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Cervical cancer is the fourth most common cancer in women globally. In 2018, 570.000 women were diagnosed with cervical cancer, and 311.000 of them died from the disease.1 In Indonesia, cervical cancer is the second most common cancer. According to GLOBOCAN, there was a decrease in incidence from 17.2% to 9.2% from 2018 to 2020. This decrease has also been seen in other countries such as the United States. However, the distribution of cervical cancer varies widely among countries. WHO projected that the global burden of cervical cancer is projected to continue to increase, rising to 700 000 cases (21% increase) and 400 000 deaths (27% increase) in 2030 compared to 2018. Preventive measures become an important step to manage this situation. Preventions such as HPV vaccination, screening, and treatment of precancerous lesions have been found to be effective.

Cervical cancer is the second most common cancer that affects women, especially in developing countries including Indonesia. Cervical cancer is a type of cancer found in the cervix, precisely in the squamous columnar junction (SCJ). Early screening for cervical cancer can be reduce the risk of cervical cancer. One of the popular screening tool methods for the detection of cervical pre-cancer is the Visual Inspection with Acetic Acid (VIA) method. This is due to the level of effectiveness, convenience and low cost. This paper proposes a method for the detection and segmentation of the SCJ region on VIA images using U-Net. This study is the first research conducted using the CNN method to perform segmentation tasks in the SCJ region. The best performance results are shown from the Pixel Accuracy, Mean IoU, Mean Accuracy, Dice coefficient, Precision and Sensitivity values, namely 90.86%, 56.5%, 75.69%, 34.09%, 41.24%, and 56.91%. Keywords: Cervical Pre-cancer, Screening VIA, SCJ, U-Net.

Objective: To determine the efficacy of Channa striata extract on serum albumin level and wound healing after radical hysterectomy in cervical cancer patients in Mohammad Hoesin Hospital Palembang.Methods: A clinical trial was conducted in Mohammad Hoesin Hospital Palembang during period of January – September 2019. Samples were cervical cancer patients undergoing radical hysterectomy. Serum albumin level was measured before surgery, after surgery, and after the administration of Channa striata extract capsule. Efficacy of the supplement was analyzed with SPSS version 20 using paired t-test.Result: Twenty-eight cervical cancer patients undergoing radical hysterectomy who fulfilled inclusion criteria were obtained. Majority of patients were aged between 40-49 years old (89.3%), normoweight (39.3%), and lived in rural area. Mean duration of surgery was 154.46 ± 40.47 minutes. Serum albumin level before surgery, after surgery and after the administration of Channa striatus extract were 3.4 ± 0.61 g/dL, 2.91 ± 0.42 g/dL, and 3.11 ± 0.49 g/dL, respectively. There was a statistically significant difference between serum albumin level before and after the surgery (p=0.000). However, no statistically significant difference was found between serum albumin level after surgery and after administration of Channa striata extract capsule (p=0.750).Conclusions: There was no significant difference between serum albumin level after surgery and after administration of Channa striata extract capsule.Keywords: cervical cancer , channa striatus extract , radical hysterectomy, serum albumin level. Abstrak Tujuan: Untuk mengetahui efikasi ekstrak Channa striata terhadap kadar albumin serum dan penyembuhan luka pasca histerektomi radikal pada pasien kanker serviks di RS Mohammad Hoesin Palembang.Metode: Uji klinis dilakukan di RS Mohammad Hoesin Palembang selama periode Januari – September 2019. Sampel adalah pasien kanker serviks yang menjalani histerektomi radikal. Kadar albumin serum diukur sebelum operasi, setelah operasi, dan setelah pemberian kapsul ekstrak Channa striata. Khasiat suplemen dianalisis dengan SPSS versi 20 menggunakan uji-t berpasangan.Hasil: Didapatkan 28 pasien kanker serviks yang menjalani histerektomi radikal yang memenuhi kriteria inklusi. Mayoritas pasien berusia antara 40-49 tahun (89,3%), normoweight (39,3%), dan tinggal di daerah pedesaan. Durasi rata-rata operasi adalah 154,46 ± 40,47 menit. Kadar albumin serum sebelum operasi, setelah operasi dan setelah pemberian ekstrak Channa striatus berturut-turut adalah 3,4 ± 0,61 g/dL, 2,91 ± 0,42 g/dL, dan 3,11 ± 0,49 g/dL. Ada perbedaan yang signifikan secara statistik antara kadar albumin serum sebelum dan sesudah operasi (p=0,000). Namun, tidak ditemukan perbedaan yang signifikan secara statistik antara kadar albumin serum setelah operasi dan setelah pemberian kapsul ekstrak Channa striata (p=0,750).Kesimpulan: Tidak terdapat perbedaan yang bermakna antara kadar albumin serum setelah pembedahan dan setelah pemberian kapsul ekstrak Channa striata.Kata kunci: ekstrak Channa striatus, histerektomi radikal, kadar albumin serum, kanker serviks.

