Objective: To analyze the relationship between levels of serum vascular endothelial growth factor (VEGF) and bleeding occurrence in depo medroxyprogesterone acetate (DMPA) acceptors. Method: We employed a cross‐sectional study on 70 DMPA acceptors with DMPA use of 3 to 6 months who presented for midwifery service in Palembang. Blood samples were obtained in order to assess levels of serum VEGF using ELISA (enzyme‐linked immunoabsorbent assay) method. Laboratory assessments were carried out in PRODIA laboratory in Jakarta. Result: We recruited 70 subjects into our study. After 3 to 6 months of using DMPA, as much as 26 subjects (37.1%) reported complaints of bleeding and 44 subjects (62.9%) reported no bleeding. The mean level of serum VEGF in DMPA acceptors with bleeding was 355 K 170 pg/ml, and 323 K 202 pg/ml in acceptors with no bleeding. We identified a significant association between duration of use and bleeding occurrence (p0.05). Conclusion: In our sample, we found an association between duration of DMPA use and presence of bleeding but VEGF levels was not found to be different in women experiencing abnormal uterine bleeding and those who did not. Keywords: bleeding, DMPA acceptor, serum VEGF

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Introduction Surgery is the most important therapeutic modality for the treatment of primary lung cancer. Studies normally reported as 30-days or 90-days post-operative mortality or 5-years survival. However, survival for ≥10-years is rarely mentioned. Method Retrospective data collection from a tertiary centre database was implemented which include patients who underwent pneumonectomy from January 1998 until November 2019. The data was analysed for short and long-term outcomes including their respective Thoracoscore. Results 268 patients who had pneumonectomy were selected, in majority for lung cancer. 79.1% were male with mean age is 63. Overall operative mortality in this cohort was 4.9% while reported national mortality for pneumonectomy for lung cancer is 7%. No 30-days post-operative mortality in the last 5 years. The 5,10- and 15-years survival rate for patients are 36.9%, 23.9% and 20.3% respectively. This showed significant increase in the survival rate for 5- and 10-years post-pneumonectomy in comparison to previous study. Long-term survival was better in female with age <70 years. The overall survival rate >15 years is 0.4%. Conclusions This study shows that our operative mortality for pneumonectomy is significantly lower (30% less) than national mortality. This confirms that pneumonectomy is still an effective modality in the treatment of lung cancer.

Objective: To provide a randomized comparison between Jadena® and Norplant® in terms of efficacy and acceptability among Indonesian women. Method: This study was a phase IV, open label, randomized, multicenter study throughout Indonesia. Subjects were Indonesian adult women who were randomized to receive Jadena® or Norplant® as their contraceptive method. The subjects were recruited from 6 large cities in Indonesia, such as Medan, Palembang, Jakarta, Semarang, Surabaya, and Makassar. Result: Of 600 subjects, 301 women getting to Jadena® and 299 women to Norplant® were enrolled between August 1998 and February 1999. The mean age was 29.8 (SD 5.3) years old, ranging from 18 to 40 years old. We did not find the pregnancy during the study. Non-pregnancy probability at the end of one year was similar between Jadena® (0.920 (SD 0.016)) and Norplant® users (0.916 (SD 0.084)). The continuation rates of Jadena® at one and three-year were 95.3% and 66.8%; whereas, the continuation rates of Norplant® was 94.3% at year-1 and 70.2% at year-3. Conclusion: The new two rod levonorgestrel subdermal system (Jadena®) showed similar efficacy with the old six capsule levonorgestrel subdermal system (Norplant®) in term of birth control. Both implant systems also have similar tolerability profile. Jadena® is easier to insert and remove than Norplant®. Keywords: birth control, efficacy, implant