparahan DS dalam median yaitu 2,25 0,25-21.

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Seborrhoeic Dermatitis DS is a chronic inflammatory disorder on skin characterized by erythematous plaque and oily yellowish scales in areas of body with high sebaceous glands, including the scalp. DS occurs in 1-5 of the population and causes negative impact to quality of life. Sebum secretion, one of DS factors, has varrying rates according to age of a person, where the peak incidence is in first three months of life, puberty, and adult age 30 60 years.

Purpose of this study was to know the correlation between age and DS severity score. In this cross sectional study, consecutive sampling method was used and total subjects were 87 patients of Poliklinik Kulit dan Kelamin RSCM. Age was obtained based on date of birth on identity card and DS severity score was measured by seborrheic dermatitis area severity index SDASI.

Based on normality test and Spearmann test which had been done, the result showed that there was no significant correlation between age and DS severity score p=0.495 ; r=0.074. Age in median was 29.25 12.67-69.75 years, while the mean DS severity score in the median was 2.25 0.25-21."

"Latar Belakang : Pneumotoraks merupakan kasus kegawat daruratan yang harus ditatalaksana segera. Penilaian berbagai penyakit paru dan faktor-faktor penyebab secara tepat sangat penting diketahui sebagai panduan dalam kerjasama antardisiplin ilmu dan untuk meningkatkan penatalaksanaan pneumotoraks secara menyeluruh. Faktor risiko yang mempengaruhi kesintasan pasien pneumotoraks adalah usia dan infeksi HIV, namun data di Indonesia masih belum ada.Tujuan : Untuk mengetahui karakteristik pasien pneumotoraks dan faktor-faktor yang mempengaruhi kesintasannya selama perawatan di RSCM.Metode : Penelitian desain kohort retrospektif, dilakukan terhadap pasien pneumotoraks yang dirawat inap di RSCM pada kurun waktu Januari 2000 sampai Desember 2011. Kesintasan kumulatif selama 8 hari perawatan dan faktor yang mempengaruhi dianalisis secara bivariat dengan metode Kaplan Meier dan uji Log-rank serta analisis multivariat dengan Cox proportional hazard regression model untuk menghitung hazard ratio (HR) dan interval kepercayaan 95%.Hasil : Seratus empat pasien pneumotoraks yang memenuhi kriteria penelitian ditemukan lebih banyak pada laki-laki 78(73,1%) dengan rerata usia 39,7(simpang baku[SB],16,2) tahun. Keluhan respirasi terbanyak berupa sesak napas 103(99%) dan kelainan pada pemeriksaan fisik hipersonor 101(97,1%). Foto polos toraks menunjukkan hiperlusen avaskular 95(91,4%). Faktor penyebab kejadian yang didapatkan adalah merokok 43(41,3%), pneumonia 42(40,3%), tuberkulosis 37(35,5%), trauma dada 13(12,5%), kejadian iatrogenik 6(5,7%), keganasan paru 6(5,7%), PPOK 5(4,8%), asma bronkiale 5(4,8%) dan artritis reumatoid 1(1%). Jenis pneumotoraks terbanyak adalah pneumotoraks spontan sekunder 49(47,1%). Tatalaksana sebagian besar dengan pemasangan WSD 98(94,2%). Keluaran pasien pneumotoraks hidup 69(66,3%), meninggal 35(33,7%). Penyebab kematian terbanyak pada pasien pneumotoraks saat perawatan adalah gagal napas 16(45,8%). Faktor-faktor yang memperburuk kesintasan pasien pneumotoraks adalah trauma dada (HR=3,49 (IK 95% 1,52;8,04)) dan tuberkulosis paru (HR=3,33 (IK 95% 1,39;7,99)).Kesimpulan : Adanya tuberkulosis paru dan trauma dada memperburuk kesintasan pasien pneumotoraks selama perawatan di RSCM.

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Background : Pneumothorax is an emergency case should be managed immediately. Assessment of lung diseases and the factors that cause pneumothorax is very important to know the proper guidelines in cooperation an interdisciplinary medical science and to improve the overall management of pneumothorax. Risk factors affecting the survival rate of pneumothorax patients are age and HIV infection, but there is no data in Indonesia.

Objective : The purpose of this study was to determine the characteristics of pneumothorax patients and factors affecting survival during hospitalization in RSCM.

Methods : Retrospective cohort study design conducted on pneumothorax patients who were admitted in RSCM in the period January 2000 to December 2011. Cumulative survival rate for 8 days of hospitalization and the factors affecting analyzed by bivariate with Kaplan Meier method and log-rank test and multivariate analysis by cox proportional hazard regression model to calculate hazard ratio (HR) and 95% confidence intervals.

Results : A total of 104 pneumothorax patients were reviewed. Their mean age was 39.7 years (SD ± 16.2 years) with a male to female ratio of 3:1. Commonest symtoms was shortness of breath 103(99%) and abnormalities on physical examination was hypersonor 101(97.1%). Plain chest X-ray showed hyperlucent avascular 95(91.4%).

Etiologic factors for the incidence of secondary pneumothorax were smoking 43(41.3%), pneumonia 42(40.3%), tuberculosis 37(35.5%), chest trauma 13(12.5%), iatrogenic 6(5.7%), lung malignancy 6(5.7%), COPD 5(4.8%), asthma 5(4.8%) and rheumatoid arthritis 1(1%). Commonest type of pneumothorax was secondary spontaneous pneumothorax 49(47.1%). Most of pneumothorax patients were successfully managed by chest thoracoscopy 98(94.2%). Outcome of pneumothorax patients were live 69(66.3%), died 35(33.7%). Causes of death in pneumothorax patients was respiratory failure 16(45.8%). Factors that worsen the survival rate of pneumothorax patients were chest trauma (HR = 3.49 (95% CI 1.52 to 8.04)) and pulmonary tuberculosis (HR = 3.33 (95% CI 1.39 to 7.99 )).