Screening is a public health intervention administered to a target population without symptoms. Screening is not performed to diagnose a disease, but to identify individuals with a higher likelihood of developing the disease itself or a precursor to the disease. Not all diseases are suitable for screening programs. The following criteria help determine whether a disease is suitable for a screening program: (1) The disease is bound to have serious consequences. (2) The disease must have a detectable preclinical and asymptomatic stage. (3) Treatment at the preclinical stage should influence the long-term course and prognosis of the disease being screened. (4) Care must be available and accessible to those who have a positive screening test. History, screening tests and treatment options for cervical pre-cancer meet these criteria.

HPV is a sexually transmitted virus, and high-risk HPV DNA was found in 99.7%of cervical cancer specimens. Within 12 to 24 months of exposure to the virus,90% of HPV infections disappear or become inactive. However, infection with high-risk strains of HPV persist which then increases the risk of progression to cervicalcancer. The detection of precancerous lesions consists of various methods,including pap smear (conventional or liquid-base cytology / LBC), visualinspection of acetic acid (IVA), visual inspection of lugoliodine (VILI), and HPV DNAtest (genotyping / hybrid capture).

Cervical cancer in Indonesia in 2018 ranks second in cancer in women in Indonesia with an incidence rate of 348.809 cases with a mortality rate of nearly 60% of the incidence, namely 207.210 deaths. Deaths from cervical cancer are projected to continue to increase and are estimated to reach 12 million deaths by 2030 if not treated properly. The incidence of cervical cancer in Indonesia is estimated to have 180.000 new cases per year and the death rate is thought to reach 75% in the first year. This death is mainly associated with the majority of newly diagnosed patients who are already at an advanced stage (70% of cases) and are already at the terminal stage at the time of diagnosis.

WHO has created a global strategy to accelerate the elimination of cervical canceras a public health problem and a world burden. Cervical cancer is a disease thatcan be prevented and cured, as long as it is detected early and treated effectively.Cervical cancer is also a disease that reflects global injustice. The burden isgreatest in low- and middle-income countries, where access to public healthservices is limited and screening and treatment for the disease has not been widelyapplied. In 2018, nearly 90% of all deaths worldwide occurred in low and middleincome countries. Furthermore, the proportion of women with cervical cancer whodie from the disease is more than 60% in these countries, more than double thenumber in many high-income countries, which is only 30%.

The International Association for the Study of Pain defines pain as “unpleasant sensory and emotional experiences associated with actual or potential tissue damage.” Pain is common among patients with cancer, with the prevalence of pain being 66.4% in advanced metastatic disease or terminal, 55% during anticancer treatment, 39.3% after curative treatment, and moderate to severe pain were reported in 38.0% of all patients. Pain is one of the most common and dreaded symptoms in cancer sufferers, but the exact number of cancer patients who experience pain is difficult to determine. There are a wide variety of studies in defining pain and the tools they use to measure the complexity of this symptom. Good or complete pain control can be achieved in 80-90% of cancer patients. Nevertheless, despite major advances in pain control, cancer-related pain continues to be a major public health problem globally.

