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B Affandi

Publications and source records attributed to B Affandi.

43 records · Page 3Linked to original sources

Five-year experience with Norplant.

At Klinik Raden Saleh, Department of Obstetrics and Gynaecology, University of Indonesia, from 1 May until 31 August, 1981, Norplant contraceptive implants were inserted into 437 Indonesian women. The continuation rates of Norplant at first, second, third, fourth and fifth year were, respectively, 96%, 92%, 88%, 82% and 78%. Bleeding problems were the most common cause for removal. The cumulative five-year net pregnancy rate for Norplant was 1.8 per 100 women. The Norplant contraceptive system is thus seen to combine the highest acceptability as measured by its continuation rate with the highest long-term effectiveness among the available temporary contraceptive methods.

Adult↗

Serum lipids in Norplant implants users: a cross-sectional study.

One of the methods to establish the safety and risk profile of hormonal contraceptives is employing a study on their metabolic effects. In order to evaluate the effect of Norplant implants on serum lipids, a cross-sectional study was undertaken at Klinik Raden Saleh, Jakarta. The subjects recruited were divided into 8 groups depending on the length of Norplant use, i.e. before insertion, 6 months, 12 months, 24 months, 36 months, 48 months, 60 months and one week after the removal of Norplant. Blood samples were collected from the subjects after an overnight fast. The parameters studied were triglycerides, total cholesterol, HDL-cholesterol and LDL-cholesterol. There were no significant differences between the groups regarding the triglycerides and HDL-cholesterol (p greater than 0.05). There were significant differences between the groups regarding the total cholesterol and LDL-cholesterol (p less than 0.01).

Adult↗

The interaction between sex hormone binding globulin and levonorgestrel released from Norplant, an implantable contraceptive.

Two-hundred-and-eighty Indonesian women were provided with Norplant, a levonorgestrel-releasing implant. At various time intervals, up to 5 years after Norplant insertion, levonorgestrel and sex hormone binding globulin (SHBG) were assayed in blood plasma. After an initial burst of approximately 7 nmol/l, the levels of levonorgestrel rapidly decreased during the first month. The decrease continued to a nadir (1.1 nmol/l) which was reached 10 months later. The decrease was followed by an increase to a broad peak of 1.5 nmol/l which was reached 2 years after insertion. Thereafter, a slow-decrease at a rate of approximately 18 pmol/month was seen. SHBG levels decreased significantly already 1 week after insertion. A nadir of levels (25 nmol/l) was reached 3 months later. The levels increased slowly again and remained constant (32 nmol/l) from about 15 months to 5 years. During the entire period of study highly significant correlations of levonorgestrel with SHBG were seen. In another group of 25 women the levels of levonorgestrel and SHBG were studied before and one week after insertion of Norplant. A significant correlation (r = 0.77) was found between the preinsertion levels of SHBG and postinsertion levels of levonorgestrel.

Adult↗

Effect of Norplant on mothers and infants in the postpartum period.

To evaluate the effect of Norplant on lactation and the growth of the infant, a comparative study on lactating women using a cohort approach has been carried out in Klinik Raden Saleh, Department of Obstetrics and Gynaecology, University of Indonesia and Dr Cipto Mangunkusumo General Hospital, Jakarta. The recruitment of the study group took place between 1 November 1983 and 31 August 1984. The inclusion criteria, among others, were age 18-40 years, full term gestation, spontaneous delivery, 4-6 weeks after delivery and plans to breastfeed for at least 6 months. The study group consisted of 60 Norplant acceptors, while the control group consisted of 60 Cu-7IUD acceptors. The subjects had a free choice in deciding which form of fertility regulation they preferred. After 6 months of observation the following conclusions were drawn: Norplant use did not have any effect on maternal body weight, hemoglobin concentration or breastmilk production in comparison with IUD use. The development of infants breastfed by Norplant acceptors was not delayed compared to that of infants breastfed by IUD acceptors.

Adult↗

Peritoneal factors in infertile women in Jakarta, Indonesia.

In a study of internal genital infection and endometriosis, gynecologic examinations discovered only 46 patients (14.9%) with these abnormalities out of 308, but laparoscopic examinations of the same patients detected far more patients with these abnormalities (208, or 67.5%). Thus, laparoscopic examinations can prove useful in improving the clinical diagnosis of infertility in women.

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Insertion and removal of Norplant contraceptive implants by physicians and nonphysicians in an Indonesian clinic.

This paper reports on a study in which the performances of physicians were compared to those of nonphysician health personnel in inserting and removing NORPLANT subdermal contraceptive implants. The study was conducted in Raden Saleh Clinic at the University of Indonesia, Jakarta, from September 1982 to August 1984. In a group of 828 women who accepted NORPLANT 285 insertions were performed by physicians and 543 by nonphysician health personnel. During the study period, 122 removals were performed (43 by physicians and 79 by nonphysicians). This small proportion of removals reflects the high continuation rate for NORPLANT. There was no significant difference between the two groups of acceptors regarding age, parity, education, or side effects. The average insertion times were 7.6 minutes for the physician group and 7.4 minutes for the nonphysician group (p greater than 0.1). The average removal times were 21.7 minutes for physicians and 21.8 minutes for nonphysicians (p greater than 0.9). Complications during and following insertion and removal were minimal for both groups, and no significant differences were found. It was concluded that nonphysician health personnel are qualified to administer the NORPLANT contraceptive implants.

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