Conclusions : Factors that worsen the survival rate of pneumothorax patients were pulmonary tuberculosis and chest trauma that hospitalized in RSCM."

"Latar belakang: Hampir 50% epilepsi adalah wanita terjadi pada usia reproduksi 15-49 tahun. Banyak penelitian menyebutkan bahwa terdapat interaksi antara epilepsi dengan hormon reproduksi wanita. Epilepsi temporolimbik dapat mengganggu regulasi aksis hipothalamus- hipofisis-ovarium (HHO) sehingga mengganggu hormon reproduksi dan pada akhirnya menyebabkan gangguan menstruasi. Oleh karena itu dilakukan penelitian yang bertujuan untuk mengetahui perubahan hormon reproduksi yang terjadi pada wanita dengan epilepsis. Pada penelitian ini juga akan dilakukan klasifikasi gangguan menstruasi pada wanita dengan epilepsi berdasarkan kriteria The International Federation of Gynecology and Obstetrics (FIGO), dimana kriteria ini merupakan kriteria baru untuk mendefinisikan perdarahan uterus abnormal.Metode penelitian: Penelitian ini dilakukan dengan studi potong lintang (cross sectional) untuk mengetahui karakteristik hormon reproduksi dan gangguan menstruasi pada wanita dengan epilepsi di RSUPN Cipto Mangunkusumo pada September hingga Desember 2021. Data primer dan sekunder diperoleh dari rekam medis dan electronic health record (EHR) pada pasien wanita dengan epilepsi dan wanita tanpa epilepsi yang berobat ke RSUPN Cipto Mangunkusumo. Analisis data yang digunakan adalah bivariat Chi Square dan Mann Whitney. Hasil: Pada penelitian ini diperoleh 67 subjek wanita dengan epilepsi dan 50 subjek wanita tanpa epilepsi dengan rata-rata usia wanita dengan epilepsi 29,27  9,26 tahun. Onset terjadinya epilepsi adalah 18,57  9,857 tahun dengan usia menarche adalah 12,85  1,317 tahun. Onset epilepsi setelah menarche banyak terjadi sekitar 70,1%. Epilepsi lobus temporal merupakan sindrom epilepsi terbanyak sekitar 70,8%, dengan sisi kanan terbanyak sekitar 46,8%. Peningkatan hormon reproduksi khususnya hormon luteinizing hormon (LH) 10,1 (0,1-100,3) mIU/mL (p: 0,008) dan hormon estradiol 71,2 (0-3350) pg/mL didapatkan pada wanita dengan epilepsi dibandingkan dengan wanita tanpa epilepsi. Gangguan pada volume darah mentruasi didapatkan pada wanita dengan epilepsi lobus temporal dibandingkan dengan lobus ekstratemporal RR 4,255 (1,188-15,231), dengan nilai p: 0,022.Kesimpulan: Peningkatan hormon LH dan estradiol pada wanita dengan epilepsi berhubungan dengan bangkitan epileptik yang mengganggu regulasi aksis hipothalamus- hipofisis-ovarium sehingga mengganggu hormon reproduksi.

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Background : Approximately 50% of epilepsy occurs in women with the reproductive age of 15-49 years. Many studies said that there is an interaction between epilepsy and female reproductive hormones. Temporolimbic epilepsy can interfere the regulation of the hypothalamic-pituitary-ovarian (HPO) axis so that it interferes reproductive hormones and ultimately causes menstrual disorders. Therefore, this study aimed to determine the changes in reproductive hormones that occur in women with epilepsy. This study will also classify menstrual disorders in women with epilepsy based on the criteria of The International Federation of Gynecology and Obstetrics (FIGO), where this criterion is a new criterion for defining abnormal uterine bleeding.

Method : This study was conducted with a cross sectional study to determine the characteristics of reproductive hormones and menstrual disorders in women with epilepsy at Cipto Mangunkusumo General Hospital from September to December 2021. Primary and secondary data were obtained from medical records and electronic health records (EHR) from women with epilepsy and women without epilepsy who seek treatment at Cipto Mangunkusumo General Hospital. Analysis of the data used Chi Square and Mann Whitney bivariate.

Result : In this study, there were 67 female subjects with epilepsy and 50 female subjects without epilepsy with the average age of women with epilepsy is 29,27  9,26 years. The onset of epilepsy was 18,57  9,857 years with the age of menarche is 12,85  1,317 years. The onset of epilepsy after menarche is mostly about 70.1%. Temporal lobe epilepsy is the most common epilepsy syndrome around 70.8%, with the right side being the most common around 46.8%. Increased reproductive hormones, especially luteinizing hormone (LH) 10.1 (0.1- 100.3) mIU/mL (p: 0.008) and estradiol hormone 71.2 (0-3350) pg/mL were found in women with epilepsy compared to women without epilepsy. Disorders of menstrual blood volume were found in women with temporal lobe epilepsy compared with extratemporal lobe epilepsy RR 4.255 (1.188-15.231), with p value: 0.022.

Conclusion : Elevated LH and estradiol hormones in women with epilepsy are associated with epileptic seizures that disrupt the regulation of the hypothalamic-pituitary-ovarian axis, thereby disrupting reproductive hormones."