Context: Polycystic ovarian syndrome (PCOS) is a common endocrine system disorder among the women of reproductive age, yet the etiology of PCOS remains unclear. Infertility in females with PCOS can be caused by anovulation, high luteinizing hormone levels, and hyperandrogenism. Aims: This research analyzed the role of the aromatase gene (CYP19A1) in PCOS pathogenesis. Settings and Design: This study used an observational, cross-sectional design. Subjects and Methods: A total of 110 research participants (55 PCOS patients and 55 non-PCOS patients) were included in the study. Statistical Analysis Used: A real-time quantitative polymerase chain reaction was used to analyze the mRNA expression for aromatase in granulosa cells. Results: The relative expression of aromatase mRNA is lower in women with PCOS compared to those without PCOS ( P < 0.05). Relative expression of CYP19A1 (aromatase) mRNA in PCOS group was 0.38 ± 0.25, whereas in non-PCOS group was 1.00 ± 0.00. The decline in aromatase activity contributes to an increase in testosterone level. This condition has a role in hyperandrogenism which is a typical characteristic of PCOS women. Granulosa cells in polycystic ovary undergo disturbance in the development and cannot respond to follicle-stimulating hormone (FSH) stimulation. Lack of stimulation of FSH causes induction inadequacy to aromatase enzyme activity in the aromatization process. The decline in FSH activity is caused by various factors that are associated with typical characteristics of PCOS. Conclusions: There is a decrease in the relative expression rate of granulosa cells’ aromatase mRNA in women with PCOS compared to the non-PCOS.
Introduction The clinical and economic impact of cervical cancer consistently become a serious burden for all countries, including Indonesia. The implementation of HPV vaccination policy for a big country such as Indonesia requires a strong commitment from several decision-makers. The aim of this study was to provide a comprehensive description on cost-effectiveness and the budget-impact of HPV vaccination policy in Indonesia. Method A cohort Markov model was used to evaluate the cost and the clinical impact of HPV vaccination for 10 years old girls in Indonesia. The researchers consider two doses of all three available HPV vaccines adjusted with the HPV infection profilewith 95% vaccination coverage to estimate the national cervical cancer incidence and mortality. The Budget impact analysis explores three different scenarios covering (1) Two districts per year expansion, (2) oneprovince per year expansion and (3) achieving the National Immunization Program in 2024. Results Upon fully vaccinating almost 2.3 million 10-year-old girls, 34,723; 43,414; and 51,522 cervical cancer cases were prevented by Quadrivalent, Bivalent and Nonavalent vaccines, consecutively. Furthermore, the highest (591 cases) and lowest (399 cases) mortality were prevented by Nonavalent and Quadrivalent vaccines, respectively. Most of the vaccines were considerably cost-effective and only the Bivalent vaccine with the GAVI/UNICEF price which will be considered a cost-saving strategy.To provide national coverage of HPV vaccination in Indonesia, the government has to provide an annual budget of about US$49 million
BackgroundAn imbalance between pro- and anti-angiogenic factors contributes to impaired trophoblast invasion during pregnancy, leading to failure of uterine spiral artery remodeling, blood vessel ischemia, and pre-eclampsia (PE). Anti-angiogenic semaphorin 3B (SEMA3B) and pro-angiogenic cullin 1 (CUL1) are expressed in both the placenta and maternal blood. The present study investigated correlations between serum and placental SEMA3B as well as CUL1 levels in late-onset PE.MethodsThis cross-sectional study included 50 patients with late-onset (≥ 32 weeks gestation) PE. Maternal serum was obtained before delivery, and placentas were obtained immediately after delivery. SEMA3B and CUL1 levels were evaluated by ELISA. Results were statistically analysed by Spearman correlation test, with a P < 0.05 considered statistically significant.ResultsWhile elevated serum SEMA3B levels significantly correlated with increased placental SEMA3B levels in late-onset PE (R = 0.620, P = 0.000), alteration of serum CUL1 levels did not correlate with alteration of placental CUL1.ConclusionAlteration of circulating maternal SEMA3B, but not CUL1, levels can potentially be used to monitor PE progression during pregnancy.
