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Abstract : Myasthenia gravis (MG) is a rare autoimmune disorder caused by antibodies that destroy receptors in the post-synaptic neuromuscular junction. The production of antibodies is related to the failure of the T-regulatory cell to destroy the autoreactive cell. This research aims to analyze the differences in Treg levels between selected MG patients and healthy controls. Myasthenia gravis patients were patients in RSUP Dr. Kariadi Hospital Semarang that met inclusion and exclusion criteria. The healthy controls were gender-matched with the MG patient group and got physical examination and questionnaire to establish as ‘healthy’. Treg analysis with flowcytometry and BD bioscience Treg cocktail that identify as CD4+CD25brightCD127dim. Analysis variable with SPSS 28.00 There is no significant correlation between Treg level and other variables, like age, disease duration, severity, or the level of the antibody acetylcholine receptor. The mean Treg level in the MG group compared to the healthy group is 4,75% vs 12,81%. There is a significant difference in the level of Treg serum in patient MG compared with healthy controls (p≤0,001). There is no significant difference between CD4+ and CD25+ between the two groups.

Abstract : Electronic cigarettes (e-cigarettes) have become increasingly popular globally, including in Saudi Arabia, raising concerns about public awareness and use. This study aimed to assess the awareness of the general population of Qassim, Saudi Arabia towards e-cigarettes and the association with sociodemographic factors. A cross-sectional study was conducted among the general population of Qassim, Saudi Arabia from January to March 2024. A convenient sample of 422 participants completed an online self-administered questionnaire to assess their awareness and attitudes towards e-cigarettes. Descriptive statistics, Mann-Whitney U, and Kruskal-Wallis tests were used for data analysis. The mean awareness score was 3.79 (SD=1.3) out of 6. Awareness was significantly higher among females, higher income groups, divorced/married, and retired participants. Over 94% of participants had heard about e-cigarettes previously, but 50.9% had never smoked. While 35.5% had used e-cigarettes, 54% of them used e-cigarettes with nicotine. Most participants (64.0%) believed e-cigarettes may have associated health risks, and 77.7% thought there should be age restrictions on e-cigarette use. The general population in Qassim, Saudi Arabia had moderate awareness about e-cigarettes, with variations across sociodemographic groups. Targeted educational campaigns are needed to improve awareness about the potential harms of e-cigarette use, especially among high-risk groups.

Abstract : Since it was discovered as the cause of Covid-19 infection, the SARS-CoV-2 Virus has continued to mutate. And the last is the discovery of the XBB.1.16 (Arcturus) subvariant in March 2023. In Indonesia, the spike in cases due to XBB.1.16 subvariant occurred in mid-April 2023 where the number of cases reached more than 1,000 per day. Phylogenetic analysis needs to be carried out to determine the evolution that has occurred in XBB subvariant in Indonesia, especially on Java Island, because Java Island is one of the most densely populated islands in Indonesia. The purpose of phylogenetic analysis is to determine the evolutionary relationship of SARS-CoV-2 in Java Island and to obtain information about pathogen through sequence data. This study aims to look at phylogenetic pattern of XBB subvariant SARS-CoV-2 in Covid-19 patients on Java Island. A total of 123 genome sequences of SARS-CoV-2 were taken from data available at GISAID from September 2022 to May 2023. The reference genome sequence of SARS-CoV-2 which was first discovered in Wuhan, China. Making phylogenetic patterns using Nextstrain Algorithm. Our data of the 123 whole genome sequences revealed 7 clades, namely Clade 22B, 22D, 22E, 22F, 21L, 23 A dan recombinant. A total of 27 Pango Lineages were identified. The dominant lineage were XBB.1.9.2, XBB.1.9.1 and XBB.1. There are also BQ lineages cocirculated with XBB lineages in Java Island. There are convergent evolution, of the spike protein that increase the binding affinity of SARS-CoV-2 S protein to human angiotensin-converting enzyme 2 (ACE 2) which is L452R, N460K and R346T. And also there are mutation that contribute to evasion of antiviral humoral immunity induced by vaccination and natural SARS-CoV-2 infection which is R346T, K444T and F486V. These mutations that causes faster spread and a higher infection rate than the previous variant were found in the XBB subvariant in Covid-19 patient in Java island. In Java island we can find that BQ lineages cocirculated with XBB lineages.

Abstract : Ovarian granulosa cell tumors are rare and account for 2-5% of ovarian malignancy. Granulosa cell tumors showed some features of normal granulosa cells with estrogenic effects. Therefore, the diagnosis is usually by common ovarian symptoms or endometrial pathologies. Depending on age estrogen, excess symptoms might be present. A high level of estrogen, steroid hormones excess, age, the presence of symptoms, and the presence of p53 mutation are the risk factors. Therefore, endometrial biopsy is mandatory, the standard therapeutic protocol consists of total radical hysterectomy with bilateral adnexectomy, and unilateral adnexectomy is an option with meticulous follow-up to preserve reproductive function. A six-cycle carboplatin and paclitaxel is the preferred adjuvant modality with bleomycin, etoposide, and cisplatin (BEP) an effective alternative. Stage 1 patient treatment should be individualized case by case depending on stage, risk, and differentiation. We presented a rare case of ovarian granulosa cell tumor with endometrial cancer presenting with post-menopausal bleeding.

Abstract : The development of technology in all areas of life has effects on people's behavior patterns and habits. Which results in hypertension gaining increasing prevalence and resulting in various complications. This study aims to provide an overview of plasma MDA levels and antioxidant gene expression SOD1 and SOD2 in hypertension patients: This study is an analytical observational with a case-control research design approach in the Angke sub-district, Tambora district, West Jakarta. A total of 60 respondents participated in this study. The data studied included subject characteristics (age, sex, disease history, anthropometric data, body mass index, blood pressure), MDA levels and SOD antioxidant gene expression. The research instruments used were questionnaires and laboratory tests of fasting blood glucose, total cholesterol, MDA levels, and antioxidant gene expression using PCR. Results: MDA levels in normotension patients were higher than in hypertension patients. SOD1 gene expression levels were relatively higher in normotension patients, with p <0.05. Conclusion: SOD1 gene expression differs in meaning between hypertension and normotension groups.