Background: Polycystic ovary syndrome (PCOS) is a chronic disorder and is one of the most common endocrine disorders in women of a reproductive age. The prevalence of PCOS is growing globally; 52% of women in Southeast Asia alone suffer from this disorder. This disorder is caused by chronic hyperandrogenism, which hinders folliculogenesis. There is also a close relationship between hyperandrogenism and hyperinsulinemia/insulin resistance (IR), and it is estimated that 40–80% of PCOS patients suffer from insulin resistance (IR). Mesenchymal stem cells (MSCs) and their secretomes have been shown to alleviate PCOS symptoms by decreasing IR and androgen secretion by reducing inflammation. This study aimed to systematically review the literature to study the reported potential of MSCs and their secretomes in decreasing inflammation markers in PCOS treatment. Methods: A systematic literature search was performed on EMBASE, PubMed (MEDLINE), and the Cochrane Library with the terms insulin-resistant PCOS, mesenchymal stem cells, and secretome or conditioned medium as the search keywords. A total of 317 articles were reviewed. Four articles were identified as relevant for this systematic review. Results: The results of this study supported the use of mesenchymal stem cells and their secretions in decreasing inflammatory markers in the treatment of polycystic ovary syndrome. Conclusions: This review provided evidence that treatment with mesenchymal stem cells and their secretomes has the potential to treat PCOS due to its ability to downregulate androgen levels and increase insulin sensitivity, which thereby lowers the level of proinflammatory factors.

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Clinical pathway menyediakan standar pelayanan minimal dan memastikan bahwa pelayanan tersebut tidak terlupakan dan dilaksanakan tepat waktu.Mioma uteri menjadi salah satu pilihan kasus yang diteliti kesesuaian diagnosisnya dengan clinical pathway. Hal ini disebabkan karena kasus mioma uteri sering terjadi dan memerlukan high cost serta hight risk bagi pasien yang menderita kasus tersebut. Penyebab utama mioma uteri belum diketahui secara pasti sampai saat ini, tetapi penyelidikan telah dijalankan untuk memahami keterlibatan faktor hormonal, faktor genetik, growth factor, dan biologi molekular untuk tumor jinak ini. Metoda penelitian menggunakan Cross sectional. Tujuan penelitian ini untuk mengamati penggunaan clinical pathway terhadap tindakan laparaskopi dan laparatomi atas indikasi mioma uteri berdasarkan variabel  lama operasi, jumlah perdarahan saat operasi, komplikasi, lama dirawat (Length Of Stay) dan transfusi pasca operasi.Waktu penelitian dilaksanakan pada bulan Januari sampai Juni2017.Populasi   pada penelitian   ini adalah seluruh wanita dengan diagnosa mioma uteri yang menjalani operasi baik laparatomi maupun laparoskopi di RSPAD Gatot Soebroto yaitu sebanyak 53 pasien. Hasil penelitian ini diperoleh 53 kasus mioma uteri, terdapat 21 pasien (39.6%) laparoskopi miomektomi, 6 pasien (11.3%)   laparoskopi histerektomi, 14 pasien (26.4%) laparatomi miomektomi dan 12 pasien (22.6%) laparatomi histerektomi. Penggunaan clinical pathway terhadap kesesuaian diagnosa pre operasi dan pasca operasi 12 kasus (22.6%) tidak sesuai dan 41 kasus (77.4%) yang sesuai. Dari 5 variabel yang diambi (lama operasi, jumlah perdarahan, lenght of stay, komplikasi dan transfusi) hanya ada 1 variabel yang berhubungan dengan penggunaan clinical pathway terhadap tindakan laparatomi dan laparaskopi pada kasus mioma uteri yaitu jumlah perdarahan (p = 0.036). Kata kunci : laparaskopi, laparatomi, mioma uteri, clinical pathway