Analysis of the clinical efficacy of leuprolide acetate in the treatment of obese patients with endometriosis and its role on the expression of MIF gene

Endometriosis is an invasive but benign disease of women that develops in endometrial glands outside the endometrium and uterine muscle. It affects about 15-20% of women of childbearing age. One effective way to treat endometriosis is to use GnRH agonists, which inhibit estrogen production. However, one of the possible side effects of this treatment is obesity and BMI increasing, which is a concern for some patients. This study investigated the role of leuprolide acetate in treating overweight patients (BMI≥30) and their comparison with non-overweight patients (BMI<30) for six months. Also, the effect of this medicine was evaluated on the expression of the MIF gene, which is an effective gene in obesity. For this purpose, a clinical trial was performed on 75 women with endometriosis aged 18 to 35 years. These patients were divided into two groups. The first group consisted of 38 patients with BMI<30. The second group consisted of 37 patients with BMI≥30. Both groups were treated with leuprolide acetate at a dose of 3.75 mg/month (intramuscularly) for six months. In addition to clinical evaluations, the expression of the MIF gene was assessed by the real-time PCR technique. The results showed that treatment with leuprolide acetate during six months in both groups reduced dysmenorrhea, dyspareunia, and chronic pelvic pain (P<0.05). Although this decrease was greater in the BMI <30 group, the difference was not significant. Also, after collecting the side effects of the medication, it was found that hypoestrogenism, such as cramps and spotting, was more in the first group; Endogenous complications such as oily skin, acne, and hirsutism were also more common in the second group. The results of MIF gene expression showed that the expression level before and after the start of the experiment in the second group (BMI≥ 30) is higher than the first group (BMI <30). The results also showed that the two groups increased the expression of the MIF gene after treatment with leuprolide acetate. This increase was statistically significant in the second group (P = 0.042). Generally, it was found that this medication causes more weight gain in obese people and increases the risk of obesity-related diseases among these patients. Therefore, it is recommended that this treatment be used with caution in obese patients with endometriosis.

Effect of methanol extract of Anacardium occidentale stem bark on agonist-induced contraction in rat uterine muscle

Anacardium occidentale (Ao) is widely used in ethnomedicine and the effect on contractility of the gut and heart muscles of laboratory rodents have been established however, its effect on the contractility of uterine muscle has been rarely researched. The present study investigated the effect of stem bark methanolic extract of Anacardium occidentale (AoME) on Isolated Rat Uterus Strips (IRUS). The Anacardium occidentale methanol extract (AoME) was obtained by solvent extraction. The IRUS were suspended in a bath containing 15 ml of De Jalon's solution through a silk connected to a force transducer. A tension of 1.0 g was applied. The strips were allowed to equilibrate for a period of 60–90 min before the commencement of the experiment. The extract (0.025- 0.3mg/ml) added cumulatively did not modify the normal tonus in most of the IRUS used except in one where it feebly contracted it. However, the contractile responses induced by acetylcholine (10-9 -10-5 M) and oxytocin (10-9 -10-5 M) on the IRUS were almost completely blocked by pre-incubated AoME at a concentration of 0.2 mg/ml. Stem bark methanol extract of Anacardium occidentale shifted the log concentration curve of both agonists to the right. The present results report the antagonistic effects of stem bark methanol extract of Anacardium occidentale on oxytocin and acetylcholine-induced contraction in rat uterus strips. Keywords: Anacardium occidentale, Oxytocin, Acetylcholine, Uterus, Smooth muscle

Abdominal Stretching as a Therapy for Dysmenorrhea

BACKGROUND: Dysmenorrhea is pain during the menstrual period caused by uterine muscle cramps. The Dysmenorrhea prevalence in Indonesia is categorized as high at 64.25%. The dysmenorrhea symptom could be very disruptive and even decrease women’s productivity. Related to this problem, abdominal stretching is one of the alternatives to reduce pain from dysmenorrhea. AIM: This research was aimed to find out the effect of abdominal stretching on the pain intensity of menstrual cramps. METHODS: It was a quasi-experimental research with a pre-test post-test control group design. The sample was 130 female adolescents that were taken by total sampling. The sample was divided into two groups, which were the intervention group and the control group. RESULTS: The research finding, with a 0.000 (p < 0.005) significance value was obtained by using the Wilcoxon test. CONCLUSION: It means abdominal stretching exercise is significantly effective to reduce pain intensity from menstrual cramps (dysmenorrhea) in female adolescents. It is suggested to implement abdominal stretching as nursing care for menstrual cramps.

