Introduction: Medical students need to learn histology to understand the relation between microscopic structure and function of cells and tissues. Pictures of manual preparation made by students can be used as notes and can describe students' understanding of the observed structures. Producing good pictures in a short time is a challenge for medical students. The use of digital illustrator technology is expected to be a solution to overcoming these problems. This study aims to measure the perception of acceptance and satisfaction rate of medical students in Gorontalo towards digital illustrators in apprehend histology practicum.Method: Cross-sectional descriptive survey with modified questionnaires from previous studies. The sampling technique used purposive sampling and involved 54 first-year students. The raw data were analyzed using Microsoft Excel. The mean value calculated for each item was compared with the theoretical mean value of 2.50 to determine whether the respondents agreed with the statement.Results: All items have an average rating exceeding the theoretical mean of 2.50. Also, the mean of 3.91 (SD = 0.58) for all items substantially exceeds the theoretical mean. Items with the highest perceived rate of perceived utility, ease of use, intention to use, and actual use of digital illustrator teaching materials in learning practical skills will significantly increase students' motivation, interest, and acquisition of practical skills.Conclusion: the use of digital illustrators is perceived positively by medical students in helping histology practicum learning, which is indicated by the high rate of acceptance and rate of satisfaction with its use.

In the urogenital system, simvastatin is associated with interstitial cystitis adverse effects, but the exact mechanism is not yet clearly defined. This study aims to determine the effect of simvastatin on eosinophilic inflammation of bladder tissue in vivo. Laboratory experimental research design with the post-test only control group using 24 female Wistar rats aged 8-10 weeks were randomly divided into simvastatin 50mg/kg BW (n=12) or placebo carboxymethylcellulose 0.5% (n=12). All groups received treatment through oral gavage for thirty days. After that, each group was divided equally into three subgroups: control rat, day 0 Interstitial Cystitis (IC) rat (IC0), and day 3 IC rat (IC3). Control or IC0 rats each received intravesical instillation of buffered saline or protamine sulfate (PS), respectively, and were terminated immediately less than 3 hours after instillation. The IC3 rats received intravesical PS instillation and were terminated three days post-instillation. The bladder tissue was made in Hematoxylin-Eosin histology preparations. As in previous studies, the results showed successful desquamation of the urothelium after PS instillation. Tissue eosinophil counts were significantly higher in the simvastatin group than in the placebo group in the IC3 model (15.50±5.92 vs. 4.00±2.83, p=0.013). It can be concluded that the mechanism of the adverse effect of simvastatin on bladder tissue is through increased tissue inflammation mediated by eosinophils along with urothelial layer destruction by the protamine sulfate.

Coronavirus Disease 2019 (Covid-19) has now become a concern around the world. Until 6 September 2020, there were 190,665 cases in Indonesia, and it was in the third rank of most cases in the Asian region. It is important to determine the criteria of return to work for healthcare workers with Covid-19 positive in Indonesia. This case report discussed a female patient, 32 years old with chief complaint of fever and itchy throat since 2 days ago. She is a health care worker in the hospital, with a history of treating patients with positive confirmation of Covid-19 for 2 days in the ordinary ward before the case was confirmed with a history of contact approximately 5 days ago. The patient was diagnosed with positive confirmation of Covid-19 and was required for self-isolation. The patient still had positive results of RT-PCR Covid-19 up to the third examination in 30 days after the initial RT-PCR testing, although received specific antiviral treatment with oral oseltamivir and oral supplementation. Based on growing evidence that Sars-Cov-2 may not infectious for more than ten days in the mild-moderate disease, this case report is strengthening the use of symptom-based strategic approach to determine when to return to work in Indonesian healthcare workers with positive COVID-19.

Thyroid disease is quite common. The cardiovascular clinical manifestations of hyperthyroidism are palpitation, systolic hypertension, fatigue, or with the basis of existing heart disease, angina or heart failure. In men, the disease is more frequently to develop into congestive heart failure than in women, thus more exploration is needed. This case report discussed a 42-year-old male patient who was admitted to the emergency department due to palpitations, shortness of breath aggravated with activity and lie down position, and alleviated with resting, cough with white sputum, epigastric pain, and constipation since the past 3 days. He was diagnosed with a history of hyperthyroidism and congestive heart disease 1 year ago and routinely consumed propylthiouracil (PTU). He had a history of herniotomy 10 days before admission. The patient did not have a history of hypertension, diabetes mellitus, or hypercholesterolemia. The patient has a smoking habit of up to 3 packs/day since a teenager. The patient was diagnosed with hyperthyroid heart disease (congestive heart failure, atrial fibrillation, and coronary heart disease) with comorbid of electrolyte imbalance, hypoalbuminemia, and thrombocytopenia. The patient was treated in the Intensive Care Unit (ICU) and was given oxygen therapy, crystalloid infusion, antithyroid drug, beta-blocker, diuretics, digitalis, anti-angina, anti-thrombotic, and adjunct therapy. The patient was treated for 8 days in ICU, followed by 2 days in the ward with a good outcome. Early detection and intervention followed by close monitoring is key management for the patient with hyperthyroid heart disease, especially in a male patient, to achieve a better outcome.

Understanding the human immune response toward Mycobacterium tuberculosis infection is important for controlling its infection. Its transmission through the air consists of "droplets nuclei" containing TB bacilli. After initial infection, the human body will provide diverse immune responses and will determine different clinico-histopathologic finding. This response starts from innate immunity that consists of phagocytosis by distal alveolar macrophages or nasal microfold cells, then will be continued by dendritic cells to be transferred to mediastinal lymph nodes to induced adaptive immune responses. This response is mediated by cells through IFN- γ signaling which will enhance phagocytosis. If this response is effective, there will be a latent infection with an initial histopathological finding of caseosa granulomas and predominantly followed by chronic granulomas. In a few cases, it can be reactivated via the IL-10 activation pathway and exogenous factors, it will induce a great adaptive immune reaction and provide more severe clinico-histopathological manifestation. The existence of the human body's immune response to Mycobacterium tuberculosis, etiher innate or adaptive immunity will determine the clinical course and pathology that will occur.