Objective: to determine risk factors inhydatidiform mole patients who will develop into Gestational Trophoblast Neoplasm (GTN) in Dr.Mohammad Hoesin Hospital Palembang Method: An observational analytical study with case control design was conducted in Department of Obstetrics and Gynecology in Dr. Mohammad Hoesin Hospital Palembang / Faculty of Medicine Sriwijaya University Palembang from January 2017 to August 2017. The frequency and distribution of data are described in tables. Bivariate analysis was done to determine correlation between independent variable and dependent variable using Chi Square/Fisher Exact test and multivariate analysis was used to know which independent variable has the biggest influence to the occurrence of Gestational TrophoblastNeoplasm (GTN) post evacuation of hydatidiform mole. Data analysis was done using SPSS version 21.0. Results: There were 45 patients who fulfilled inclusion criteria with control group and case group ratio 1 : 2 (15 cases and 30 controls). Statistical analysis showed a significant correlation between patient age, pre-evacuation β HCG level, parity, and histopathologic appearance with occurrence of Gestational Trophoblast Neoplasm (GTN) after evacuation of hydatidiform mole (p

Cervical cancer is the third leading cause of death of women worldwide and number one in developing countries. On the Gynecology Division of Oncology Dr. Mohammad Hoesin Hospital Palembang administration of neoadjuvan chemotherapy is used as a therapy in advanced stage cervical cancer. Decreased CD4 cell value in the human body indicates a decrease in white blood cells or lymphocytes that play a role in fighting infections that enter the human body. This study aims to determine the value of CD4 in advanced cervical cancer at Dr. Mohammad Hoesin Hospital, Palembang. A case series study was undertaken in January to September 2017 at Dr. Mohammad Hoesin Hospital Palembang. There were 30 patients with advanced cervical cancer who meets the inclusion criteria. The frequency and distribution of data are described in tabular form. The effectiveness of NAC was analyzed using Paired T Test/Wilcoxon. Assessment of CD4 as a predictor of NAC therapy response was seen from the values of sensitivity and specificity. Data analysis using SPSS version 18.0. In this study, there were 30 patients with advanced cervical cancer. Mean age was 47.93 ± 9.537 years with age range 32-72 years and the highest stage was 3B (63.3%). With statistical analysis, there were no differences in age, height, stage and type of therapy between patients with positive and negative treatment response (p > 0.05). In addition, there was difference in the value of mass (p = 0.000) and the mass width (p = 0.000) before and after NAC therapy. There was no difference in CD4 values before and after NAC therapy series I (p = 0.072) but there are difference in CD4 values after NAC series II therapy (p = 0.021) The CD4 values after NAC series I therapy had a sensitivity of 82.14% and a specificity of 100% while the CD4 values after NAC II series therapy had a sensitivity of 89.29% and a specificity of 100%. It can be concluded that the CD4 cell value of patients with advanced cervical cancer increasing with Neoadjuvant Chemotherapy (NAC) therapy and can be used as a predictor of treatment response in patients with advanced cervical cancer.

Object: To assess the diagnostic value of Risk of Ovarian Malignancy Algorithm (ROMA) in predicting ovarian malignancy. Methods: Diagnostic test was performed at dr. Mohammad Hoesin Hospital Palembang during June 2016 to November 2016. Data were analized with SPSS version 21.0 and Med-calc statistic. Results: A total of 57 subjects were recruited in this study. Subjects were divided into two groups: the premenopausal and postmenopausal group. Analysis with ROC curve was performed, the ROMA optimal cut-off of ROMA was 23.7% and 48.15% in the premenopausal and the post-menopausal group, respectively. With the optimal cut-off, the sensitivity was 79.41% and specivicity was 75%, positive predictive value wa 73.07% and negative predictive value 83.77% with accuracy 76.92% in diagnosing ovarian malignancy. Compared to RMI-3, the sensitivity was 65.5% and specivicity was 85.7% with accuracy 75.44%. Conclusion: ROMA is not a reliable diagnostic tools of ovarian malignancy. Keywords: CA125, HE4, ovarian cancer, risk of ovarian malignancyalgorithm/ ROMA, risk of ovarian malignancy index/RMI