Efektivitas Air Rebusan Jahe Merah terhadap Intensitas Nyeri Haid

The menstrual cycle lasts an average of 28 days. During menstruation some young women will feel menstrual pain, or in medical language called dysmenorrhea which is caused by uterine muscle spasms. The purpose of this study was to determine the effectiveness of red ginger boiled water on menstrual pain in female students at the Health Polytechnic of Palangka Raya. This research method uses Pre-experimental research with One Group Control Pretest-Posttest Design study. The population of this research is female students at Poltekkes Palangka Raya and the sample size is 73 respondents with the sampling technique used is purposive sampling. The statistical test used in this study was the Wilcoxon test. The results of the statistical test showed the value of Z = -7.047, which means that giving red ginger drink 7.047 times can help reduce the intensity of pain during menstruation. Statistical test results obtained a p value of 0.001 (p <0.05) meaning that there is an effect of red ginger boiled water on decreasing the intensity of menstrual pain. There is an effect of red ginger boiled water on decreasing the intensity of menstrual pain.

Kecemasan pada Ibu Hamil di Masa Pandemi Covid 19 di RSUD Ibnu Sutowo Baturaja

Di Indonesia, terdapat 107.000 (28,7%) ibu hamil yang mengalami kecemasan dalam menghadapi persalinan. Kecemasan akan berdampak negatif pada ibu hamil sejak masa kehamilan hingga persalinan, seperti janin yang gelisah sehingga menghambat pertumbuhannya, melemahkan kontraksi otot rahim, dan lain-lain. Dampak tersebut dapat membahayakan ibu dan janin. Tujuan penelitian ini adalah untuk mengetahui faktor hubungan kecemasaan Ibu hamil dimasa pandemi covid 19 di Poliklinik RSUD Ibnu Sutowo. Penelitian ini dilakukan menggunakan dengan pendekatan Cross Sectional dengan jumlah sampel sebanyak 37 ibu hamil dan instrumen pada penelitian ini menggunakan lembar kuesioner. Hasil analisis uji Chi- Squre didapatkan ada hubungan antara umur dengan dengan kecemasan dengan hasil p value 0,010 < α (0,05), ada hubungan antara pendidikan dengan dengan dengan kecemasan didapatkan p value 0,001 < α (0,05),ada hubungan antara pekerjaan dengan dengan kecemasan pada ibu hamil di masa pandemi covid 19 di RSUD Ibnu Sutowo Baturaja didapatkan p value 0,024 < α (0,05). Disarankan sosialisasi dan penyuluhan, pemberian leaflet tentang penyakit covid 19 dan pemeriksaan kehamilan, serta dianjurkan untuk pelaksanaan pendidikan informal untuk ibu hamil atau ibu- ibu di RSUD Ibnu Sutowo Baturaja melalui pertemuan online (daring). Kata kunci : factor; kecemasan; ibu hamil ANXIETY IN PREGNANT MOTHERS DURING THE COVID-19 ERA AT IBNU SUTOWO HOSPITAL OF BATURAJA ABSTRACT In Indonesia, there are 107,000 (28.7%) pregnant women who experience anxiety in facing childbirth. Anxiety will have a negative impact on pregnant women from pregnancy to delivery, such as a restless fetus that inhibits its growth, weakens uterine muscle contractions, and others. These impacts can harm the mother and fetus. The purpose of this study was to determine the relationship factors of anxiety in pregnant women during the COVID-19 pandemic at the Ibnu Sutowo Hospital of Baturaja. This research was conducted using a cross sectional approach with a sample of 37 pregnant women and the instrument in this study used a questionnaire sheet. The results of the Chi-Squre test analysis showed that there was a relationship between age and anxiety with p value 0.010 < (0.05), there was a relationship between education and anxiety, p value 0.001 < (0.05), there was a relationship between work with anxiety in pregnant women during the covid 19 pandemic at Ibnu Sutowo Hospital of Baturaja obtained p value 0.024 < (0.05). It is recommended that socialization & counseling, provide leaflets about Covid 19 and pregnancy checks, and it is recommended for the implementation of informal education for pregnant women or mothers at Ibnu Sutowo Hospital of Baturaja through online meetings (online). Keywords: factors, anxiety, pregnant women.

