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Biomedical subjects

R S Samil

Publications and source records attributed to R S Samil.

11 recordsLinked to original sources

Health of Indonesian women city-dwellers of perimenopausal age.

In the last few years more women of climacteric age, living in urban areas, have been seeking medical care. In 1989, on the invitation of 6 women's organizations in Jakarta and other cities, the Indonesian Menopause Society gave talks and held discussions in cooperation with the Department of Obstetrics and Gynaecology, Faculty of Medicine of the University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta. These occasions were used to accumulate data from women participants of 40 years of age and older. The age of the respondents ranged between 40-59 years. Most were 42 years old (13.9%). Ninety-four percent were still married. Twenty-five percent had three living children. Sixty-three percent of the respondents were high school graduates who worked full time (33%), part time, or were unemployed. The average menarche age was 13 and menopausal age 50-51. Menopausal complaints were rare, hence medical consultations were rare. Tranquilizers were prescribed for those who did seek medical help. This data constitutes the basis of the formulation of a strategy to solve menopause related problems in Indonesia, where female life expectancy, and the contribution of women to society, is on the increase.

Adult↗

Pregnancy after removal of Norplant implants contraceptive.

Many concerns have been expressed regarding the introduction of a new contraceptive method into family planning programmes. One of the concerns is the return of fertility after discontinuing the method. To evaluate the subsequent fertility status of the Indonesian women after removal of Norplant, a prospective longitudinal study was undertaken in Klinik Radeb Saleh, Jakarta. Fifty-one women whose Norplant were removed because of their wish to become pregnant were followed-up for a period of two years or until pregnancy occurred, whichever was earlier. Two groups of women who had Lippes C IUD removed or discontinued the use of DMPA for planning pregnancy served as control and were followed-up for equal length of time. The cumulative conception rate for ex-Norplant users, ex-IUD users and ex-DMPA users at one year was 76.5, 74.7 and 70.2 per 100 women, respectively. There was no significant difference between the groups (p greater than 0.05). The present study, along with other studies, indicate that the prolonged use of Norplant do not impair the return of fertility.

Adult↗

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↗

Epidemiology of gestational trophoblastic neoplasm at the Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

This retrospective research was conducted in the Department of Obstetrics and Gynaecology of the Dr. Cipto Mangunkusumo Hospital, Jakarta, covering the period between 1977 and 1981. The incidence of hydatidiform mole was 1 in 77 pregnancies. The incidence of malignant trophoblastic disease was 1 in 185 pregnancies. Of the 406 cases of hydatidiform mole, 22.9% became malignant. Patients of 24 years of age or younger had a higher risk of getting hydatidiform mole (P less than 0.05) compared to older patients. The risk of becoming malignant increased with age and became evident after 40 years of age. Parity 1 or less was associated with a higher risk of getting hydatidiform mole (P less than 0.05), but had no influence on hydatidiform mole becoming malignant. The influence of blood group was not so clear, although there was a tendency for moles to occur more frequently in patients with blood groups A or B. By contrast, there was a tendency for the change into malignancy to occur more frequently in women with blood groups B or O. Gestational age had no influence towards the change into malignancy or metastasis. Uterine size (greater than 20 weeks gestation) correlated with the progression of hydatidiform mole into malignancy. However, subsequent metastasis was not influenced by the size of the uterus. It was found that 76.4% of malignant trophoblastic diseases originated from hydatidiform moles, 12.4% from abortions, 9.5% from normal deliveries, and 1.2% from ectopic pregnancies. Non-hydatidiform moles had a slightly greater risk for metastasis, although this was not significant. Hydatidiform mole in histologic stages II or III (Hertig-Mansell classification) had a significantly greater tendency (P less than 0.05) to become malignant than in stage I.

Adolescent↗

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.

Adult↗

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.

Adult↗