Perbedaan Kualitas Seksual pada Wanita Akseptor KB Hormonal dengan KB Non-Hormonal

Background: Sexual intercourse in the family is the peak of harmony, therefore both parties must be able to enjoy it together. Sex dissatisfaction can lead to differences of opinion, disputes and ultimately divorce. Hormonal contraception has side effects, one of which is an imbalance of the hormones estrogen and progesterone which can cause changes in sexual activity. Each type of family planning has its own side effects, but in most cases a decrease in sexual desire is a side effect that can be found in every use of the type of family planning. The purpose of this study was to determine differences in sexual quality in female hormonal and non-hormonal family planning acceptors.Methods: Descriptive analytic type of research with a comparative design using the Case Control approach, a sample of 68 Wus which is a hormonal and non-hormonal family planning acceptor. Simple Random Sampling sampling technique and observation sheet instrument and SQOL-F questionnaire. This research uses Chi Square data analysis.Results: Chi Square Continuity Corrections test results showed significant results P = 0.000 (P <0.1), meaning that P value 0.000 is smaller than 0.1 there are differences in sexual quality in female hormonal and non-hormonal KB acceptors.Conclusion: Most non-hormonal family planning acceptors have good sexual qualities while hormonal birth control acceptors mostly have moderate sexual quality.

Updating Insights into Rosiglitazone and Cardiovascular Risk through Shared Data: Individual Patient- and Summary-Level Meta-Analyses

ABSTRACTObjectiveTo conduct a systematic review and meta-analysis of the effects of rosiglitazone therapy on cardiovascular risk and mortality using multiple data sources and varying analytical approaches.DesignSystematic review and meta-analysis of randomized controlled trials.Data sourcesGlaxoSmithKline’s (GSK) Clinical Study Data Request (CSDR) and Study Register platforms, MEDLINE, PubMed, Embase, Web of Science, Cochrane Central Registry of Controlled Trials, Scopus, and ClinicalTrials.gov from inception to January 2019.Study selection criteriaRandomized, controlled, phase II-IV clinical trials comparing rosiglitazone with any control for at least 24 weeks in adults.Data extraction and synthesisFor analyses of trials for which individual patient-level data (IPD) were available, we examined a composite of the following events as our primary outcome: acute myocardial infarction, heart failure, cardiovascular-related deaths, and non-cardiovascular-related deaths. As secondary analyses, these four events were examined independently. When also including trials for which IPD were not available, we examined myocardial infarction and cardiovascular-related deaths, ascertained from summary-level data. Multiple meta-analyses were conducted, accounting for trials with zero events in one or all arms with two different continuity corrections (i.e., 0.5 constant and treatment arm comparator continuity correction), to calculate odds ratios and risk ratios with 95% confidence intervals.ResultsThere were 33 eligible trials for which IPD were available (21156 participants) through GSK’s CSDR. We also identified 103 additional trials for which IPD were not available from which we ascertained myocardial infarctions (23683 patients) and 103 trials for cardiovascular-related deaths (22772 patients). Among trials for which IPD were available, we identified a greater number of myocardial infarctions and fewer cardiovascular-related deaths reported in the IPD as compared to the summary-level data. When limited to trials for which IPD were available and accounting for trials with zero-events in only one arm using a constant continuity correction of 0.5, patients treated with rosiglitazone had a 39% increased risk of a composite event compared with controls (Mantel-Haenszel odds ratio 1.39, 95% CI 1.15 to 1.68). When examined separately, the odds ratios for myocardial infarction, heart failure, cardiovascular-related death, and non-cardiovascular-related death were 1.25 (0.99 to 1.60), 1.60 (1.20 to 2.14), 1.18 (0.64 to 2.17), and 1.13 (0.58 to 2.20), respectively. When all trials for which IPD were and were not available were combined for myocardial infarction and cardiovascular-related deaths, the odds ratios were attenuated (1.13 (0.92 to 1.38) and 1.10 (0.73 to 1.65), respectively). Effect estimates and 95% confidence intervals were broadly consistent when analyses were repeated including trials with zero events across all arms using constant continuity corrections of 0.5 or treatment arm continuity corrections.ConclusionsResults of this comprehensive meta-analysis aggregating a multitude of trials and analyzed using a variety of statistical techniques suggest that rosiglitazone is consistently associated with an increased cardiovascular risk, likely driven by heart failure events, whose interpretation is complicated by varying magnitudes of myocardial infarction risk that were attenuated through aggregation of summary-level data in addition to IPD.Systematic review registrationhttps://osf.io/4yvp2/What is already known on this topic-Since 2007, there have been multiple meta-analyses, using various analytic approaches, that have reported conflicting findings related to rosiglitazone’s cardiovascular risk.-Previous meta-analyses have relied primarily on summary-level data, and did not have access to individual patient-level data (IPD) from clinical trials.-Currently, there is little consensus on which method should be used to account for sparse adverse event data in meta-analyses.What this study adds-Among trials for which IPD were available, rosiglitazone use was consistently associated with an increased cardiovascular risk, likely driven by heart failure events.-Interpretation of rosiglitazone’s cardiovascular risk is complicated by varying magnitudes of myocardial infarction risk that were attenuated through aggregation of summary-level data in addition to IPD.-Among trials for which IPD were available, we identified a greater number of myocardial infarctions and fewer cardiovascular deaths reported in the IPD as compared to the summary-level data, which suggests that IPD may be necessary to accurately classify all adverse events when performing meta-analyses focused on safety.

Exact Probabilities and Confidence Limits for Binomial Samples: Applied to the Difference between Two Proportions

An exact probabilities method is proposed for computing the confidence limits of medical binomial parameters obtained based on the 2×2 contingency table. The developed algorithm was described and assessed for the difference between two binomial proportions (a bidimensional parameter). The behavior of the proposed method was analyzed and compared to four previously defined methods: Wald and Wilson, with and without continuity corrections. The exact probabilities method proved to be monotonic in computing the confidence limits. The experimental errors of the exact probabilities method applied to the difference between two proportions has never exceeded the imposed significance level of 5%.