Effects of Steganotaenia Araliacae Root Extract on Contractile Function of Isolated Rat Ileum

Background: Various parts of a small tree, Steganotaenia araliacaeare used as medicine in local traditional settings in Zambia to initiate and augment parturition although very little is documented about its physiological and pharmacological effects. Steganotaenia araliacaecold extract has been observed to cause contractions of uterus in rats but its effect on non-uterine muscle is unclear. The aim of this study was to establish the contractile effect of Steganotaenia araliacaecold extract on isolated rat ileum smooth muscle.Method: Animals were sacrificed by cervical dislocation. Abdominal incisions were made to expose and dissect three ileum segments from each rat. The ileum segments were immediately transferred and mounted in the organ bath containing Tyrode solution. The contractile effects of acetylcholine (a reference agonist) and Steganotaenia araliacaecold extract on ileum segments were investigated starting with the least effective doses, thereafter doubling the doses until maximal tissue response was observed. Antagonists that include atropine, indomethacin, mepyramine, ondansetron and nifedipine in the presence and absence of Steganotaenia araliacaecold extract were also investigated to establish the mechanism of actionResults: Steganotaenia araliacaecold extract increased the contractile force of isolated rat ileum in a dose-response manner but had no significant effects on the frequency of the spontaneous contractions. Pre-treating the tissue with atropine, indomethacin, mepyramine or ondansetron did not inhibit the contractile force of Steganotaenia araliacaecold extract, while pre-treating the tissue with nifedipine inhibited its contractile force by 100% (p<0.05)Conclusion: The cold root extract of Steganotaenia araliacae induced contractions on isolated rat ileum smooth muscle in a dose response manner by probable activation of calcium channels. It is possible that SAEᶜif used in high doses may cause severe abdominal cramps an effect that needs to be noted as it is being used in parturition.

Stump tumors: clinical, histological and therapeutic aspects a case report

Smooth uterine muscle tumor of uncertain malignant potential (STUMP) belongs to a unique entity that is rare and known by its complexity. Histology is the gold standard for the diagnosis. The aim of the study was to expose the latest researches in the field, about the clinical and radiological aspects to find a way to recognize these tumors way before surgery in order to discuss the best therapeutic strategy, by way of a clinical case report.

Feature Extraction from Uterus Signal and Image for Diagnosing Pregnancy Complications

Preeclampsia is a disorder that arises during pregnancy which results in maternal death during delivery, fetal death in the womb and growth retention in infants based on the degree of severity and duration of onset. The markers for identification are found to be Strength of uterine muscles, Decreased velocity & volume of Uterine Artery, Poor placentation, Deficient in Remodeling of Spiral artery. The proposed work emphasis on extraction of features of EHG signal and Ultrasound Image of normal and suspected preeclampsia patients at second trimester to identify the condition at the earliest. The ability of the Uterine Muscle can be identified by recording of electrical activity of the uterus, by a device called Electrohysterograph that uses surface bipolar electrodes placed at various points in the lower abdominal of pregnant women that can indicate the possibility of Preterm labor. The anatomy of Uterus, an indicator of weaker cervix and anatomy of kidney can be analyzed by abdominal Ultrasound Imaging. Based on the combined analysis of images and signal along with the support of biochemical tests it is possible to identify the disease at the start of second trimester.

Analysis of Fluctuations of Uterine Contractions in Preterm Pregnancies using Adaptive Fractal Features of Electromyography Signals

Analysis of fluctuations of uterine contractions under varied gestational ages is clinically significant. In this work, fluctuations associated with Preterm pregnancies are analyzed. For this, uterine electromyography (uEMG) signals in Preterm condition with varied gestational ages are considered. The signals are subjected to Adaptive Fractal Analysis (AFA) where a global trend is identified using overlapping windows of varying orders. The signal is detrended and fluctuation function is estimated. Hurst exponent features are extracted and analyzed statistically. Results show that AFA is able to characterize the variations in the fluctuations of Preterm uEMG signals. The feature values are distinct and vary with gestational age. Coefficient of variation is observed to be low, indicating that these features could handle inter-subject variability of Preterm signals. As early diagnosis of premature delivery is imperative for timely medical intervention and treatment, it appears that the proposed features could aid in determining the changes in uterine muscle contractions in Preterm condition.