BACKGROUND The Indonesian Expanded Program of Immunization has implemented tetanus and diphtheria (Td) vaccination to replace the tetanus toxoid vaccine in pregnant women since the year 2016. Td vaccine is administered to protect against diphtheria and tetanus to the mother and her baby as well. This prospective study was conducted to assess the adverse reactions after Td immunization; besides, a retrospective study was conducted to observe the presence of severe local reaction (Arthus reaction), premature birth, and low birth weight history in the medical records of pregnant women who had received Td immunization in the past year.METHODS A prospective observational study was conducted in 200 pregnant women. Local reactions and systemic events occurring within 28 days after immunization were recorded in the diary card and were confirmed by the health worker in the follow-up visit. A retrospective study was also conducted to evaluate 750 medical records of pregnant women who had received Td immunization. The study was conducted from September 2017 to January 2018. The study has been registered at ClinicalTrials.gov ID: NCT03383653. RESULTSIn 185 pregnant women who completed the study, the most common local reaction was pain, occurring in 33.5% of subjects within 24 hours after vaccination. Fever, other systemic reactions, and serious adverse events were not reported during the observation. In the retrospective study, 647 medical records were validated. No Arthus reaction was observed. The prevalence of premature birth was 1.24%, and that of low birth weight was 2.63%, which were below the normal rates.CONCLUSIONS Td vaccination in pregnant women was safe and well-tolerated.
Background: To explore the effect of ethynil estradiol and desogestrel on proliferation and apoptosis hydatidiform mole trophoblast cell. Methods: From April 2008 until March 2009, we collected 15 samples of hydatidiform mole tissue. Trophoblast cells was isolated and culture at RPMI 20% FBS medium. Only 7 samples (46%) shown good growth. Cell was identified using cytology and β HCG test. Trophoblast cells good quality than devided into three groups observation. First group get ethynil estradiol 10 nmol/mL, second group get desogestrel 100 nmol/mL, Third group get DMSO 1%. Cells incubated and observe at 24, 48, 72, 96 hours. Cell cycle, apoptosis and β HCG was evaluated at each time observation. Cell cycle evaluation using BD cycle test plus DNA reagent, apoptosis evaluation using FITC-Annexin V. Analyze using FACSCalibur flowcytometer. β HCG evaluation using Abbott AxSym total β-HCG reagent pack. Results: The group of cell that get ethynil estradiol in concentration 10 nmol/mL had cell proliferation index, amount cells and β HCG level higher than control after 72 hours observation. The group of cell that get desogestrel in concentration 100 nmol/mL have cell proliferation index, amount cells and β HCG level lower than control after 48 hours observation. There are no differences of apoptosis between the two group and control. Conclusion: Ethynil estradiol will increase proliferation of hydatidiform mole trophoblast cell, while desogestrel will decrease proliferation of hydatidiform mole trophoblast cell. There are no effect of ethynil estradiol and desogestrel on apoptosis of hydatidiform mole trophoblast cell.
A B S T R A C TIntroduction To explore the effect of ethynil estradiol and desogestrel onproliferation and apoptosis hydatidiform mole trophoblast cell. Methods: From April2008 until March 2009, we collected 15 samples of hydatidiform mole tissue.Trophoblast cells was isolated and culture at RPMI 20% FBS medium. Only 7samples (46%)shown good growth. Cell was identified using cytology and β HCG test.Trophoblast cells good quality than devided into three groups observation. Firstgroup get ethynil estradiol 10 nmol/mL, second group get desogestrel 100 nmol/mL,Third group get DMSO 1%. Cells incubated and observe at 24, 48, 72, 96 hours. Cellcycle, apoptosis and β HCG was evaluated at each time observation. Cell cycleevaluation using BD cycle test plus DNA reagent, apoptosis evaluation using FITC-Annexin V. Analyze using FACSCalibur flowcytometer. β HCG evaluation usingAbbott AxSym total β-HCG reagent pack. Results: The group of cell that get ethynilestradiol in concentration 10 nmol/mL had cell proliferation index, amount cells andβ HCG level higher than control after 72 hours observation. The group of cell thatget desogestrel in concentration 100 nmol/mL have cell proliferation index, amountcells and β HCG level lower than control after 48 hours observation. There are nodifferences of apoptosis between the two group and control. Conclusion: Ethynilestradiol will increase proliferation of hydatidiform mole trophoblast cell, whiledesogestrel will decrease proliferation of hydatidiform mole trophoblast cell. Thereare no effect of ethynil estradiol and desogestrel on apoptosis of hydatidiform moletrophoblast cell.
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