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.

Purpose: This research is a preliminary study to observe the high-risk HPV infection profile among asymptomatic women, as a basis for developing Indonesian-specific reagents and implementing a national vaccination program. Methods: The research subjects were female employees/families of BUMN (state-owned enterprises) who underwent annual routine medical check-up. The research sample was a cervical swab which was examined using the Cobas^® 6800 platform for HPV identification and INNO Lipa (Fujirebio) kit for identification of the genotype. Results: Out of 858 cervical swab samples collected in this study, 31 samples were excluded as they had invalid results from the initial examination, so the remaining 827 samples continued this study protocol. Of those samples, 69 (8%) samples gave positive results, giving an overall HPV prevalence of 8%. Among HPV-positive samples, HPV 52 was the most common genotype (N = 15, 21.7%) found as both single-infection and multiple infections. The median age of subjects was 38 years. There were nine samples (13%) with multiple infections of two or more genotypes and seven samples (10.1%) with no specific genotype identified. Conclusion: HPV prevalence was 8%, with HPV 52 being the most common high-risk type, making it a necessity to develop a diagnostic kit and vaccine for national vaccination program that is specific for Indonesian population which includes this genotype.

Neuromyelitis Optic (NMO) is an inflammatory disorder involving central nervous system which often co-exists with other autoimmune diseases such as Sjögren’s syndrome (SS). NMO manifestation could precede or follow SS, but the role of anti-SSA in the pathogenesis of NMO remains unclear. We present a case of NMO with anti-AQP4 anti-SSA antibody positive. A-44-year-old female presented with right side weakness. The symptoms began with numbness that improved spontaneously. She also complained pain and dry sensations on her eyes. Schirmer test on her left eye, antinuclear antibody (ANA) and anti- SSA antibody were positive. Cervical MRI revealed intramedullary lesion on T2- weighted-image at C2-C5 level. She was diagnosed as NMO with positive anti- AQP4 and probable SS. She received 1g methylprednisolone for 5 days proceeded with mycophenolic acid. One-year observation showed clinical improvement. Systemic autoantibodies must substantially be evaluated in NMO. Comprehensive diagnosis and providing appropriate immunosuppressant might prevent further disability and relapse.

Purpose: Diarrhea is one of the leading causes of mortality in children living in developing countries. The etiology of acute diarrhea in each healthcare center varies depending on place, time, and population. This study aimed to identify pathogen patterns in human immunodeficiency virus (HIV) -infected and non -HIV children suffering from acute diarrhea, using multiplex real time reverse transcriptase polymerase chain reaction (RT-PCR), in an Indonesian tertiary hospital. Methods: This cross-sectional study was conducted at Dr. Cipto Mangunkusumo National Hospital from March 2019 to April 2020. Results: The study showed that multiplex RT-PCR results were positive in 58.9% of the specimens, with more positive results in HIV -infected children than in non -HIV -infected children (70% vs. 54.7%). Altogether 72 enteropathogens were detected from all specimens. Enteropathogens in non -HIV children with acute diarrhea consisted of bacteria (70.6%) and viruses (29.4%) with a predominance of enteroaggregative Escherichia coli (25.4%), followed by Campylobacterspp. (11.8%), enteropathogenic E. coli (9.8%), Norovirus GII (7.8%), and Clostridium difficile (7.8%). Enteropathogens in HIV -infected children consisted of viruses (57.1%), bacteria (28.6%), and parasites (14.3%) comprising Norovirus GII (24%), Cryptosporidium spp. (14.3%), Campylobacter spp. (14.3%), Norovirus GI (14.3%), and Astrovirus (14.3%). Cryptosporidium spp. was the only parasite found in this study and was found only in HIV -infected children. In non -HIV children with acute diarrhea, most pathogens were invasive bacteria, while in HIV -infected children, more viral and parasite infections occurred, primarily caused by opportunistic pathogens.

Link of Video https://youtu.be/cQUhwa50jAM Background: Predictors of mortality in COVID-19 patients, which are essential factors in guiding patient management, are poorly understood. In Indonesia, several inflammatory markers have been utilized to evaluate the severity of COVID-19. This study aimed to determine the role of C-reactive protein (CRP), D-dimer, interleukin-6 (IL-6), and XCL1/lymphotactin levels in predicting 28-day mortality in patients with COVID-19. Methods: A prospective cohort study was conducted with COVID-19 patients admitted to the emergency department at Cipto Mangunkusumo Hospital and Medistra Hospital, Jakarta, Indonesia, from June 2020 to February 2021. The predictors of 28-day mortality in COVID-19 patients in this study included CRP, D-dimer, IL-6, and XCL1 levels at admission. Cox proportional hazard regression analysis was used to determine the independent predictors of 28-day mortality in the study population. Results: A total of 120 patients with COVID-19 were enrolled in the study; 21 (17.5%) died within 28 days after admission. According to our multivariate analysis, a CRP level (HR, 8.55; 95% CI, 3.310-22.088) ≥ 110 mg/L and a D-dimer level (HR, 20.642; 95% CI, 6.909-61.667) ≥ 4640 ng/mL were identified as independent predictors of 28-day mortality in COVID-19 patients. Conclusion: A C-reactive protein level ≥ 110 mg/L and a D-dimer level ≥ 4640 ng/mL can be used to predict 28-day mortality in COVID-19 patients.

Background: Patients hospitalized in the intensive care unit (ICU) have a higher susceptibility to infections. Respiratory infections are the most common nosocomial infections. Rising antibiotic resistance due to indiscriminate use of antibiotics and poor adherence to standard precaution in healthcare facilities compounds the problem. The main aim of this study is to assess microbial patterns and antibiotic resistance from bronchoalveolar lavage specimens in severe pneumonia patients. Methods: This retrospective study was conducted in an Indonesian tertiary care hospital from January 2016-December 2020. Written and verbal informed consent was obtained prior to bronchoscopy procedures. Patients were enrolled if they had severe community-acquired pneumonia (CAP) according to American Thoracic Society (ATS)/Infectious Disease Society of America (IDSA) criteria, had high-risk hospital-acquired pneumonia (HAP), late-onset ventilator-associated pneumonia (VAP), or pneumonia caused by Coronavirus disease (COVID-19). Respiratory specimens via bronchoscopy were inoculated on general semi-sloid thioglycolate media. Testing for antibiotic susceptibility was done using the disk diffusion method. Results: Two hundred and one patients’ data were analyzed. The majority of patients were males (65,17%) and above 60 years of age. The most common type of pneumonia was CAP (39,3%). Neurologic/cerebrovascular disease was the most common comorbidity (35,32%). Acinetobacter baumannii was the most frequently isolated microorganism. Ampicillin/sulbactam and amikacin were found to yield lower microbial resistance. Conclusion: Combination of ampicillin/sulbactam and amikacin appeared effective as initial empirical therapy in severe pneumonia patients. Further studies are needed to evaluate the feasibility and effectiveness of this combined therapy.